18 May 2021

Dr Ashley Bloomfield responds to critical report on Covid-19 vaccine rollout

From Checkpoint, 5:16 pm on 18 May 2021

Director-General of Health Ashley Bloomfield says he is aware of the risk outlined by the Auditor-General's review about completing the vaccine roll out on time, however, he is confident they are on track.

The weighty report by the Auditor-General raises serious concerns about whether the government can reach its targets and if there's even enough vaccine in the country.

Dr Bloomfield acknowledged the programme was huge and ambitious, with the aim of nearly 8,000,000 doses of vaccine to be given before the end of the year.

However, he told Checkpoint, "we are ahead of our scheduled delivery at the moment."

"Well over 400,000 vaccinations have been given, we're on track for delivering over a million doses before the end of June and we've got a big scale up then from July to ensure that all New Zealanders who are eligible are able to be vaccinated before the end of the year."

Vaccinators and supply

While the report praises the health sector for its hard work and the government for contracting enough doses to vaccinate all of New Zealand and several Pacific countries, it highlights major shortcomings and substantial risks, including whether there are enough vaccinators and enough vaccine.

However, Bloomfield said that workforce had grown in the last two to three weeks, since the Office of the Auditor-General did itswork.

"We're well over 4500 people now trained to vaccinate, our aim is to have 6000 before the end of June, and that's the number we think we'll need to be able to deliver [the vaccine] through July, through the rest of the year for that wider group."

Modelling suggests that at the peak of the roll out, about 1500 vaccinators would be needed on any one day. 

In a statement today, the Minister for Covid-19 Response said 5000 trained vaccinators had been trained, but the ministry's vaccine dashboard shows only close to 2000 vaccinators were in operation. 

Bloomfield said that was because the vaccine delivery at this stage was being done at the level that supply was available.

"We know the supply is constrained through to the end of June. That's why we've got the sequencing framework. But from July when we scale up, we now have this larger pool, as you've said, over 5000 vaccinators available. Some of them will be part time, some will be sort of seconded from other roles, but we will have four times as many vaccinators trained as we think we will require at the peak of the delivery."

Is there an overarching plan?

The plan to extend the rollout to the general public is also not yet fully developed, the report noted. It said the Ministry of Health needed to improve transparency with public, especially about uncertainty and challenges ahead.

Bloomfield said that programme had always been a phased approach, but added that there was an overall plan for how New Zealanders would be vaccinated.

"We know we have to scale up, but in each phase, as we get to it, there is detailed planning around the information systems, the workforce, the logistics of getting the vaccine out, which sites we will use, how we will involve general practice and pharmacies so that planning - the detailed planning - is happening as we plan for the next phase. 

"At the moment, we're doing all that detailed planning for the next stage of the scale up, which is from July."

Although the report highlighted a "significant risk" around supply of vaccines, Dr Bloomfield said he did not believe there was a big risk but they had identified the risk around manufacture and supply chains due to the global situation.

"Pfizer has been very good and delivered exactly as they said they would. So we're confident about vaccine supply between now and the end of the year. 

"But so saying, we still have other vaccines that are going through the approval process, including the Janssen vaccine, Novavax vaccine and Astrazeneca. So we have alternative vaccines should we need them.

"They [the office of the Auditor-General] were encouraging us, and you'll have seen us doing this over the last few weeks, to put that on the table with the public and say look actually we're planning to have this vaccine, but there are some things that may be outside our control. 

"So far we're confident, but we need to be ready that there could be a disruption to the supply chain. So we're planning for that."

Booking systems and logistics

Inconsistencies around the booking system were also noted in the report. Bloomfield said an initial version of the Covid-19 immunisation register was actually available from December 2020 if it had been needed then.

"It's been in place since the start of the programme and going very well. We now have the logistics system in place. Again, that's being developed as the programme has developed, we have an adverse events monitoring system and the one thing that is just coming online - and we're trialling it at the moment - is a national booking system. 

"So far DHBs have been using their own local systems. Some of those are quite simple, they are spreadsheets or ... others are bespoke or dedicated bookings.

"Our plan is, before the end of June, to make sure that we can have those systems integrated so that they can share data. And so far we are on track. It's a herculean task. Yes, and the OAG (Office of the Auditor-General) is pointing that out. It's not without risks, but that's why we've got a team working on it and managing those risks."

The Auditor-General was giving his independent view, Bloomfield said, and it was natural for his own view to be different in some respects because of his proximity to the programme.

"The second point here is, even on a week-by-week basis, things do change. Since the team came in and did a lot of the work on this, there's been a lot of work that's happened from the teams here in the ministry, so we found the report very helpful. We got an early heads up on the issues they were identifying and we've worked to address those already."