5 Nov 2021

NZ doing 'incredibly well' with vaccination rates - top immunologist

From Checkpoint, 5:36 pm on 5 November 2021

The 90 percent double vaccination target set by the government has turned more than a few people into amateur statistician, counting every jab, daily averages, downward trends and overdue second shots.

And while some DHB regions are close to the 'holy grail', others are way off. Double doses in Tairāwhiti are at 65 percent, 69 percent in Taranaki, 67 percent in Tai Tokerau and in the Lakes DHB, 68 percent are doubled-dosed.

So is the government's vaccination target even possible?

Doctor Nikki Turner, director of the Immunisation Advisory Centre, told Checkpoint gaining extra percentage points is getting harder and taking longer, but it is worth it.

"The people who are supportive and wanted to be vaccinated have come forward and got vaccinated. Now you're getting into a much harder group, and you expect much lower rates of uptake.

"So any gain at this point is a gain and we're not expecting to suddenly get big numbers.

"New Zealand's already worked really hard at getting first dose vaccinations. So we're really now into the group that requires a huge amount of extra resourcing and legwork to get any further at all."

Dr Turner said she would not describe the remaining group of unvaccinated as "resistant". 

"There's a whole range of issues as to why these people are not getting vaccinated. Many of them are scared. Some of them still may have access issues despite the huge amounts of effort our services are putting in.

"Some of them have just got misinformation and they're hearing the echo chamber and getting really anxious.

"And there is always a small percentage in the population, New Zealand's always had it, that do not support the Ministry of Health, the national science approach, general science, they will always be with us.

"So this is a mixed group of people still, they're not all the same."

Dr Turner said there is a range of reasons why some might not return for their second vaccine dose three weeks after the first. 

"Younger people in particular, if they've had a vigorous reaction to the first dose, it's fine to delay for more like up to six weeks for the second dose, because they will actually have very good protection from the first dose and they can afford a few more weeks get.

"So some people might have had quite a vigorous reaction the first time and just want a bit more time before they come into the second.

"There will be a few people that may have had a bad experience, have not enjoyed it and are nervous about coming back for the second. They will be a small percentage, but they will be in there as well.

"From a clinical point of view is New Zealand is doing incredibly well.

"We gave ourselves a really high target at 90 percent. We are doing better than most other countries in the world.

"And that is what is going to make a difference to our country when Covid spreads through our community.

"So any more percentage we can get at this point in any part of the country is worth going for. We've always had a mixed bag around the country with different reasons for different communities, why they're slow to uptake.

"What we need to do now is put all the resources we can into those communities where the coverage is lower. Support the community, support the health services, they've got a range of reasons why they're behind.

"There's no point at yelling at them and polarising them. What we recognise is that communities are different and they need local support." 

The question of when the country opens up from lockdowns is a political question, not a health one, Dr Turner said.

"I think 90 percent was incredibly high aspirationally, and I am astounded and thrilled at how close New Zealand is to getting 90 percent.

"We have achieved that for first dose in many areas, and we're not far off and others. So this was aspirational, and we're getting close to it. So I'm very impressed. Very few countries in the world managed to get anything like that for an adult vaccination campaign.

"Countries are always left with what we'd say are equity gaps, where you get lower coverage in some areas than others.

"To do so and leave it in a large way means that we'll have large pockets of people where the disease can spread. So we may not be able to fully close the equity gap, but it's still worth putting in the extra legwork for the next few weeks to try and close it as much as we can.

"Because everybody is going to suffer if we have large communities that are still more at risk than others. That does leave everybody at risk. So it's tough. It's requiring patience. And yes, first doses are getting harder and harder to get in. We are still making progress.

"We don't need more mandates. We need more support now, to the communities, the health sectors that are really working their butts off at the moment, to see if they can get out there and support those people.

"There's a point at which mandates are not going to gain us anything else. So at this point, we need support and respect and to see if we can get a few more percentage, particularly in those communities where it's low."