17 Nov 2022

Covid-19: 'Risk-based approach' guiding decisions on vaccine boosters

9:51 am on 17 November 2022
Collage of rising bar graph, ambulance and doctor

Photo: AFP.com - RNZ / Composite image RNZ

With Covid-19 cases on the rise, the government has stepped in to expand some groups' eligibility for second booster shots.

From 18 November, Māori and Pacific people over the age of 40 will be able to book their second booster.

Ministry of Health data showed those groups were twice as likely to die from the virus, with the risk increasing for older people.

The move will see more than 63,000 Māori and Pacific people immediately become eligible.

Those in the general population aged 50 and over are also eligible for a second booster.

Dr Rawiri McKree Jansen said the premature death statistics from Counties Manukau Health highlight the state of the healthcare system.

Dr Rawiri McKree Jansen of the Māori Health Authority says he would have liked to see second boosters rolled out to Māori and Pacific people over the age of 40 sooner. Photo: LDR / Stephen Forbes

Te Aka Whai Ora Māori Health Authority chief medical officer Rawiri McKree Jansen told Morning Report the decision was a good example of why the new authority was needed.

"I'm pleased that Te Aka Whai Ora is now in play and bringing influence towards using science to protect Māori communities, Pacific communities - to save Māori lives, in fact."

The expanded rollout was based on recent data which showed Māori and Pacific populations were at greater risk of severe health outcomes in the event they contracted Covid-19.

"The strong motivation is looking at the surge that we're experiencing and looking at the evidence that we've had from Omicron," he said.

"Māori and Pacific have two- and three-times the hospitalisation rate compared to non-Māori, non-Pacific; and two- or three-times the death rate due to Covid."

Aligning protection mechanisms - in this case vaccinations - to those higher-risk groups made "really good sense", he said.

Jansen said two recent Waitangi Tribunal reports had illustrated how important it was to have Māori expertise around the table to help enable good health outcomes for Māori.

He would have liked to see second booster shots rolled out to Māori and Pacific people aged 40 and over sooner, but was "pleased to see that it's in place now".

Encouraging those newly-eligible to get the vaccines would require good communication, he said, but he was confident there were Māori communities that were "well organised to get that message out".

"That will be a feature of conversations in whānau and in communities as we get ready for the end of the year ... that being protected from Covid is a really important thing for you and for your whānau and for your community."

'A risk-based approach'

Ministry of Health chief science advisor Ian Town told Morning Report it was unlikely second boosters would be rolled out to more of the general population unless there was strong evidence to do so.

"We're really still using a risk-based approach, and so what we'll be looking at in that regard are, things like some of those newer vaccines ... the bivalent vaccines, looking for the evidence around that and probably widening those conversations in the new year to provide recommendations to the director-general [of health]."

He said a decision in Australia to expand access to an additional booster shot to those aged over 30 was not based on a great deal of evidence.

"If you look at the fine print there, what it says is they've made it available to people who are concerned - so that's different from coming out with a strong recommendation."

He said polling had shown there was an element of 'vaccine fatigue' in the community so clear evidence of a benefit would be required ahead of any expanded rollout.

"If we go out in the new year with an additional booster, we'd like to see evidence, and we'd like to be sure of the benefits."

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