As the country's measles outbreak continues, parents and GP practices are expressing frustration as stock runs out and vaccinations have to be cancelled.
The outbreak is acute in Auckland, where 1007 of the 1172 cases of the disease have been reported. Vaccines have been shipped to Auckland, but that's left many practices without stock.
Rebecca Reed has been trying to get her 11-month-old vaccinated ahead of a trip to Australia and told Kathryn Ryan that she was frustrated at the inconsistent information she’s been given, but at the same time doesn’t blame the GP practice.
Measles vaccine. Photo: RNZ / Cole Eastham-Farrelly
In July, she says she tried to get her baby vaccinated at nine months old, but was told to wait until she was older. Prior to their travel to Australia, Reed says she phoned to book an appointment to get her baby vaccinated at 11 months old and was told she could just go in without an appointment – only later to find out that the clinic had run out of vaccinations.
But Reed says she tried to inquire again because she knew the plane was a risky place with the outbreak going on and was told it wasn’t possible for a baby under 12 months, despite what was earlier claimed.
“I mean, one minute, you're told that you can get your baby vaccinated and protected. And then the next thing, it's all changed and you can't and that's because the supplies are short and they’ve taken them up to Auckland.
“And what I am also concerned about is that having these drop-in clinics for people that needed a booster from five to 50, whereas my understanding is if you have just one vaccination, you are 95 percent covered.
“Now why didn’t the Ministry of Health or the government say, right, the priority across the board and nationwide is those under five and babies or people who haven't got a vaccine at all? They should be the ones getting the vaccine first.”
Reed says her biggest concern is to protect her children but she’s now having to take a risk of going on the plane with her unvaccinated baby. And she says she’s not alone in this predicament.
“I know of another mum who booked an appointment to go into see her doctor and only be told after an hour-and-a-half of waiting that they didn't have any vaccines left and she was in tears. And it's quite common across the board. I think there's a lot of parents that I speak to that are actually quite stressed about it.”
The waiting game
While GP practices around Auckland have also run out of vaccine for their patients, Birkenhead Medical Centre manager Jo Bennett says their practice is under pressure and awaiting for assurance of more supply on the way.
“The last MMR vaccines that we had into the practice was received on 2 September. We've done two or three orders since then, but the ministry of health’s actually held them or not enabled them to be distributed. And so we are still waiting and we are unsure when those will arrive.”
As a result, Bennett says they’ve had to cancel three days’ appointments and have a waitlist of nearly 100 for vaccination.
“The first two times we rescheduled appointments, assuming that we would get the stock and now we've just had to cancel because otherwise we're doing the same work over and over again. So it's put a huge increase of workload on the staff here and we just can’t give clarity to our patients. So it'd be great to get some sort of assurance that we will get stocks at some point.”
While she says she understands that the reasons probably involve prioritising vaccines for those most vulnerable in the areas hardest hit by the outbreak, it’s still made the situation difficult at her practice.
“Because we were told that there’s no shortages, and media has told patients to make sure that they come in and ensure that they are vaccinated and then we are unable to provide that service.”
They too ended up prioritising patients when their stock started to decrease, she says, which the ministry has also been sending notifications to practices about.
Distribution of stock
The Director General of Health, Dr Ashley Bloomfield, told Kathryn Ryan that he’s listened to the concerns and frustrations and appreciates people's patience.
He says New Zealanders can be reassured that they will get their vaccine supply - with another 52,000 doses expected to arrive in the country on Sunday and be distributed to the appropriate places by Tuesday next week.
In response to reassurances to GP practices on supply, he says he’ll be talking to the centre in Auckland to ensure clear information is being sent on when vaccine supplies can be expected to be renewed.
On the other hand, he says the problem was not just with supply but distribution of the vaccines to the areas where it’s needed most – hence why further distribution was paused on Monday last week.
“We found for example, even in the Auckland region, some practices had 200-300 doses, while others had none or very few.
“And so the Auckland district health boards and Public Health Service, through their incident management team, have taken over really the insuring of distribution of vaccines. So that practices - particularly those where the populations are most affected and that is still on the Counties Manukau, South Auckland region - have got vaccines.”
However, Dr Bloomfield denies there’s been any delay in the process getting underway, adding that everything has run according to the usual procedures in an appropriate time.
“[That's] the approach that we take to any disease outbreak, including measles, and public health units around the country are dealing with outbreaks, or usually small ones of either gastro intestinal disease or other diseases, all the time. That's what they do very well."
When it became clear in August that Auckland’s outbreak was still increasing, they changed the approach, he says. A combined incident management team was set up for better oversight and management nationwide.
“Also just noting that all the cases outside of Auckland now are from contact with Auckland. So getting on top of the outbreak in Auckland, with oversight from our national health coordination centre and the regional incident management team, that's key to us being able to manage what happens across the rest of the country and avoid further outbreaks.”
Prioritising vulnerable groups
During the week, Dr Bloomfield says they received a message about the huge demand on practices which meant in some instances children were not able to have their first dose of the vaccine.
“That's why we sent a message and said then 'at the moment prioritise and focus on delivering vaccine to those children and getting them vaccinated on time', we need to protect our children, they’re the ones who are worst affected when they get the disease so that's the highest priority.
“Then in the Auckland region as well, we know that there's higher transmission in the 15 to 29 age group.”
He says they’re starting to plan for a catch-up campaign aimed at the groups of people that are most affected in Auckland. They’ve also set up an outreach programme, where nurses have been trained to vaccinate, which is underway in South Auckland schools – particularly secondary schools – he says.
For mothers with babies, he says those under 12 months aren’t routinely vaccinated because it's not as effective and those children will end up still needing follow-up vaccines, but GPs can apply discretion where necessary.
“At the moment though, we are only routinely still vaccinating and prioritising children 15 months outside of Auckland and 12 months in Auckland. The very best way to protect children under 12 months is for us to get on top of the outbreak and to reduce the spread of measles around the community.”
