COVID-19 and immunisations – guidance for health providers

Guidance from the New Zealand Ministry of Health and IMAC on maintaining the essential immunisation during the COVID-19 situation. It is strongly encouraged that practices continue to recall parents of infants and influenza eligible patients to ensure they are able to receive their vaccination on time.

Strategies being used to slow the spread of COVID-19 in communities, including postponing or cancelling non-urgent elective procedures and using telemedicine instead of face-to-face encounters for routine medical visits, has created confusion among some patients over whether they should go to providers for their routine vaccinations, and some providers are concerned over how to deliver them safely. 

The Ministry of Health and IMAC are offering healthcare providers (GPs, clinics, pharmacies) the following guidance on maintaining essential immunisation during COVID-19.

Highest priority vaccinations

It is strongly encouraged that practices continue to recall parents of infants and influenza eligible patients to ensure they are able to receive their vaccination on time. Maintaining these programmes is highest priority.

Influenza vaccination to high risk groups including those aged 65 and over and frontline workers

The influenza immunisation programme has been started earlier this year to ensure that the eligible and most vulnerable members of the community receive their influenza vaccine as soon as possible. This will not protect against COVID-19 but is important protection to reduce the burden of influenza, both to keep individuals as healthy as possible through winter and reduce the burden on general practice and hospital services through the winter.

Infant vaccination programme, particularly to maintain control for measles and pertussis 

Delivering the National Immunisation Programme for infants remain crucial. Do NOT delay the infant or 2nd second year of life immunisation events – the risk of pertussis and measles is just as high as ever. The 4-year-old event is important, but potentially could be delayed for a short time, if necessary due to practice circumstances. However, any 4-year-old who has not received their first MMR must continue to be recalled.

Pregnant women

Vaccinating pregnant women both for influenza and pertussis-containing vaccines remains high priority because the risk of pertussis and measles is just as high as ever.

Vaccinations that can be delayed

All adolescent, shingles and non-urgent tetanus-containing vaccines (except for wound management) can be delayed for the lock-down period if practices wish. The Ministry will work with practices and school-based immunisation programmes to plan for catch-up immunisation once the emergency response period is over.

Strategies for keeping your practice and healthcare workers safe

Each provider/practice will develop their own approach. Some suggested examples that are currently in use around New Zealand (and internationally) include the following:

  • Schedule well visits in the morning (consult rooms are the cleanest in the morning) and sick visits in the afternoon.
  • Separate patients spatially, such as by placing patients with sick visits in different areas of the clinic or another location from patients with well visits.
  • Allow patients in one at a time and keep them in separate rooms.
  • Vaccinate in cars directly outside the facility.
  • Collaborate with other providers in the area to identify separate locations for holding vaccination clinics.
  • The 20-minute wait post-vaccination for adolescents and adults can be reduced with the correct protocols in place. IMAC has provided a position statement on this, supported by the Ministry. Read more

Some providers may not be able to deliver vaccination services. For any general practices in this position, they must contact their PHO and discuss alternative arrangements, including referring families to another provider who can offer vaccination services.

Personal protective equipment (PPE) and vaccination 

Providers concerned about the risk of COVID-19 transmission from asymptomatic patients may wish to use appropriate PPE.

  • Only staff who will be in contact with the patient for more than 15 minutes and within 2 metres need to wear PPE.
  • All patients entering premises should be screened before entry and those who are at risk of having or having had contact with COVID-19 should be assessed and followed up following appropriate current protocols.
  • All providers who are vaccinating will undertake an appropriate pre-vaccination check using correct personal distancing, only meeting the patient during the actual vaccination event. For many adult vaccinations this can be done with no need to touch the patient.
  • You can also ask the patient to wear a mask or turn their face away from you. 

References

  1. Keep calm and keep vaccinating! Ministry of Health, The Immunisation Advisory Centre, NZ, 2020
  2. Observation period post influenza vaccination – 13 years and above. The Immunisation Advisory Centre, NZ, 2020

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Credits: Health Navigator Editorial Team. Last reviewed: 26 Mar 2020