6 August 2021
Document 1
Minutes/Actions
Date:
11 December/ Hakihea 2020
Time:
1:00 pm – 4:00 pm
ACT 1982
Chair:
Te Puea Winiata,
Attendees: Dr Helen Petousis-Harris, Dr Angela Ballantyne, Silao Vaisola-Sefa, Dr Api
Talemaitoga; Nicky Birch, Taima Campbell, Kevin Pewhairangi, Vince Barry,
Dr Jan White, Dr Rawiri Jansen, Loretta Roberts and Dr Nikki Turner
Kelvin Watson, Casey Picket, Debbie Edwards, Carl Billington, Mathew
Parr, Ana Bidois, Mike Stewart, Matthew Zhong; YiYan Chuah
Apologies:
INFORMATION
Item
Agenda Item
1
Introduction
• IIAG input and feedback on the golden thread.
• Welcomed further input to inform programme thinking
2
Equity discussion (Ana)
• The Director-General noted the need for the equity to be explicit across the
programme and the pil ars
• Programme wil start with Te Tiriti and the practical considerations for each of
the pil ars
• The programme wil need to be more transparent and look to use the IIAG to
strengthen the equity discussion
Meaning of Equity to incorporate WHO definition?
• The Ministry’s current definition of equity recognising people with dif erent
levels of advantage.
• PHARMAC: “the absence of avoidable, unfair or remediable differences”
Action: Suggest the WHO definition adds or replaces the current MoH definition
• Noted the programme is fast moving, but ongoing clarity of equity is
needed.
• Currently the treaty is absence in programme documents, having it in the
written plan is important but not sufficient, it must be enacted at every stage
RELEASED UNDER THE OFFICIAL
Request: Across the seven pil ars: how does it help the equity agenda and how
does each pil ar incorporate it
• Ministry aims to answer Treaty in each of the pil ars and acknowledges
further work needs to be done
3
Sequencing Framework (Casey)
Outlined thought process behind the sequencing
• Development based on those most at risk of contracting or transmission
• Noted that the first shipment (225,000 courses) wil cover tier 1 and part of
tier 2. Decisions on particular groups who are easier to distribute for a two-
dose vaccine could be considered.
• There is ordering within tiers there is if lettered (a,b,c).
• There are unknowns to sequencing:
o how long we wil be ‘sequencing’ before non-sequenced roll out
Household contacts rationale discussed
ACT 1982
• Household contacts of tier 1 was included given the increase risk of
contracting and transmitting the disease.
• Household of Pregnant women – uncertainty whether they were able to
vaccinated, therefore vaccination of household to protect transmission to
them.
• Households were estimated numbers and were increased beyond average
household size in New Zealand. It is likely overestimated, but data difficult
to confirm.
IIAG – Feedback and Notes on sequencing
• Household contacts does it help in the long-term OR is it better to save the
vaccine and immunise people in tier 2? INFORMATION
• Noted the actual operational implementation is difficult
o Reaching overstayers - Sequencing team has recommended
regardless of visa status, the vaccine is available (accounts for
overstayers)
o how to find out
who is a close contact or household contact of
tier 1 is difficult.
o
Identifying comorbidities is difficult: GP databases are not
easily fit for this purpose
o
I AG noted Alternatives exist:
Using community services card
holders as proxies
• Frontline public sector needs to be clarified to first responders (Police and
firefighters) to avoid any misinterpretation
• Equity: Notes that over 65 is not a consistent indicator across dif erent
ethnic groups (Maori and Pasifika life expectancy is lower) not a scientific
basis.
Actions: IIAG Request:
Whether the sequencing framework wil be refined more from this (Yes)
•
Whether a geographic approach should be considered – at certain
o parts of the country are far away from the border
o parts adjacent to the high risk areas border/ports/MIQ should be
RELEASED UNDER THE OFFICIAL
prioritised
o Noted the ease on operational roll out possibly eased through this
approach
• Any changes to sequencing are made available to the group over the break
4
Service Design (Mike Stewart)
Feedback
Principles:
• Treaty and equity need to be stronger; as well as including DHBs and other
providers. We need the right people engaged through the process and not
just DHBs.
• Need to ensure DHBs do not leave Maori and Pasifka off; use good
examples of DHBs working well in partnership
• Providers who are vaccinating on the frontline need to be engaged – cited
measles campaigns as DHB led programs which could be improved
Workforce
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Concern the flu campaign in March – May will divert workforce.
• Early planning is the Flu workforce will be able to switch to COVID which
wil match the increase in deliveries and broadening of the sequencing.
• Consider: using novel approaches – a non-regulated but credentialed
workforce which is mobile and able to deliver the vaccine closer to the
community.
For the first workforce Pfizer vaccine has logistics, scale challenges
• Vials unable to be split means large sites may be preferred
Roadblocks in expanding the workforce exist including
• APC for paramedics
INFORMATION
• DHBs holding aged care contracts to get those nurses into the programme
• Nursing Council – to have nursing graduates and students involved.
•
Action: Programme to engage with IMAC on roadblocks
Rationale for workforce must be correct
• Primary care is already delivering flu vaccine and additional tasks.
• Best use of time must be clear (i.e. requirement for pop-up testing resulted
in low turnout but required staff to be present/ready throughout)
•
Agreed: programme look to use comms and messaging to avoid low
turnout. Aims to not impact BAU
Data 2019 model -
• Rawiri outlined a novel data prediction model created within his PHO which
predicted vaccinations in 2020. Model used 2019 data and could be
expanded to COVID-19 vaccinations
• Benefits of model: identified groups which require early or extra effort to
vaccinate.
•
Action: Model could be made available to a national level for national
promotion and alternative models of delivery.
Noted: Maori providers will impact community uptake
• Chair notes Maori providers play key role and develop relationships with the
community.
Consumers
RELEASED UNDER THE OFFICIAL
Noted: Barriers to access cover leave to attend events
• Availability: Annual/Sick leave or the time to attend a vaccination wil impact
lower socio-economic communities and jobs disproportionately. This must
be factored in service design.
o
Discussions across Government are occurring, likely MBIE policy
decision versus an MoH decision.
• Communities face dif erent access concerns (distance and time to reach a
vaccination point). Suggests mobile units, availability in community settings
(marae)
• These barriers may prevent the wil ingness of certain groups to be
vaccinated.
Providers
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Provider Colleges must be notified and not just DHBs. Solely using DHBs creates
risk if provider groups are not informed and suggests the following are notified
• Nursing Council
ACT
• College of GPs
• Pharmacy Guild
DHBs Letter: mindful of Christmas and early January break
• Suggests sensitivity when engaging and being mindful the sector is
stretched through its COVID-19 response.
• However DHBs should be engaged and clarity on what MoH is looking for
should be given
5
Communications and Stakeholder engagement (Carl)
Overview
INFORMATION
Focuses
• Proactive messages before end of year
• Early work on content plans to get messages through summer and quarter 1
• Broader campaign on Q2 and throughout 2021
• Campaign work in 2022 – this is to acknowledge the length of protection;
multiple vaccines that come on in dif erent
OFFICIAL stages.
Approach or lenses for announcement
• Specialist outreach to Maori: devolved model to those with community reach
THE
• Specialist outreach to Pacific: as above
• Health workforce: IMAC and Ministry channels
• Aotearoa New Zealand: Ad agencies (Clemenger type)
Feedback
• Request for joint fronting of media of DG, Maori, Cabinet and Pasifika
UNDER
instead of having separate timings – Carl to put the request forward
• Weakness of ad agencies: they do not have Maori and Pacific experience or
capability; while not used for specialist outreach won’t have the ability to
tailor messages to be inclusive to broader minority groups.
Comms strategy
How it is Informed by research is limited so far
• initial piece of research by Horizon identified low Maori uptake
•
RELEASED Follow up research has been completed: looking at attitudes, sources of
trust and what is required to encourage vaccinations
• Noted research does not account for increased PR activity by vaccine
manufacturers and Political announcements.
How to counter known low uptake – elderly Asian population has low flu vaccination
uptake?
• Meeting with DIA ethnic community managers
• Welcomes IIAG and others to suggest further channels
How is health line being used?
• Health workforce wil be engaged and supported
• Outgoing channel to deal with the queries and questions received to be
developed
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Adverse reactions expectations – need to be outlined to allow ability to
communicate
ACT
• Essential surveil ance activities such as background rates of adverse events
of special interest or other effects should be prepared.
• This preparation wil help inform and prepare the programme and
communications to ensure confidence
• Programme: noted met with adverse reaction monitoring pil ar and have
some initial understanding on how it wil be designed and captured
• Acknowledges novel chal enges exist when administering in non-clinical
settings
6
Closing (Te Puea)
• Noted open to contact before the next meeting (22nd January 2021)
INFORMATION
• Receiving information before this date is welcomed (sequencing changes)
• There are issues with multi-dimensional communications plan to reflect
Aotearoa New Zealand
• Challenges with the vaccine: including the process around adverse risks
through Medsafe is linked to our comms.
• Noted Medsafe wil be fielding a high volume of requests
OFFICIAL
THE
UNDER
RELEASED
Document 2
IIAG Minutes/Actions
Date:
22 Kohitātea/January 2021
1982
Time:
1:00 pm – 4:00 pm
ACT
Chair:
Te Puea Winiata
Attendees: Dr Helen Petousis-Harris, Dr Angela Ballantyne, Silao Vaisola-Sefa, Dr Api
Talemaitoga, Nicky Birch, Taima Campbell, Kevin Pewhairangi, Vince Barry,
Dr Jan White, Dr Rawiri Jansen, Loretta Roberts, Dr Tristram Ingham
Mathew Parr, Casey Picket, Carl Billington, Ana Bidois, Mike Stewart, Kris
Golding, Matthew Zhong, Lil ias Henderson
Apologies: Nikki Turner
INFORMATION
Item
Agenda Item
1
Introduction and welcome
• This is the first meeting of 2021
• Welcomed Dr Tristram Ingham to the meeting. He has strong ties with the
disability sector and wil bring his expertise to the group
• Te Puea acknowledged the team who worked over the break to ensure this
OFFICIAL
mahi progressed at pace
Mat Parr (MoH) provided an update on the Programme
THE
• Medsafe continues to have a robust approvals process and is working to ensure
we have access to a safe and effective vaccine. Their process has already
been expedited and are accepting rolling submissions from manufacturers.
They are also working closely with Australia’s TGA to share data
• We are placing pressure on our suppliers to ensure they deliver on the batches
that they have commit ed to providing
UNDER
• Operational readiness is on track for 1 March and this is becoming a very real
date and where possible we wil be prepared sooner
• The new variants are also a threat and we are being mindful about what this
means for Māori and Pacific communities
• DHBs plans for rollout are due with us today
Group discussion
• Mat confirmed that IIAG is the only advisory group for the vaccine, and noted
that Steering Group makes decisions based on advice from I AG
RELEASED
• Recent trial data from Norway raised concerned about vaccine safety. New
Zealand needs to be prepared for this. Medsafe is focusing on safety and
efficacy and wil likely give conditional approval to the vaccine, meaning there
are a list of conditions that will be similar to Australia. STAG is also providing
clinical advice about the population that wil be best suited for the vaccine
2
Minutes from previous meeting
• No amendments to previous minutes.
3
Decision to Use Framework decisions, roles and responsibilities
Kris Goulding (MoH) gave an overview of the Decision to Use Framework
• Medsafe wil be approving the vaccine for use, however we stil need to decide
whether or not to use the vaccine. This decision-making framework is in
addition to what Medsafe is preparing
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• Decision to Use focuses on who gets the vaccine, how, and when
• Key components of the framework that wil inform the decision include:
o Context – we need the most up to date information about New Zealand’s
current situation etc
ACT
o Timing – we may be assessing multiple vaccines at once and we wil
need to decide when is right to use each one
o Information – is needed in order to make the best decision
o Assessment – provide our overall advice about the decision
• The Ministry proposes that two advisory groups wil support the Decision to Use
o IIAG – to focus on implementation
o Science and technical group (yet to be formed) – focus on the clinical
and technical aspects
• There is a chance that as things progress the I AG may need to convene more
often than on a fortnightly basis
INFORMATION
Group discussion
• Information sharing across the groups needs to be connected. Important that
the IIAG is informed by what the STA group advises, and vice versa. This
should include a formal advice mechanism that is reflected back to Ministers
• Equity of access wil need to be cross referenced between a science and
technical group and IIAG to ensure both groups are on the same page about
who is best placed to receive the vaccine
OFFICIAL
• The framework makes sense as a place to authorise and provide advice so
Ministers can make a wider decision
• IIAG members may need to attend additional meetings to get the decision
finalised in a timely manner
THE , and possibly a joined-up meeting with the science
and technical group
Wider group discussion on other topics
• Minor changes to the sequencing framework but these wil be discussed later in
the hui
UNDER
• There is no specific control group for trialling the vaccine in New Zealand
specifically. However, we are in a good position compared to other countries
and we can learn from what is happening there
• Hesitancy of healthcare workers overseas is a risk that we should be aware of.
We wil implement catch up vaccinations for those who decide they want it later
in time. This could develop into a wider communications issue for the broader
public if there is hesitancy among medical professionals
• Flu vaccine wil not be administered at the same time as the COVID-19 vaccine.
This is something the science and technical advisory group can advise on and
RELEASED can assess data from overseas
• Members are already hearing concerns in the community about the cost of the
vaccine
Endorsed the framework.
Action for Mat and Kris to consider how meeting logistics might occur over the next
month.
4
Sequencing Framework: proposed evidence reviews and advice on risks for
Māori and Pacific peoples
Casey Pickett (MoH) presented updates to the sequencing framework
• Prior to Christmas the Steering Group considered I AG’s feedback about
lowering an age for Māori and Pacific eligibility. Their view was that decisions
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around ethnicity need to be steeped in evidence and we should rely on the best
epidemiological evidence across jurisdictions
• We have established an internal working group to consider the scope, nature
and strength of the risk for Māori and Pacific people. This group has
ACT
commissioned evidence that investigates the risks to Māori
• Evidence from the new working group wil be collated and submitted to
Ministers for their view on options
• Questions posed to the I AG: is there anything we should be reviewing? How
would you like to work with us? Open to your guidance about how we engage
and consult
Group discussion
• When considering international data, you need to be careful – it should eb
considered on social and ethical grounds rather than biological
o Although we can look at similar international indicators such as
INFORMATION
deprivation and social housing, they are applied in a dif erent context
o Ethnicity is a proxy measure for a number of social and cultural aspects
o Consider other risks such as exposure and where cases are coming
from, biological risk, communication risks
• IIAG would like a role in commissioning the research to determine what
information is needed. This wil be particularly important moving forward, as this
is only one component of the vaccine rollout
OFFICIAL
• If pakeha under 65 are eligible in each scenario, an equivalent age must be
determined for Māori and Pacific people
• Māori epidemiologists should be involved with a peer review of the sequencing
framework
THE
• Different facilities have varying levels of risk profile depending on the level of
interaction between staff and patients
• Prison inmates should be explicitly included as a cohort because the state has
an additional ethical obligation towards them having removed their rights
• DHBs wil have to make key decisions based on these broad categories. This
wil be supported
UNDER by the definitions submitted to the previous IIAG hui and will
be subject to ongoing refinement. There wil be some level of discretion given to
DHBs to implement
• DHBs have not always been able to successfully deliver for the disability sector
during the COVID-19 response, as was evident with PPE. Would caution that
their success may be limited
• The Framework has been updated to include Aged Residential Care workers as
a result of an evidence review focused on risk factors for segments of the
population. This was discussed at the IIAG, then at Steering Group, returned to
RELEASED IIAG for consideration and wil soon be submited to Cabinet
• Important to engage with the wider disability sector on the sequencing
framework as Tristram doesn’t represent all views
Action for Casey to investigate the funding request to allow the IIAG to commission
research. This may include topics such as international evidence of COVID-19
transmission in residential and prison settings, as well as identifying underlying
factors that cause that risk.
Action for Casey to talk to Rawiri offline about Māori epidemiologists who can
complete a review of the report.
Action for Casey to consider an age threshold for Māori and Pacific populations
1982
should one be implemented for the wider pakeha population.
Action for Casey to touch base with Tristram about aged residential care residents.
ACT
Action to update the Framework to include prisoners.
Action to commission a disability report about the types of risks and international
evidence.
Ensure we are being equitable in the standard of scrutiny that is applied when
making decisions around changing tiers of the sequencing framework.
Ensure the underlying principle of the vaccine rollout is reiterated in memos, which
is focused on risk and minimising harm.
INFORMATION
Note caution should be exercised when extrapolating findings when linking things
to ethnicity, especially in a different context to New Zealand given the social and
cultural factors.
Note that relying on DHBs to distribute to Māori, Pacific and disability cohorts may
not be the most effective at promoting uptake.
5
Readiness and border workforce immunisation roll out plan
OFFICIAL
Mat Parr presented an update about the immunisation rollout plan
• Kelvin Watson is no longer the GM responsible for this workstream and we are
actively recruiting for someone to step into this role
THE
• We are trying to get ahead of the size and scale of the programme and sharing
information weekly with DHB CEs and PHUs
• The slides show that we have more than enough vaccine available for the
whole country, but it wil depend on delivery schedules as to when we can
actually inject people
• We have carried out workforce modelling to match it to system capacity, and
UNDER
additional modelling is being done to detail the granular level
• NZDF has been included in the emergency services category as they interface
with the MIQ facilities and have offered their vaccinators in return who can help
us reach rural locations
Group discussion
• Māori distribution networks need to be looped in to ensure the equity measure
is represented
• N
RELEASED ew vaccinators have a health background of some form, even if they have not
previously given a vaccination. The training they receive includes how to use
the CIR, but we are expecting that administrators wil also be needed to enter
data into the CIR
• Consider how a non-regulated workforce could be mobilised across a wider
Māori and Pacific network to distribute the vaccine further
• There is a delay if we are having to wait until DHBs are ready to deliver,
because only after that point wil they engage with providers
• Communications are needed that relates to the impact on other immunisation
programmes, such as the measles programme. This requires clear messages
from Ashely to share with the sector, and ensuring that people are on standby
ready to deliver the vaccine as soon as it arrives
• Ethnicity data can be used to tell a story and determine what success looks like
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for Māori. An update for the group would be useful about the CIR and the role
of ethnicity data
• Concern that people may change their ethnicity to become eligible for the
vaccine. There is an operational challenge with recording data in the system as
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of a certain date, and we have to accept that the occasional person wil sneak
through the system
Action for the Ministry to pull together a view for Māori and Pacific providers which
wil be brought back to the I AG.
Action for Mat to organise an update for the group about the CIR to discuss at the
next meeting.
Action for Mat to present what the reporting wil look like at the next meeting.
INFORMATION
Action for the policy team at the Ministry to ensure that non-registered vaccinators
are able to deliver the vaccine to Māori and Pacific communities.
Action for Carl to coordinate with the Ministry to ensure clear messaging around
other immunisation campaigns.
6
Māori and Pacific immunisation delivery strategies
OFFICIAL
Ana Bidois (MoH) presented an update on the Māori and Pacific immunisation
strategy
• The Māori and Pacific strategy has a focus on a separate comms plan, and we
can also look to develop a disability strategy
THE
• Welcome feedback about service delivery models in order to promote uptake
among Māori and Pacific communities
• Further updates wil be provided at the next meeting
Group discussion
• Costings for Māo
UNDER ri providers may not include funding for infrastructure, such as
fridges etc if similar services are already provided
• Confirmed that the wider New Zealand comms include the Māori population and
will not solely target pakeha
• We want to take a whānau approach to delivering and ensure that people who
are high risk are protected
• Wil pharmacies be used as a delivery point? This is one of the main contact
points for whānau and it is important that it is made accessibly
• There is a strong preference for comms to come directly from the Ministry rather
RELEASED than from DHBs
• Where possible, the Ministry should seek to utilise existing provider networks,
especially in the disability sector
• Concern that there could be low uptake among Māori with current public
sentiment, and the comms strategy wil be critical for this. Positive messages
that speak to collective whānau and encourage people to look out for each
other resonate with the community
Action for Ana to confirm the service delivery mechanisms and follow up whether
pharmacies wil be involved.
Action for Ana to get a copy of the Māori Influenza report from the Māori Health
Directorate at the Ministry.
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Action an update on the financially modelling including the equity and rural
adjuster
Action for Mat to speak to the Disability Directorate at the Ministry to ensure the
ACT
are involved with this work.
7
Communications and stakeholder engagement update
Carl Billington (MoH) presented a comms and engagement update
• A new team has come on board to support specifically with Māori and Pacific
comms
• Clemengers wil partner with the Ministry to deliver the wider New Zealand
campaign, that wil have a specific Māori view baked into it
• The campaign wil start from 15 February and consistent high-level framing will
apply across messaging that is delivered nationwide, as well as to Māori and
Pacific audiences. Messaging wil continue to evolve over the following weeks
INFORMATION
Group discussion
• The group would like an update at the next meeting about our global obligations
and how we are supporting smaller countries who may need vaccines more
than us
• A deliberate engagement approach is required for working with stakeholders
• Getting ahead of the messages that we expect wil come from individuals is
OFFICIAL
important
Action to provide an update at the next meeting about how our leftover vaccines
could be made available for the global market.
THE
8
Any other business and next steps
• Exposure is a risk for the disabled community
• We need to be clear at what point we open the borders again. There wil be
increasing public pressure once vaccine rollout commences and it wil be
important for us t
UNDER o weigh up the level of risk
9
Closing
• Te Puea thanked members for their time and contributions
• Noted the group may convene more frequently than in a fortnight.
Action Tracker 21 January
Item
Action
Lead
Due Date
RELEASED
3
• Mat and Kris to consider how meeting
Mat Parr
5 February
logistics might occur over the next month.
2021
4
• Casey to investigate the funding request to
Casey
5 February
allow the I AG to commission research. This
Pickett
2021
may include topics such as international
evidence of COVID-19 transmission in
residential and prison set ings, as well as
identifying underlying factors that cause that
risk.
• Casey to talk to Rawiri offline about Māori
epidemiologists who can complete a review of
the report.
• Casey to consider an age threshold for Māori
1982
and Pacific populations should one be
implemented for the wider pakeha population.
• Casey to touch base with Tristram about aged
residential care residents.
ACT
• Update the Framework to include prisoners.
• Commission a disability report about the
types of risks and international evidence.
5
• Ministry to pul together a view for Māori and
Mat Parr &
5 February
Pacific providers which wil be brought back to
Carl
2021
the IIAG.
Billington
• Mat to organise an update for the group about
the CIR to discuss at the next meeting.
• Mat to present what the reporting wil look like
at the next meeting.
INFORMATION
• Policy team at the Ministry to ensure that non-
registered vaccinators are able to deliver the
vaccine to Māori and Pacific communities.
• Carl to coordinate with the Ministry to ensure
clear messaging around other immunisation
campaigns.
6
• Ana to confirm the service delivery
Ana Bidois
5 February
OFFICIAL
mechanisms and follow up about whether
2021
pharmacies wil be involved.
• Ana to get a copy of the Māori Influenza
THE
evaluation report from the Māori Health
Directorate at the Ministry
• An update on the financial modelling including
the equity and rural adjusters
• Mat to speak to the Disability Electorate at the
Ministry to ensure the are involved with this
UNDER
work.
7
• Provide an update at the next meeting about
Mat Parr
5 February
how our leftover vaccines could be made
2021
available for the global market.
RELEASED
Document 3
IIAG Minutes/Actions
Date:
29 Kohitātea/January 2021
1982
Time:
9:00 am – 10:00 am
ACT
Chair:
Te Puea Winiata
Attendees: Taima Campbell, Kevin Pewhairangi, Dr Rawiri Jansen, Dr Tristram Ingham,
Nicky Burch
Casey Picket, Debbie Edwards
Apologies: Mathew Parr, Ana Bidois
Item
Agenda Item
1
Introduction and welcome
INFORMATION
• Tristram opened the hui with a karakia
• The discussion today wil focus on the options presented in the document
emailed by Debbie which presents different options for the Sequencing
Framework
2
Sequencing Framework Options
OFFICIAL
Casey Pickett (MoH) introduced the table and options for Sequencing
• The discussion today wil focus on several options for the IIAG to discuss and
share your feedback. We would like your feedback about what has been
presented and whether to
THE refine or add in other options to help understand your
preferred option
• Eventually these options and accompanying advice wil be presented to
Ministers. More than one option can be presented
• A separate session wil take place with the Pacific members of the IIAG
UNDER
Options Analysis
• Options 1, 2 and 4 are preferable with some changes needed to the framing
• Option 1: Lower age threshold for Māori and Pacific older adults compared to
rest of older adult population in the sequencing
o Reword to something along the lines of “the Māori age will be X which is
compared to the Pakeha age of X”
• Option 2: Reserve/ring fence a portion of available vaccines for relevant service
providers with guidelines to deliver to vulnerable Māori and Pacific communities
o This could be successful
RELEASED o Need appropriate resourcing and engagement from whānau, iwi and
communities
• Option 3: Immunisation of cohorts with relevant underlying conditions with a
focus on prioritising Māori and Pacific older adults first
o A combination of options 1 and 2 and less relevant
o Language needs tweaking
• Option 4: Target vulnerable communities (e.g. based on deprivation index or
geographical location) which include high populations of Māori and Pacific
peoples
o A viable option but language needs to be adjusted – focus on equity and
needs
o Currently implies racial profiling and would caution avoiding this
language and words such as “deprivation”, or “hard to reach”
o Alternatives could include “most in need”
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o Suggestion that we could use a Community Services Card as a
measure, but this has been tested with the community and there was
considerable push back
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Group Discussion
• What is the purpose of our immunisation programme? There are a number of
answers:
o To protect whānau and the people of Aotearoa
o To support the Elimination Strategy and keep COVID-19 out of New
Zealand
o To protect the health system and communities in the process
o Minimising transmission is a consideration but is not the primary focus at
this stage due to the lack of information about whether vaccines can
reduce transmission. This evidence is not expected for some time
• The Sequencing Framework is trying to acknowledge that Māori have had
INFORMATION
worse outcomes and have been disproportionately impacted by COVID-19.
Need to ensure we are doing the best by Māori
• Clearer messaging is needed from the Government. We are currently seeing
different messages from iwi, for example, where the Government has retained
Northland at Level 1 but iwi are advising their own people to behave as if they
are at Level 2. We should make things simple for whānau and deliver
messages that resonate OFFICIAL
o Ensure that mainstream communications don’t undermine the message
that is delivered to Māori and Pacific communities
• Language for all the options needs refining and Nicky wil support Debbie and
Casey with this THE
• Changes to language can also be reflected throughout other Ministerial advice,
such as in the current Cabinet paper
o This is an opportunity to be explicit with Ministers when we talk about
the Māori population being “at risk”
o Exposure risk – people who have a risk of being exposed to COVID-19 if
they are working in MIQ, for example
UNDER
o Risk of impacts caused by COVID-19 – includes characteristics such as
comorbidity, immune deficiency, reduced access, a health system that
doesn’t meet needs
o Transition from “vulnerable” to “needs”
o IIAG would be happy for the Ministry to directly say they have received
advice on this and need to change the way we do things
• Māori and Pacific cohorts need to be addressed as distinct groups. While they
are similar in the way they mobilise their communities, the methods of
engagem
RELEASED
ent are dif erent and may require dif erent solutions
• Desire to be innovative in the delivery solutions, such as commissioning for
outcomes directly with providers. We could allow Māori to implement their own
sequencing because there are already cultural examples in play, such as how a
marae works. There may be opportunities to commission parallel streams so
some areas have better access than other providers
• Māori know their own people and should be trusted to deliver it to those who
need it most. This conversation needs to take place with DHBs
• There is a challenge as to how we can truly achieve equity when vaccine stocks
are limited
• It is important that we constantly review the framework and include the most up
to date information where we can, especially given the number of unknowns
• There is danger in being too prescriptive and people need flexibility and room to
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make their own decisions
• A range of levers wil be required that can be utilised depending on the
scenario. Includes elements such as direct commissioning, clear
communications to build on the national narrative, and building on the success
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of the Māori immunisation campaign
• Next steps wil be to present these options, or a combination of options, and
eventually submit to Ministers for their consideration. IIAG is able to make
strong recommendations that the Ministry wil incorporate into its advice
• Wil resume this conversation at the I AG meeting next Friday 5 December
Action for Nicky to work with Debbie to tidy up the language under the options
headings. Debbie wil recirculate and test with the group.
Action for Casey to follow up again with the Māori Health Directorate and source a
version of the influenza report that can be shared with the I AG.
INFORMATION
3
Closing
• Te Puea thanked members for their time and contributions
Action Tracker 29 January
Item
Action OFFICIAL
Lead
Due Date
2
• Nicky to work with Debbie to tidy up the language
Debbie
5 February
under the options headings. Debbie wil
Edwards
2021
recirculate and test with the group
THE
• Casey to follow up again with the Māori Health
Casey
Directorate and source a version of the influenza
Pickett
report that can be shared with the IIAG
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RELEASED
Document 4
IIAG Minutes/Actions
Date:
5 Hui-tanguru/February 2021
1982
Time:
1:00 pm – 4:00 pm
ACT
Chair:
Te Puea Winiata
Attendees: Nikki Turner, Loret a Roberts, Beth Williams, Rhonda Sherriff, Kevin
Pewhairangi, Silao Vaisola-Sefo, Dr Tristram Ingham, Nicky Birch, Vince
Barry, Angela Ballentyne, Dr Helen Petousis-Harris, Taima Campbell, Dr
Rawiri Jansen, Apisalome Talemaitoga
Mathew Parr, Carl Bil ington, Mike Stewart, Debbie Edwards, Ana Bidois,
Michael Dreyer, Edward Falloon, Luke Fieldes, Joe Bourne
Apologies:
INFORMATION
Item
Agenda Item
1
Introduction and welcome
• Kevin opened with a karakia
• The group noted additional members of Rhonda Sherrif and Vince Barry
attending this meeting
OFFICIAL
• Today’s agenda is very full as the programme is working at pace towards the
delivery date. Any immediate feedback is welcomed
2
Minutes from previous meeting
THE
• Minutes from the previous meeting are accepted
3
Programme Update
Mat Parr (Programme Director) provided an update about the programme
• Today’s discussion involves a lot of highly sensitive information and we would
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appreciate you keep this to yourselves, especially information that relates to
timeframes
• Latest delivery schedules indicate the vaccine wil arrive during the week of 15
February, with a possible vaccination start date of 20 February
• Medsafe approved the Pfizer vaccine for use earlier this week, and approvals
for the AstraZeneca and Janssen vaccines have been received and are being
worked through by Medsafe
• Training has been brought forward and wil commence next week
RELEASED
• Where possible we are working to the sequencing framework to ensure the
vaccine is received by those who need it most
• Three distinct delivery phases which wil increase in scale to adjust to demand:
o Phase 1 – Pfizer vaccine wil be arriving in weekly doses (55,000
initially). Border workers and high-risk health workers wil be vaccinated
first, and DHB staf will be immunised in this cohort. DHB sites will be
brought online in a staged and controlled manner
o Phases 2 and 3 – delivery ramps up and we wil begin to engage with
community providers with targeted outreach. Delivery of vaccines
increases in May/June with other vaccines becoming available
• We expect that enough vaccines wil have arrived by September to vaccinate
the NZ population. Initial work is being done to consider our options for
donating vaccine if we have too much
• Planning is underway to set up daily reporting mechanisms
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Group discussion – overlap with other vaccine programmes
• What is the impact on other vaccine programmes? Flu season is also
approaching, and MMR campaigns are underway but if we proceed with these
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there is a risk that we undermine the COVID-19 vaccine programme
• Clinical advice recommends a 2-week gap between COVID-19 and flu, and a 4-
week gap between COVID-19 and MMR
• Border workers may be in the cohort who are scheduled to receive a MMR
vaccine
• The group agreed COVID-19 is a bigger risk than flu and MMR and should take
priority over other vaccination programmes. To support this, clinical advice is
urgently needed from the Ministry to DHBs and providers as a priority. DHBs
are currently under pressure to deliver the MMR campaigns and there needs to
be clarity about what is expected and when. IIAG is prepared to support with
this
INFORMATION
• Need to be mindful of the opportunity cost of delivering COVID-19 vaccines
• Not running with the flu vaccine would be highly confusing. It should be
delivered to those who are at highest risk rather than the private sector
• Capacity is an issue for delivering multiple immunisation programmes,
particularly when it comes to storage
• If people who have long-term conditions are unlikely to receive the COVID-19
vaccine initially, this would be a good opportunity to ensure they get a flu
OFFICIAL
vaccine
• We need to be mindful of whānau who wil be making choices about whether
they take the vaccine or not, especially if cost is a factor. Layering three
vaccines is complex and needs
THE to resonate with communities
• Is there an opportunity to use the flu vaccine as a dry run for COVID-19 and get
people used to the idea of immunisation?
Group discussion – general
• Vaccine suitability is a question that lots of people wil be concerned about – is
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there a brand that is better suited for some populations? At this stage we don’t
have enough information about them, but it is likely people won’t have a choice
• General population wil be wanting to receive the most effective vaccine and
this needs to be factored into the comms
• What work is being done in relation to frontline workers who choose not to take
the vaccine? The impact on employers who may need to stand people down
hasn’t yet been finalised and this has been a focus in the media. The Crown is
seeking advice from the Solicitor General, but this is an issue for the private
sector rather than for the Crown. PM has been clear that the vaccine is not
RELEASED mandatory, but it is up to individual employers to decide what they want to do
• To ensure equitable access for the disability community we need to be
deliberate about asking harsh questions about people’s disabilities. The
Washington Group Question Sets are the preferred method for data screening
• Even though we are delivering at pace, the sequencing framework cannot be
ignored
• Is there an opportunity to commission a piece of work to explore the vaccine
rollout across disability and mental health sectors? This would also look to
leverage the flu vaccine report from the Māori health directorate at the Ministry
Action for the programme to draft a memo based on IIAG feedback and share
clinical advice with the sector about overlap with other immunisation campaigns
and reiterate that COVID-19 is the priority.
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4
Update on the COVID-19 Immunisation Register (CIR)
Michael Dreyer (Group Manager, National Digital Services) presented an update on
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the CIR
• Michael has been responsible with running the national IT system and leading
the COVID-19 response with border testing and contact tracing solutions
• We have developed a system that wil eventually replace the National
Immunisation Register
• The CIR wil eventually become the new National Immunisation Solution once
the data is migrated across from the NIR
• Capability for the CIR wil continue to improve over the phased rollout of the
vaccine to supportCOVID-19 vaccine delivery
• We are also working to ensure that CARM has the capacity to deliver post-
event monitoring
INFORMATION
Edward Falloon presented a live demonstration of the CIR
• We have designed it to make it paperless, but acknowledge there may also be
circumstances that affect functionality, and this can be managed manually
• Three phases of the vaccination event where the CIR will be used: reception,
vaccination and recovery
• The waiting time as part of the recovery wil be 30 mins
OFFICIAL
• It has been designed to make it easy for the vaccinator
• The programme works in real time and connects to people’s NHIs
THE
Group discussion
• We need to be clear with individuals that they can’t opt out of having their data
put into the system, and this needs to be shared upfront
• Would be useful for people to have the opportunity to complete the form
themselves
• Some areas need to be worked through in more detail to ensure suitability for
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the disability sector
• The question relating to symptoms is very broad in nature
• Providers can experience challenges outside their control which means
technology isn’t feasible e.g. Adverse weather conditions, technology failure.
How can we account for this? We wil always need a wat to capture things on
paper as a last resort and IMAC are developing a paper version of the online
system
• There are likely to be additional staffing implications of using this system
depending on the number of people being vaccinated in one site. This will be
RELEASED taken into account during DHB planning
• We are using an existing GP notification system
• Migration with GP systems is challenging. At this stage it wil be additional to
those systems and GPs wil be required to log into a separate portal before it
can be migrated into the newer NIR
Note if members have further questions on the CIR they can contact Michael
Dreyer at
[email address].
5
Update on reporting
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Luke Fields (Lead, COVID-19 Vaccine Reporting) presented on the Ministry’s plans
for reporting
• This work is separate from the technology component but there is overlap with
some of the data that we need
ACT
• We are focused on getting high quality data that can ensure we have accurate,
robust and timely reporting that can be used for analytics and decision making.
The credibility of data results in credibility for the programme, so we need to be
putting out numbers that we have confidence in
• There are a diverse range of stakeholders who are interested in this and we
need to share information with stakeholders as it becomes available
• We are establishing processes to ensure we can deliver on the analytics once
vaccination begins
• We have created templates for standardised reporting. The CIR system is
based on Salesforce and has limited reporting capabilities, so we wil report
through Snowflake that can support more advanced analytics
INFORMATION
• As we don’t have any current data the first test wil be when we go live on Day 1
• Daily reporting wil be the focus, but we wil have the ability to access more up
to date information should we need it
5. Reporting update
• Presentation attached here: for IIAG 5 Feb 2021.pp
OFFICIAL
Group discussion
• Missing reporting measure is the number of people who have received the first
THE
dose vs the second dose
• We need to keep in mind the audience – we may have to tailor information to
different audiences
• Privacy should be top of mind if we are using dif erent datasets
• The highest value for reporting wil be when providers are having conversations
with people on the ground and can share the most up to date information
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• May want to consider how we screen people and align them to the different
groups in the sequencing framework. This was missing in the CIR fields and
means it wil be dif icult to report on it
Note if members have any feedback on reporting mechanisms they can get in
touch with Luke at
[email address].
6
Report back on sequencing
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Debbie Edwards (Principal Advisor, System Strategy & Policy) provided an update
on the sequencing framework
• Further discussions have been had to ensure we are upholding our Te Tiriti
obligations and ensuring equity of access
• A meeting took place with Māori members on Tuesday, and with Pacific
members on Thursday
• Ideas were put forward at each meeting which have been very helpful and
improved the framework
• Nicky provided some helpful language that is strengths based and more
positive which has been shared with the comms team so they can influence
their language also
• We have proposed that an allocation of vaccine is set aside in Tier 3 that can
be distributed to Māori and Pacific communities nationally by providers who are
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best placed to determine where it goes. This looks at a locality system, rather
than the focus being aged-based and is a whānau-centred approach
• Need to consider questions such as infrastructure and IT support so that it can
be delivered in time
ACT
• Plan to have additional meetings over the coming weeks to refine further
Group discussion
• Connecting with Māori networks wil be important, especially to ensure rural
communities have access, and means we can be more agile when distributing
• Al ows for us to have conversations with whānau about vaccine hesitancy and
what it means for them
• It is critical that the Crown lands the correct messaging to give context to the
message, and this is reflected in the changes that Nicky suggested to the
wording
• There is not one strategy over others that wil lead to success. We need a
INFORMATION
combination of options to make meaningful impact
• Need to be mindful of closing the gap to prevent some cohorts from falling
being exposed to risk. Examples include uber/courier drivers
• Varying approaches are necessary to capture the different population groups
across locations
• The iwi comms collective is leading the messaging for Māori and is concerned
that they have fallen behind the narrative because announcements have
OFFICIAL
already been made
• Further guidance is needed about what is considered a “household contact”
THE
7
Action tracker/round table updates from teams
Carl Billington (Lead, Stakeholder Engagement) presented an update on the
comms workstream
• Nicky’s feedback about the language has been taken on board
• Although we are trying to push the wider team on their assumptions of who is
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included in a household it is stil challenging and we would appreciate your
feedback
• We are working through ways we can actively seek community input and put
them into action
• The focus for the past week has been on border workers and employees who
have been very engaged. This has helped us to get feedback about the
workforce will look like
• A public campaign wil commence on 15 February and has had input from
Clemmengers, Mahi Tahi and other agencies, and Carl wil circulate these draft
RELEASED plans with the IIAG. The underlying message is that we reached this point by
standing together, and people are carrying the risk for us
• Resources within the Ministry are stil coming on board but there is a
considerable amount of work for a small team to get through
Group discussion – communications and engagement
• The PM has reiterated the message that Māori are concerned about the
vaccine and we should be commit ed to working through these collectively
• The group agreed we should be moving away from the “household contacts”
language and instead focus on what people know but referring to a “bubble”
which wil resonate for more people, especially the disability community
• IIAG members would be happy to participate in expert panels that could be
presented to border agencies etc
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• The comms programme within the Ministry wil need support from outside
groups. The group agreed to support Carl with engagement and be available to
prevent turnover from within the team. Comms is critical to building trust and we
need to support Carl to deliver
ACT
Group discussion – other business
• Clarity is needed about the definitions of groups that fit at each level – who is a
“border worker” etc. Anyone who is currently receiving a swab is frontline
• Need to confirm whether the vaccinators have been vaccinated also. They wil
be vaccinated as they come into contact with the border workforce and we need
to ensure their safety
Action for Carl to share draft campaign planning with the IIAG.
Action to share the most up to date definitions as agreed with DHBs with the IIAG
INFORMATION
so there is a clear breakdown of categories, noting this work is ongoing.\
8
Closing
• Te Puea reiterated that the IIAG would be available wherever possible to
support with the quick decision making that wil be happening over the next two
weeks, and the group wil stand behind the Ministry
OFFICIAL
• Nicky closed the hui with a karakia
THE
Action Tracker 5 February
Item
Action
Lead
Due Date
3
The programme to draft a memo based on IIAG
Joe Bourne
12/2
feedback and share clinical advice with the sector
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about overlap with other immunisation campaigns
and reiterate that COVID-19 is the priority.
7
Carl to share draft campaign planning with the IIAG.
Carl
12/2
Billington
7
The programme to share the most up to date
Mat
12/2
definitions as agreed with DHBs with the IIAG so
Parr/Simon
there is a clear breakdown of categories, noting this
Everitt
work is ongoing.
RELEASED
Document 5
IIAG Minutes/Actions
Date:
11 Hui-tanguru/February 2021
1982
Time:
4:30 – 5:30 pm
Chair:
Debbie Edwards
ACT
Attendees: Nicky Birch, Silao Vaisola-Sefa, Dr Api Talemaitoga, Kevin Pewhairangi, Dr Tristram
Ingham, Dr Rawiri Jansen
Debbie Edwards, Ali Ajmal, Sam Austin, David Pickering, Lillias Henderson
Apologies:
Te Puea Winiata, Taima Campbell, Tamati Shepherd-Wipiiti, Casey Pickett
Item
Agenda Item INFORMATION
1
Introduction and welcome
• Debbie welcomed everyone and acknowledged David who is attending from the Pacific
Team at the Ministry of Health
• Today’s discussion wil focus on sequencing and the options that have been col ated to
ensure Māori and Pacific communities are fairly represented in the vaccine rollout
Note that the minutes reflect comments from the IIAG members unless otherwise noted.
OFFICIAL
2
Sequencing discussion
Debbie Edwards provided a recap of what was covered in the previous sessions and where
THE
the group landed with sequencing
• Previous breakout sessions were held with the Māori and Pacific cohorts and we
agreed that a combination of options presented is most effective
• The proposed approach developed by the IIAG members includes ring fencing the
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vaccine for Māori and Pacific communities, and supporting Māori and Pacific service
providers with the necessary resourcing and infrastructure, and including a risk-
adjusted age threshold
• It was also noted that:
o Language being used is positive and strengths based
o Building on the capability of providers
o Adequate resources and service support are critical
• Support would need to include guidance for providers so they can successfully deliver
RELEASED to the framework
• Debbie noted that the current focus is on planning for the implementation of Tiers 1
and 2, and the policy team is shifting its focus to planning Tier 3 sequencing
Group discussion
• Need to keep in mind that the Treaty obligations focus on partnership and, with no
disrespect, we shouldn’t be bunching together Māori and Pacific whānau
• Currently Tier 2 includes older people and those living with underlying conditions.
Need to ensure this also includes people with disabilities. Tier 2 should also include
people who are living in private hospital care who are not necessarily elderly, such as
Māori with diabetes etc
1982
o DHB modelling for older people focuses on ARC who are over 65 - would
encourage the Ministry to test these numbers
o There is a large cohort of people who are not elderly living in ARC who should
also be eligible for a vaccine under Tier 2. As they are currently not
ACT
represented in this group, we are at risk of discriminating against those people
(Debbie advised that if they are ARC residents they would be included in Tier
2.)
• Is there an opportunity to rol out the vaccine according to location and deliver in
certain regions first? We could identify areas of the country who are a priority and
distribute in this way
• The system needs to be responsive to Māori who change their mind and wait to
receive a vaccine. As soon as they commit and want to receive it, we should be ready
to deliver it
INFORMATION
• We should broaden the scope of Tier 3 to include Māori and Pacific people who are
living in higher risk situations that are not necessarily ARC eg. Colocation,
overcrowding etc
• Evidence that is used needs to be careful y considered and should include publications
that the Ministry may not have access to or may not look for in the first instance, such
as the impact of COVID-19 in tribal lands in North America
o Debbie noted that the Ministry’s Science and Technical Advisory group had
OFFICIAL
undertaken the evidence review, taking a broad approach, and continues to
monitor emerging evidence
o The Framework is evidence driven, and also reflects other considerations, such
THE
as expert advice and political decisions
• Tiers 1 and 2 are risk-based, and potential vaccine volumes have been considered.
Externalities mean the numbers for each tier may vary
• Currently, progressing through Tier 2 quickly means we can reach Tier 3 sooner which
is a large cohort
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o Within this tier we should consider how we first offer the vaccine to Māori and
Pacific with underlying conditions
o Distribution should be based on asking communities and providers who has
the most need. Messaging this will be critical
• We have an ethical responsibility to vaccinate prisoners. Even if it is not formally
represented on the Framework, the Crown has a responsibility to include them as a
priority group.
o Debbie noted that Aged care units within Corrections have been included
RELEASED under Tier 2
• Should consider who is best suited for which vaccine eg. Whether ARC residents wil
receive Pfizer of AstraZeneca when research shows Pfizer would be most effective for
them
o Debbie noted this is part of the Decision to Use process
o The I AG wasn’t involved as had previously been agreed
3
Other matters raised by the group Communications and engagement
• The Crown is issuing advice on sequencing and has channels for distributing
information, but there are no reciprocal channels for Māori to provide feedback
1982
• Iwi were not given enough warning about yesterday’s approval announcement.
Whānau have questions and are turning to providers for information, but it is difficult
to share this when we are not prepared and there is an information void. Iwi are ACT
coming up with general information to inform their people which is not good enough
• Comms for this programme is running too far ahead of where whānau are and
operating on the assumption that everyone will want the vaccine. Reality is that
whānau are mixed in their opinions and iwi are tired of being left behind
• The Crown is speaking to the process, not to people
• Some iwi are directly advising their community on whether to get the vaccine, and
others are focused on providing facts, and supporting informed choice
• Iwi are reaching out to the Crown through other mechanisms to get their information,
rather from the Ministry because we are receiving mixed messages
• Poor communications can be a symptom of bigger challenges and there is a concern
INFORMATION
that we are starting off on the wrong foot – if the information coming from the Crown
is poor now, this will only continue
• View that the Ministry is disconnected from Ministers which means it is difficult for the
sector to also remain updated
• Pacific community is becoming increasingly concerned with the rollout due to the lack
of information sharing, and conflicting information that exists in the community
• The same issue applies to disability networks and t
OFFICIAL here are directorates within the
Ministry who are lacking information. As an example, an IIAG member has information
that the Disability DDG has not seen
• The Ministry should be focus
THE ing on a real time co-design process with iwi, that extends
to co-develop and co-deliver
• Suggest establishing a reciprocal point of contact for all information
• They noted that Carl has been very responsive and great to work with, but their
concerns go beyond him
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IIAG’s role
• Members wanted to communicate a strong message that the IIAG is a group of
clinicians who are dedicating their clinical time at no cost to the Ministry and the
group is being blind-sided by announcements
• If Steering Group is making the real decisions that is fine, but they need to
communicate their reasons for their decisions back to the I AG
• The group lacks confidence that sequencing discussions and options we have talked
RELEASED about today will actually be implemented
• The IIAG agreed in a previous meeting that they would have a role to play in the
Decision to Use process. This has not happened for the initial vaccine approval and
instead has been a decision directly for Ministers. The group would like to see those
processes adhered to
• Would like to see some practice applying the Decision to Use Framework – step
through it because delivery is likely to be “lumpy” and will need to make decisions part
way through
• There seems to be an additional pathway of approval for sequencing that is beyond
the IIAG. This raises questions about the purpose of the IIAG whose main focus is on
the sequencing framework
1982
• Noted their appreciation to Debbie for these hui on sequencing for Māori and Pacific
communities – pleased with where its landed, but not confident that it wil be
progressed. Also for listening to their concerns
ACT
Confidentiality
• The confidentiality requirements make it difficult to honestly engage with the sector
and receive feedback on implementation planning, which limits our ability to operate
within our role as an advisory group
• Need to confirm to what extent the IIAG papers are confidential. Agreed that it was
suitable to share these papers within other parts of the Ministry but not beyond the
IIAG or MoH
• It is a symptom of a problematic communications network when an external person is
sharing papers with a DDG at the Ministry
INFORMATION
Action for Debbie to share this feedback with the Programme and escalate upwards so the
Steering Group has visibility of the IIAG’s concerns.
4
Closing
• Debbie thanked everyone for their participation and closed the meeting
OFFICIAL
THE
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RELEASED
Document 6
Māori sector hui/ Actions
Date:
22 Hui-tanguru/February 2021
1982
Time:
10am – 12pm
ACT
Facilitator: Tāmati Shepherd-Wipiiti
Attendees: John Whaanga, Ana Bidois, Keriana Brooking, Nicky Birch, Dr Matire
Harwood, Dr Rawiri Jansen, Dr Tristram Ingham, Te Ropu Smith, Te Puea
Winiata, Kevin Pewhairangi, Chrissie Hape (on behalf of Ngāhiwi Tomoana)
Tabish Hassan Ghani (Note taker)
Apologies: Taima Campbell, Dr Sue Crengle, Dr Dale Bramley
The purpose of the discussion is to discuss the operational elements required to progress
a Māori strategy/plan for the roll-out of the COVID-19 vaccines.
INFORMATION
Group discussion
Actions:
1. Strategy components should provide a view of the journey of how it's been
developed.
2. Vaccination staff and Māori providers should be c
OFFICIAL aptured and inform Operational
Guideline development.
3. Strategy components draft to be completed and socialised with the stakeholders.
4. Arrange a follow up face to face hui (Ana to set it up)
THE
5. Communications should be shown as parallel in Māori strategy components slide
Risks:
1. Lack of organisational resource and investment in disabilities to drive proper
community response.
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2. We may need to force the path with DHBs to expedite equity in our response.
3. Risk of community leaders spreading misinformation.
General Takeaways:
1. The 20% of health and disability staff are Māori.
2. Our equity response should be a collective for health and disability and informed
with lessons learned from pandemic response.
RELEASED
3. The group suggested exploring an opportunity with Ashley and Māori providers
and whānau occasionally to test the framing and track progress.
4. We need to demonstrate that we have an equity focus in all our tiers (e.g. taking a
regional focus than a national focus).
5. As we think about implementation, Māori participation needs to turn into
partnership and explore what iwi, pan iwi, hapū and DHBs are doing.
6. We need to frame implementation as partnership.
7. Māori strategy needs to be owned by the crown and partners.
8. IMAC's role is to provide culturally appropriate training.
Workforce:
1. We should take a long-term vision in building Māori workforce and capability. At a
1982
minimum we should have multi-disciplinary and diverse (Kaiāwhina etc) teams
acting in various roles that provide our whānau culturally appropriate experience.
2. For DHB workforce we need to ensure that it has appropriate support and
ACT
supervision so it’s a culturally competent experience for whānau.
3. We should leverage our Māori pharmacists in regional pop ups.
4. Providers should explore the possibility of rotating workforce.
5. Workforce needs to have capability around disability (training etc) to deliver an
effective experience.
6. Workforce needs credentialing to build qualifications.
7. We should prioritise Māori vaccinators through IMAC that are already qualified.
8. Consistency around the country is needed to show we have Treaty coverage.
Sequencing:
1. Initially planning around sequencing was done with logistics considerations and
INFORMATION an
equity lens is needed.
2. There is a lack of gold standard research in age differential for Māori and the
remaining population.
3. Tier 2 should consider our rurally placed whānau.
4. Sequencing framework should help us obtain equitable results.
5. Feedback loop should be established with Marketing & Comms on how we
continuously improve our Māori sequencing and uptake.
OFFICIAL
6. The Sequencing approach needs to be culturally and ethically appropriate.
7. We should apply lessons learned from HBDHB equity response.
8. Our Sequencing planning should protect whānau against other variants.
9. Informing our sequencing as t
THE he operational data comes through.
Communication:
1. MoH has a lack of resources to produce effective and balanced iwi comms. A
holistic approach including a regional approach is needed. MoH has secured
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investment and Māori expertise to assist with comms development. We need to
progress this with urgency and cohesive coordination.
2. Integrated Māori communication with the first drop is needed.
3. The comms should have coverage of whānau and be empathetic to the
community.
4. The comms should be developed with a codesign approach that speaks to
aspirations and commitments that resonate with whānau.
5. MoH has an existing chal enge around effective and accurate translation of the
comms collateral.
RELEASED
6. We have a challenge around effective coverage at national and regional level, this
wil be raised in plan and as an action item to highlight the tactical coverage.
Data:
1. Better visibility of Māori providers operational data is required.
2. Ethnicity and iwi affiliation information should be recorded in CIR.
3. We should leverage the work being done and lessons learned in the National
Health System.
4. The COVID app users should be provided the opportunity to record ethnicity and
iwi affiliation.
5. We should capture functioning enhanced questions as part of screening questions
for effective data col ection for visibility.
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6. The priority of data capture should be quality of data first, then access and then
analytics and then evaluation data.
7. Iwi data needs Māori data governance.
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