COVID-19

In response to the rise in cases of COVID-19, hospitalisations and deaths, Te Whatu Ora plan to send direct communications to the following groups of people from Monday, 20 November, as they have been identified as people who are mostly likely to benefit from an additional COVID-19 booster at this time of year:

• Māori and Pacific people 65+ years
• everyone 75+ years.

The direct communications will be a combination of email, SMS text and physical letters. This will be sent to approximately 294,000 people, with an anticipated uptake of 10-15 per cent.

In summary, eligible people can (and should) get a free COVID-19 vaccine every six months.

Who is eligible for an additional booster dose

Additional COVID-19 booster doses continue to be available for those who are eligible. Eligible people can receive an additional COVID-19 booster dose regardless of how many doses they have previously had.

Those who are eligible include:

• people aged 30 and older
• those aged 16 to 29 who are pregnant or are at higher risk of severe illness from COVID-19.

There needs to be six months between doses, and it’s recommended that the gap is six months after last COVID-19 infection.

Clinical discretion can be applied to spacing rules, minimum 5 months between primary and booster, 4 months between booster doses, and from 3 months after illness. Vaccine given outside this spacing will require a prescription.

Who can most benefit from an additional booster dose

IMAC guidance on who can most benefit from a further dose of COVID-19 vaccine can be found on the factsheet COVID-19 Vaccine booster guidance for late 2023, or below.

For those who are already up to date with COVID-19 boosters, the people who are most likely to benefit from another COVID-19 booster dose include the following.

• Anyone aged 75 years or over - priority to those at increased risk from severe COVID-19 outcomes (e.g. those living in residential aged-care facilities); Older people who are at increased risk of frailty if become even mildly unwell.
• Individuals aged from 16 years with considerable immunocompromise - at increased risk of severe COVID-19 and less likely to have robust immunity to SARS-CoV-2 (i.e. those who are eligible for a third primary dose).
• People aged 65 years and older of Māori and Pacific ethnicity - based on clinical discretion, if at higher risk from severe COVID-19, particularly those with chronic and multiple morbidities.
• Individuals aged 30 to under 75 years with significant complex health needs - with significant complex health needs that increase risk of frailty (e.g. living in residential care and those with multiple long-term medical conditions).

For further clinical advice please call 0800 IMMUNE (0800 466 863, or email 0800immune@auckland.ac.nz

Below is a narrative about the transition of COVID-19 care for practices to use on their website, if they wish to.  

COVID-19 Care to focus on eligibility for antiviral medicines  

Eligibility for antiviral medicine to treat COVID-19 will become the key focus of primary, hauora provider and community pharmacy care from 1st October. This will ensure the people who are most at risk of serious outcomes from the virus receive the support they need.   

The continued and greater focus on antiviral therapies reflects the transition to managing COVID-19 in the same way as other acute respiratory conditions.  

People who are not at high risk of serious illness from COVID-19 can still access related healthcare at their doctor, hauora provider or pharmacy, but they will be asked to pay just like they do for other health services. 

Public collateral to use in your practice. (This includes A3 and A4 posters, a social tile for you to use on your social media and a flyer to provide to patients if further information is requested.)

You can download each item of collateral by clicking on the image, saving it to your desktop and then printing or posting. Please register for the portal if you haven’t done so already. There is also an option to order printed versions of this collateral (A3 and A4 posters, and flyer) from Bluestar.

• Go to https://portal.bluestar.co.nz/login/moh_vaccine 
• If you already have an account, login.  
• If you do not have an account, click on the “Need to Register?” link and follow the prompts. You will receive an authorisation email to activate your account. Once you have activated your account, you can login, using your email as your username.  
• Click on the “Catalogue” tab at the top left of the page.  
• The collateral is housed under the “GoWell Campaign” category, click on the link on the left hand side of the page.  
• Choose the collateral you want printed, enter the quantity and click “Add”. 
• Once you’ve entered your order, either click on the cart to review and amend, or click on “Place Order” (top right of the page). 
• Follow the prompts and complete your order.   

Contact details are posted on the portal home page if you have questions. 

From 11.59pm on Monday 14 August, the last remaining mandatory COVID-19 public health requirements for a 7-day isolation period for people testing positive for COVID-19, along with the wearing of face masks for visitors to healthcare and disability facilities, were removed.

The wearing of facemasks by visitors in healthcare settings and continuing to isolate if positive for COVID-19 are still being strongly recommended. These remain an important way we can prevent the spread of respiratory illnesses, including COVID-19. New Zealand has a good supply of antiviral medicines, and people with a high risk of severe illness from COVID-19 will continue to be eligible for treatment with antivirals.

Key messages around recommendations for isolation and mask wearing for visitors to health and disability care settings have been developed. To support those of you who may receive queries from the public about what these changes mean for them, this set of FAQs might assist.

To support these changes, Te Whatu Ora is updating its guidance materials. Te Whatu Ora has developed national mask use and visitor guidance for hospitals and other health and disability care settings. The expectation is that hospitals and other health and disability care providers will use this guidance to set their own policies for visitors wearing facemasks on their premises.

Note that for healthcare workers, different requirements may apply before they can return to work due to their unique role. Te Whatu Ora was therefore developed specific guidance for managing the return to work for healthcare workers after they’ve been infected with COVID-19. Healthcare workers should discuss their return to work with their employer as their employer may require additional precautions.

To align with these changes to COVID-19 settings, Te Whatu Ora’s testing guidance and the Communicable Disease Control Manual will be updated.

The Unite Against COVID-19 website, as well as the Te Whatu Ora website, are updated to reflect these changes to COVID-19 settings.

Additionally, posters encouraging facemask wearing in healthcare and disability settings are available for download on the online resource toolkit, Brandkit. Providers are encouraged to display these posters around their premises.

The Government announced key changes to our COVID-19 settings on 14 August, including the removal of the last remaining mandates regarding isolation and mask wearing. These changes do not impact on the Model of Care as currently funded until 30 September, nor do they affect the implementation of the new Model of Care to begin 1 October. 

To further support model of care changes:

• A presentation by Care in the Community and Outbreak Response partners describing the COVID-19 Model of Care changes, including other areas such as PPE supply and testing. Watch the 22 min presentation. (Password is: careinthecommunity).
• Funding Guidance for Primary Care Model of Care for COVID-19, October 2023.
• Funding Guidance for Community Pharmacy Model of Care for COVID-19, October 2023.

Further questions can be submitted via this Microsoft forms link. Questions submitted by Monday 28 August are likely to be answered in the live sessions held on:   

• Thursday 31 August:  6.00 – 6.45pm (Join the Teams Live here)  
• Wednesday 6 September:  6.00 – 6.45pm (Join the Teams Live here). 

There will also be an opportunity to ask any further questions you may have during these sessions. 

The COVID-19 Care in the Community team has indicated that ongoing funded support for COVID-19 care is going to be linked directly to the new eligibility criteria for antivirals, so getting this right is going to have implications for more than just funded prescriptions.
 
The proposal outlines changes to access criteria to COVID-19 antiviral medication. The changes in this proposal would be implemented from 1 October 2023 or earlier and apply to access criteria for nirmatrelvir with ritonavir (Paxlovid), molnupiravir (Lageviro) and remdesivir (Veklury) for the treatment of COVID-19. 
 
This proposal recommends that people receiving disability support services and people with single high-risk conditions would be included in the access criteria.
 
Feedback is also being sought on how discretion could be incorporated to allow access to COVID-19 antiviral treatments for people who meet the intent of the access criteria and are not explicitly identified in the wording. 
 
To provide feedback, please email consult@pharmac.govt.nz by 5pm on Monday 21 August 2023. Please also share your thoughts with Jo Scott-Jones to help him feedback on Pinnacle's behalf. 

Over many months, a network of providers and distributors have provided RATs to the public to enable people to self-test for COVID-19. This has been important mahi and the COVID-19 Care in the Community team want to acknowledge the ongoing dedication of all the health workers and providers involved who have helped protect our communities.

A system supporting the provision of RATs has been RAT Requestor, an online tool giving access to free RATs for New Zealanders. Using this, New Zealanders have been able to pre-order and pick up publicly-funded/free RATs from a network of collection sites, testing centres, general practices and pharmacies.

Initially RATs were only available to those meeting eligibility criteria (those who were symptomatic and the household members of a case) but eligibility criteria were removed in July 2022 as part of the Winter Wellness package - all New Zealanders can access publicly-funded/free RATs.

We have good stock levels of publicly-funded/free RATs, and all New Zealanders can source these from the distribution network, detailed on the Healthpoint website and on Te Whatu Ora’s local health websites, without pre-ordering.

As a result, the decision has been made to close RAT Requestor from 30 June 2023, as it is no longer needed. From 1 July 2023, RATs will no longer be able to be pre-ordered via RAT Requestor.

Focus will continue on supporting priority and vulnerable groups most at risk and disproportionately affected by COVID-19, including Māori and Pacific people, older people, those who are immunocompromised and those with other high-risk medical conditions. This includes ensuring access to testing, including via the RATs distribution networks across Māori and Pacific NGOs.

The 0800 222 478 phoneline will continue to operate and be focussed on providing additional support to these priority and vulnerable groups, with information and assistance to source RATs, including delivery if necessary.

The primary source of information to the public about where to collect publicly-funded/free RATs is Healthpoint. Another source is Unite against COVID-19 where information on how to use RATs and how to manage risk and exposure to COVID-19 can also be found.

Telehealth services such as Healthline (0800 358 5453) and the Disability Helpline (0800 11 12 13 or text 8988) will continue to provide general health information and advice on where to source RATs.

As of 1 April 2023 the bivalent Comirnaty vaccine replaced the Pfizer COVID-19 vaccine for boosters. The bivalent vaccine produces an immune response against the original virus and Omicron variants, specifically the BA.4 and BA.5 subvariants. Further COVID-19 booster and Bivalent research can be found on the IMAC website.   

If someone has had COVID-19 it's recommended they wait six months after testing positive before getting any booster.

The eligibility criteria for additional COVID-19 boosters has been updated to clarify that all young people aged 12 to 15 who are at higher risk of severe illness from COVID-19, may receive an additional booster, with a prescription. 

To reflect the eligibility extension on 1 May to include pregnant people aged 16 and over, the guidance has also been clarified to include this age group in the ‘recommended’ category.

Read about booster eligibility on the Ministry of Health website.

Updates have recently been made to the advice around therapeutics for COVID-19. In particular, please note that Paxlovid™ (or remdesivir) are preferable treatments to Evusheld and Molnupiravir for treatment of COVID-19, read the Technical Advisory Group position statements about this on the Te Whatu Ora website.

Molnupiravir remains the only medication available for purchase for people ineligible for funded care in New Zealand.

The COVID-19 testing plan is in three parts.

• The Purpose of Testing (diagnostic, surveillance and asymptomatic screening).
• A Testing Response Framework (including testing advice under low, medium and high transmission).
• Settings based advice.

There are seven guidance documents appendixed to the Testing Plan, each focussed on particular settings.

1. Primary Care and other clinic-based settings
2. Aged Residential Care and closed facilities
3. Community providers and disability sector
4. Hospitals and secondary-based care facilities
5. Businesses
6. Testing technologies and modalities
7. Testing on arrival in New Zealand

Feedback was sought from representatives including Te Aka Whai Ora, Whaikaha, Equity and Pacific Health teams, Districts, Primary Care, Aged Residential Care, Infection Prevention and Control, Outbreak Response Clinical Advisory Group, Public Health Agency teams including Policy and the COVID-19 Technical Advisory Group, Northern Regional Health Coordination Centre, New Zealand Microbiology Network and the New Zealand Testing Laboratory Network.  

The plan will be reviewed as policy settings change and in advance of Winter 2023, or if a new variant of concern is identified.

Please see our COVID-19 claiming resources page for the most up-to-date version of these FAQs that we've been supplied.

A paediatric Pfizer vaccine which contains a lower dose of mRNA is now available for tamariki aged 6 months to 4 years who are at higher risk of severe disease from COVID-19. This is a 3 dose course. Read more on the Ministry of Health website.

You can view and download Unite Against COVID-19 branded assets and resources through the COVID-19 Resource Toolkit. 

 Please see our COVID-19 PPE guidance news page.