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Vaccines for children, such as the polio, tetanus and chickenpox vaccines, could be given in community pharmacies if a proposal from Pharmac is implemented.
Currently, funded childhood vaccines are only available from general practices, because of a barrier called ‘Xpharm’. Pharmac is seeking feedback on a joint proposal with Te Whatu Ora Health NZ to remove ‘Xpharm’ from certain funded childhood vaccines from March 1.
The aim is to increase vaccination rates, which have fallen in recent years, by providing another accessible option.
Consultation with pharmacies and general practices about the proposal, and how it could be implemented, opened on January 15 and closed two weeks later (January 29).
In a press release, Te Whatu Ora director of prevention, Alana Ewe-Snow, said one of the biggest barriers to childhood immunisation is access to vaccinators.
“General practices will continue to play a critical role in the delivery of childhood immunisations; however, we need to draw on the capability and capacity across the wider health sector to help increase options for whānau to access childhood immunisations in their communities,” Ewe-Snow said. “Because of the importance of the continuity of care provided by GPs, we will be working closely with PHOs and pharmacies to try and ensure that people accessing pharmacies for childhood immunisations are those who are unable to get to their GP or do not have a GP.”
Local GP Dr Peter Hall says the significant inequalities that exist between ethnic groups, socioeconomic strata and rural vs urban communities are a concern to health providers.
“General practices and community health organisations have put a huge effort into enabling and encouraging families to access this service. However, we have not achieved the Government’s target of 95 percent of two-year-olds,” he says.
He says from his personal perspective, the proposal for pharmacies to offer some childhood immunisations, as they do for flu and Covid-19 vaccinations, may address accessibility for some patients.
However, he says general practitioners would want to know that their concerns about issues such as continuity of care, recall, follow-up and communication, will be addressed.
“Immunisation is not just a flying visit to deliver an injection. It offers an opportunity to assess child development and maternal well-being and builds relationship with the general practice team,” Dr Hall says.
He wonders how many pharmacies will want to take it on, considering the complexity of the programme and the consent and after-care requirements.
“I also question how effective will it be, given that the biggest barriers to vaccination are social deprivation, inadequate knowledge about vaccine and misinformation,” he says. “In my view, the most effective way to deal with accessibility problems is to take the vaccines out into the community, offering the service in natural meeting places for high-risk groups.”
Pharmacist Tania Adams of Manly Unichem says, it is really important that the primary health care team work together to ensure the best possible delivery of services to their communities.
“If helping with services like vaccinations can assist the GPs, with their very large workloads, then this is a good idea,” she says.
“Pharmacists are seen by patients more frequently than any other health care professional, as we see families for not only prescriptions but also minor ailments such as coughs, colds and first aid. This proposal would provide an additional opportunity for a primary health care professional to speak with families about vaccinations, which should help increase vaccination rates.”
She says pharmacies are open longer hours, which would also increase access.
“Having said this, pharmacies would have to be set up to cater better for children – things such as bigger vaccination rooms and child friendly waiting areas – so some work would need to be done.”
Adams suggests that where GPs in the area have capacity, perhaps a better referral system could be appropriate.
