An introductory guide to the COVID-19 vaccination programme
This is a general interest guide, designed for health professionals. It provides information about the COVID-19 vaccine (mRNA-CV), the COVID-19 Vaccinator Education Course and IMAC’s role in the vaccination programme. There is no assessment or certificate provided—this is to assist you to quickly navigating some of the key information on our website that we hope you will find useful, prior to completing the official Vaccinator Education Course.
Please note: This course does not replace the COVID-19 Vaccinator Education Course, but is a non-mandatory prelude to it.
COVID-19 Vaccines General information
The New Zealand Government has directed that anyone in New Zealand, whether they are eligible for publicly funded health services or not, will be eligible to receive COVID-19 vaccination until 31 December 2021. Timing of these vaccinations depend upon the priority schedule. COVID-19 vaccines will not be available for private purchase.
The New Zealand Government has stated that COVID-19 vaccination will NOT be mandatory.
About COVID-19 vaccines
Learn more about COVID-19 vaccines in New Zealand, including how they have been developed and how they work. Please click here to find out more about COVID-19 Vaccines.
On this page:
Can COVID-19 vaccines be safely given to frail and elderly people?
There are no safety concerns around giving COVID-19 vaccine to older and frail adults. Currently, multiple COVID-19 vaccine candidates have shown to protect against severe disease in older age groups. A single dose of COVID-19 vaccine substantially reduced (over 70%) the risk of COVID-19-related hospitalisation in elderly, frail patients with extensive co-existing conditions in the UK. This is important, as increasing age is a risk factor for severe COVID-19.
Following reports of deaths of frail, elderly adults in residential care facilities after COVID-19 vaccination, independent reviews by both the CDC and the WHO concluded that the mortality rate in this population is typically high and a substantial number of deaths will occur coincidentally following vaccination. For further information, click here.
COVID-19 vaccines in pregnancy and breastfeeding
Pregnancy is a precaution for vaccination with the mRNA COVID vaccine, Comirnaty™ because initial clinical studies have not investigated the mRNA vaccine given in pregnancy – a phase 2/3 clinical trial is now underway in the US including pregnant women. Based on how the vaccine works, it is unlikely to pose a specific risk when given to pregnant women, whereas COVID-19 can be very severe for pregnant women and can lead to premature births or miscarriage.
It is recommended to delay vaccination until after delivery if the pregnant woman is at low risk of exposure, but for those at high risk of exposure to SARS-CoV-2, vaccination can be offered with informed consent. While lactating women were not included in the initial phase 3 studies, as with all vaccines on the New Zealand Immunisation Schedule, there are no safety concerns about giving mRNA COVID-19 vaccine to women who are breastfeeding.
If you had the virus and recovered, will you still be able to or need to get the vaccine?
Vaccination is being offered to people who have and have not had SARS-CoV-2 infection previously. Data from clinical trials and from countries with a lot of COVID-19 cases have shown the vaccines to be safe and effective in this group of people. It is expected that the vaccine will boost the immune response and provide good protection for those who have previously had SARS-CoV-2 infection. For more information, please click here.
COVID-19 vaccine in immunocompromised individuals
Many people take medication that suppresses their immune system, especially for the treatment of cancer, severe asthma, autoimmune diseases or following organ transplantation, or have medical conditions that can affect the immune system, such as HIV infection or kidney failure.
These conditions put you at increased risk from COVID-19, and although you may not respond as strongly to the vaccine as someone with a fully functioning immune system, it is safe for you received COVID-19 vaccine and it will provide some protection against COVID-19, particularly against severe and life-threatening disease.
It is important and safe for those receiving active treatment with immunosuppressive medications to have the COVID-19 vaccine. If you are severely immunocompromised, it is recommended to talk to your GP or specialist to discuss the optimal timing for vaccination before the vaccine appointment. Ideally, vaccination should be conducted prior to any planned immunosuppression.
It is also important for the people around you, in your household, to have the vaccine when it is offered to them to widen your protection.
Can a person who is currently sick with COVID-19 receive a vaccine?
Internationally, guidance states that people who are currently isolating or experiencing symptoms of COVID-19 should not be vaccinated until they have recovered and met the criteria to stop isolating.
Will children receive a COVID-19 vaccine?
Medsafe has not registered a COVID-19 vaccine for use in children under the age of 16 as there is no information on the effect of vaccine in younger age groups. Further research with vaccine trials enrolling children is underway overseas. Read this Stuff article with IMAC’s Dr Emma Best offering some helpful ideas on how to approach the topic of COVID-19 and vaccines with children.
Are COVID-19 vaccines safe?
COVID-19 vaccines are being held to the same high safety standards as all vaccines. They will not be given approval for use in New Zealand until sufficient data on both safety and on how well the vaccine works (efficacy) have been extensively reviewed. All clinical trials involve an independent safety monitoring committee that oversee safety and decide if it is safe to continue should adverse events arise, albeit coincidentally. Furthermore, internationally, tens of thousands of participants were enrolled in each Phase 3 trial and mass vaccination campaigns involving millions of people are currently underway. Safety information on those who have been vaccinated is being carefully collected and closely monitored. We can be confident that no shortcuts with regards to safety have been taken even though these vaccines have seemingly been produced quickly (see more below).
Any adverse events that occur after vaccination or while taking any medicinal product in New Zealand can be reported to CARM (Centre for Adverse Reactions Monitoring) at the New Zealand Pharmacovigilance Centre. The safety and responses to COVID-19 vaccines are being actively monitored in Australia and smartphone technology is being used to ask vaccinated people how they felt after their vaccination. The findings are publically reported, see AusVaxSafety website for the most recent reports.
What is the process New Zealand vaccinators are following to administer COVID-19 vaccines?
Vaccinators are following normal best practice in drawing up and administering the Comirnaty (Pfizer/BioNTech) vaccine. This is consistent with standard immunisation guidelines. Some nurses are finding they can sometimes get up to six doses out of the vial, consistent with information from the vaccine manufacturer.
Can I have the COVID-19 vaccine if I am allergic to latex?
The COVID-19 vaccine, Comirnaty, is latex-free. The vial stopper is made with synthetic rubber (bromobutyl), not natural rubber latex.
What is the acceptable timeframe between the first and second doses of the Comirnaty vaccine?
To be fully immunised with Comirnaty requires two doses given at least 21 days apart. Vaccinators are advised not to give the second dose earlier than this, and while longer spacing is acceptable, the ideal spacing is for the second dose to be given as close after 21 days as possible.
Can I delay receiving my second dose of Comirnaty?
It is recommended to have the second dose of COVID-19 vaccine (Comirnaty™) at least 21 days after the first dose. A delay for longer than 21 days is not considered to be a problem in terms of how you will respond to the second dose. It is not yet known, for how long the first dose provides protection. During clinical trials, the vaccine efficacy against symptomatic COVID-19 between the first and second doses was around 50% compared with 90% within 2 days of the second dose increasing to 95% after a week. If you are at risk of exposure to SARS-CoV-2, it is advisable to have the second dose when recommended.
Who can administer COVID-19 vaccines in New Zealand and how are they trained?
Staff administering COVID-19 vaccines must receive appropriate training. The criteria for pharmacist and authorised vaccinators is set out in Appendix 4 of the Immunisation Handbook. Training for administering the COVID-19 vaccines is in addition to this criteria. Training on the COVID-19 vaccines is recommended and will be available for those who hold prescribing rights, as well.
Training for the first cohort of vaccinators administering the Comirnaty (Pfizer/BioNTech) vaccine takes the form of online learning and webinars. This training includes detailed disease and vaccine-specific information, vaccination process information, paperwork and record-keeping, vaccine research and a review of the positive safety profile for this vaccine. They also cover responding to common concerns and where staff can go to access further support and clinical advice. This is followed by additional webinars to ask further questions and a clinical support line for vaccinators. Training will continue to expand and support more vaccinators to become authorised and complete the COVID course.
If more than one vaccine becomes available, could taking two different vaccines boost the effectiveness?
We do not know the answer to this yet as it is still being investigated in clinical trials. For more information, please click here.
How many doses of COVID-19 vaccine should I have? I already received a COVID-19 vaccination overseas.
- If you were partially vaccinated overseas with one dose of Comirnaty (Pfizer/BioNTech) vaccine, you need to have another dose at least 21 days after your previous dose when it becomes available for your priority group.
- If you received one dose of different vaccine (for example, COVID-19 vaccine AstraZenaca/Covishield or the Moderna mRNA COVID-19 vaccine), the current recommendation is to have one dose of the Comirnaty vaccine at least 4 weeks after your previous vaccination, when it becomes available for your priority group. Although these vaccines are not interchangeable, they target the same antigen (SARS-CoV-2 spike protein) and it is expected that your prior immunity will be boosted with one dose, rather than requiring the full two-dose course.
- If you received one dose of the Janssen/Johnson & Johnson vaccine or two doses of the other vaccines, you are considered fully immunised and do not require any further doses of a COVID-19 vaccine, at this stage.
To find out which priority group you are in see this COVID-19 vaccination tool
Will booster doses of a COVID-19 vaccine be needed?
Not enough time has passed since first vaccinations were given to be able to answer this question. People enrolled in clinical trials are being followed up closely, which will allow this question to be answered in due course. For more information, please click here.
Can other vaccines be administered with a COVID-19 vaccine?
Currently Medsafe advice is only available for the mRNA vaccine, Comirnaty™ (Pfizer/BioNTech). A two-week gap is recommended between any non-live vaccine, including influenza vaccine, and the COVID-19 vaccine and a four-week gap is recommended for MMR or any other live vaccines. Please note that two doses of the mRNA vaccine are required, given at least 21-days apart. However, based on first principles of how these vaccines work, adverse impacts on immunogenicity or safety are unlikely with a shorter gap between vaccines, so if it is clinically important to deliver in a shorter time, do not delay. These recommendations are likely to be reviewed.
What is the guidance around receiving a COVID-19 vaccine and having a general anaesthetic?
Based on first principles and our experience with other vaccines, there is no expectation that an anaesthetic would affect the safety or immunogenicity of the mRNA COVID-19 vaccine. The general recommendation when planning vaccination with any vaccine is explained in Section 3.1.3 in the Immunisation Handbook 2020.
COVID-19 vaccine may cause swelling of local lymph nodes. Does this affect mammogram results?
When you attend a mammogram, it is recommended that you mention to your doctor or radiographer that you have had a COVID-19 vaccination recently. This is because occasionally the vaccine can cause swelling of the lymph nodes in the arm pit near to the injection-site. This usually settles after a few days after vaccination but may be detectable on a mammogram for up to a few weeks. In this case, it is advised to monitor such lymph node changes for at least 6 weeks after vaccination.
Will ACC provide cover for COVID-19 vaccination injuries?
ACC can provide treatment and support for injuries caused by COVID-19 vaccination if the criteria for treatment injury are met. This means there’s a physical injury caused by the vaccination, that’s not a necessary part or ordinary consequence of the treatment.
For example, inflammation around the site of the injection is common with COVID-19 vaccination (an ordinary consequence) and is unlikely to be covered. Infections (such as cellulitis or septic arthritis) due to the vaccination, and anaphylaxis resulting in injury, are not ordinary consequences and are likely to be covered.
To make a treatment injury claim for a patient please complete an ACC2152 treatment injury claim form as well as an electronic or manual ACC45 injury claim form.
To help with our reporting, we need to know the COVID-19 vaccine brand name and vaccination dose number (i.e. dose one or two). This can be noted:
• on the ACC45: please tick the treatment injury box, identify this as an adverse event in the drop-down menu and then enter the COVID-19 vaccine brand name and vaccination dose number in the open comments section
• on the ACC2152: in Section 3 - Treatment claimed to have caused the injury.
More information about lodging a treatment injury claim is available on the ACC website and in the treatment injury claim lodgement guide.
To find out more please contact us on 0800 222 070 or email [email protected]
Will other COVID-19 prevention measures such as social distancing be needed if a COVID-19 vaccine is available?
As not all New Zealanders will be able to be vaccinated at once, the current public health measures, including social distancing, mask usage, rapid contact tracing and managing cluster outbreaks, will continue for some time. With an effective vaccine programme, it is anticipated these control measures can be reduced. This will require a high proportion of the population (estimated to be at least 8 out of 10 people) being immunised.
If a person is vaccinated against COVID-19, will they still be able to spread the virus to susceptible people?
An ideal vaccine stops everyone from carrying and passing on the infection as well as protecting them from becoming seriously ill. It is currently unclear whether COVID vaccines only protect against symptomatic and severe disease, or if they can also stop all infection, including asymptomatic infection (i.e. showing no symptoms). If the vaccine is only able to stop the symptoms of the disease, but unable to stop the virus from infecting us and reproducing, then the virus may still be able to be spread. Even in this case, by reducing the number of people with symptoms will help to reduce spread of the virus because fewer people will be coughing large quantities of virus on others. However, this possible limitation of the vaccine highlights the importance of continuing to follow public health advice such as hand washing and isolating if unwell, even post vaccination. For more information, please click here.
Recently published data from Israel showed that its mass COVID-19 vaccination campaign (using the Pfizer vaccine) was working well with two doses cutting symptomatic cases by 94% across all age groups.
How long will COVID-19 vaccine immunity (i.e. protection from the COVID-19 disease) last?
We would expect COVID-19 vaccines to provide protection for longer than 2 months, although exactly how long for, remains unknown at this stage. This is because not enough time has passed since the clinical trials started to be able to accurately answer this. We know that the Pfizer/BioNTech COVID-19 vaccine lasts for AT LEAST two months, because data supporting this has been reviewed by Medsafe. As part of the conditional approval of the Pfizer/BioNTech COVID-19 vaccine, more data is to be provided as it becomes available. It is anticipated that further data will be provided on durability of the immune response post vaccination in coming months.
Is there a link between COVID-19 vaccines and blood clots?
No overall increase in risk of blood clots (thromboembolic events) are associated with the COVID-19 Vaccine AstraZeneca. Both the WHO and the European Medicines Agency (EMA) have stated that given the proven effectiveness of this vaccine, the benefits of COVID-19 vaccination outweigh the risks of these possible rare side effects. COVID-19 disease results in clotting problems, which can be fatal. No causal link with clotting problems and this vaccine has been established.
Very rare cases of blood clots associated with low levels of platelets (thrombocytopenia) were reported following vaccination. After 20 million doses of this vaccine were given in the UK and Europe, seven cases were reported of blood clots in multiple blood vessels (disseminated intravascular coagulation, DIC) and 18 cases were reported of clots in blood vessels draining blood from the brain (CVST). The rate of these very rare events was slightly higher in than the pre-COVID-19 background rates: based on the pre-COVID rate, less than 1 case of DIC and 1.35 cases of CVST would be expected over a similar time period.
No safety signal of concern has been shown for venous thrombosis as an adverse event of special interest being monitored globally for all the COVID-19 vaccines. No increased risk has been identified for the Comirnaty, mRNA COVID vaccine (Pfizer/BioNTech) either, after tens of milliions of doses have been given worldwide.
Can mRNA COVID-19 vaccine affect fertility or affect future babies?
There is no biologically plausible reason why this vaccine could have any effect on our genes or fertility. Upon injection, the lipid nanoparticle containing the mRNA is taken up by specialised cells (dendritic cells) at the injection site in the arm. These cells use the instructions from the vaccine mRNA to make only the SARS-CoV-2 spike protein and the mRNA degrades rapidly. The mRNA from the vaccine does not enter the nucleus of any cells. Furthermore, no components of the vaccine or the spike protein produced reach the ovaries or the testes. More information about how this concern arose can be found here.