Vaccine a health window
In the next few months New Zealand will start coronavirus vaccination in what may be the biggest mass vaccination programme ever. Primary care providers are very good at taking health interactions as an opportunity to do other things. For example, a baby’s six-week vaccinations is often an opportunity to discuss contraception. A repeat prescription becomes an opportunity for a blood pressure check.
During the past week I have asked GP representatives, academic professors and leading epidemiologists if there is an opportunity to piggy-back a meaningful health action alongside the coronavirus vaccination programme, and if so, what is that action.
Is it a simultaneous mental health question, is it height, weight and blood pressure checks or maybe a finger prick glucose test?
What single health interaction, ideally requiring low resources and giving the greatest population health benefits, could possibly be piggybacked on to this unique coronavirus vaccination programme?
I would note here that the workflow for vaccination already requires swabs, needles, syringes and the patient to be observed for at least 15 minutes on site after the vaccine.
Discussions with my colleagues at the Royal NZ College of GPs confirm that simultaneous health screening is already best practice with vaccinations.
They make the point that this is
part of the uniqueness of primary care that extends beyond just the act of vaccine giving. They also comment that there is no list of simultaneous activities associated with each vaccine, but that the opportunity varies with each patient because everyone is different.
The epidemiologists and academic leaders were intrigued by the potential opportunity. However, the overwhelming concern, quite correctly in my view, was that the coronavirus vaccination needs to be the prime objective and nothing be done to distract from that.
This was against a background of poor distribution of the flu vaccine in each of the past few years and
similarly for the measles outbreak.
One suggestion was to simultaneously finger-prick test for coronavirus antibodies (immediate results) as a measure of recent or past coronavirus infection.
This could also contribute to what is called post vaccination surveillance, that is, how do we know a population has produced antibodies to a vaccine?
This suggestion provoked a range of responses including issues around specificity and sensitivity (effectiveness of the test) and whether any resulting information would actually significantly influence policy.
I think overall this is a good debate
to have so that we can either put new policy into action while we have time or put aside a well canvassed discussion.
In the 1990s we missed an opportunity with population wide hepatitis screening from a blood test.
There is enduring disappointment that we didn’t take the opportunity then to piggy-back the diabetes test at the same time.
My sense is that we need to get the coronavirus vaccination programme right but let’s have the discussion.
is deputy leader of the National Party and a list MP based in Whanga¯ rei.