Free flu shot not for all
With hospitals under ‘‘extreme pressure’’ from influenza and respiratory illnesses this winter, should we (and could we) vaccinate everyone against flu this year?
Yesterday, Pharmac announced it was permanently widening funded access to the flu vaccine for people with specific mental health conditions and/or addictions issues, and children aged 3-12, for the rest of the 2022 flu season.
Hospitalisation rates for severe acute respiratory infections over the past two weeks exceeded rates for this time of year over the previous seven years – but only half the available flu vaccine stock has been used.
Epidemiologist and University of Otago (Wellington) Professor Michael Baker praised the ‘‘proactive’’ move to widen funded access, but said it did raise the question of ‘‘why not make it free for everyone?’’ – particularly given the pressure on the health system.
To date, 21% of New Zealanders have had this year’s flu vaccine; including 65% of those over 65.
While there is a 75% target for those over 65, the Ministry of Health would not give a target figure for the total population.
Funded access for Māori and Pacific people aged 55-64 was also widened this season: 29% of Māori in this age group and 32% of Pacific peoples have had their flu shot.
Baker said vaccinating more children was positive, given tamariki can get very unwell, and are very good at transmitting influenza.
Meanwhile, healthy adults tend to be at lower risk of severe disease and complications than young children and those over 65, which Baker thought could be part of the reason eligibility wasn’t widened further for this group.
Professor Nikki Turner, Immunisation Advisory Centre director, thought it was ‘‘worth considering offering [the flu vaccine] to everyone’’, but noted there would be ‘‘significant’’ logistic issues involved.
‘‘If you’re going to broaden to more adults, you need to broaden access,’’ she said.
Some countries offer flu
vaccines to their whole population – ‘‘and I think that would be excellent’’ – but Turner was concerned it could be the ‘‘worried well’’ who get vaccinated over those in greater need.
There were other groups who could benefit from funded flu vaccines instead, particularly children under 5 who face ‘‘huge’’ burden from severe flu; and close contacts and family members of high-risk people, Turner said.
Infectious diseases physician and University of Otago Professor Kurt Krause said we needed to understand there’s only so much that can be done, so targeting those most vulnerable was critical.
‘‘Of course, you want to be able to do everything for everyone,’’ but there isn’t infinite resources, so you ‘‘want to be careful you make the most of the precious healthcare dollars we’ve got’’.
Pharmac’s director of operations Lisa Williams said there was not enough stock to widen access to all New Zealanders. Two million doses have been secured this season.
While Pharmac wouldn’t usually change access criteria partway through the season, it did so because only about 1 million doses had been used so far, Williams said.
At current usage rates, Pharmac expects about 400,000 doses would not be used by the end of the season, Williams said, and they want these to be put to ‘‘good use’’. The decision to include tamariki was made based on clinical advice, available stock, and likely uptake, she said.