Saturday, November 27

Health experts say talking about vaccination targets is pointless

Countries around the world are beginning to envision a future living with Covid-19 as vaccination benchmarks are reached.

Hundreds of people have started arriving for a mass vaccination event for essential workers at TSB Stadium in New Plymouth this morning.  The Taranaki DHB expects to inject nearly 7,000 people at the New Plymouth and Hāwera clinics over the weekend.

A mass vaccination event at TSB Stadium in New Plymouth last month.
Photo: RNZ / Robin Martin

But is there a magic number and when will New Zealand reach it?

For critics of New Zealand’s pandemic response, Denmark is the bright new kid on the poster.

The Scandinavian country has now lifted restrictions after vaccination rates surpassed 80 percent of those 12 and older.

The two countries have their similarities: the size of the population for one.

Denmark even had the altruism to provide 500,000 doses of the Pfizer vaccine so that the launch of the vaccine in New Zealand can advance at the pace that previously threatened to see us running out of the vaccine, or with the need for us to “reduce demand” in terms governmental.

Based on current vaccination rates, it is possible, and perhaps even plausible, that New Zealand could achieve 80 percent coverage of our eligible population this year.

So what does that mean?

Evolutionary virologist Dr. Jemma Geoghegan, a senior professor at the University of Otago, said the idea of ​​vaccine benchmarks should be treated with caution.

“Data from the UK suggest that 95 per cent of the population have some level of immunity to the virus, either through vaccination or from a past infection. They are still experiencing around 150 deaths a day from this coronavirus and this it’s during the summer. “

The British experience could provide clues as to how the virus would behave here if restrictions were lifted even after high vaccine coverage.

If the current death rate in the UK were comparable to what New Zealand might expect, it would translate to more than 3,500 deaths a year in New Zealand.

That would be more than car accidents, suicides, breast cancer, prostate cancer, melanoma, and diabetes combined.

Denmark had recorded 2,600 deaths from Covid-19 and was still seeing daily deaths.

Virologist Jemma Geoghegan from the University of Otago.

Dr. Jemma Geoghegan says the idea of ​​vaccine benchmarks should be treated with caution.
Photo: University of otago

“It may be that people abroad have become desensitized to it, because at one point it was much worse than it is today,” Dr. Geoghegan said.

“If we got to the point where we have so many deaths a day, I think it would be very difficult for the people of New Zealand to accept.”

At the current rate, the Danes could expect around 1,000 deaths a year, and their restrictions had just been lifted.

The other problem in New Zealand was vaccine equity.

Based on current vaccine equity rates when 80 percent coverage was reached for the general eligible population, only 55 percent of eligible Maori would have received two doses.

Te Rōpū Whakakaupapa Urutā co-leader Dr. Sue Crengle said that if that disparity persisted during the launch, then lifting restrictions at that point would not only be catastrophic for Maori, it would be unethical.

Te Pūnaha Matatini’s research showed that a 44-year-old Maori person was at the same risk from Covid-19 as a 65-year-old Pākehā.

Inequality in lifting restrictions would be further compounded by the disproportionately young Maori and Pasifika populations, Dr. Crengle said.

“In rare circumstances, children die from Covid, number one. Number two, there is a very rare complication of Covid called Multisystem Inflammatory Disorder, which is very unpleasant in children; it is very rare, but it still happens. And then, number three … about 8 percent of children would have Covid longer. “

Last week in the UK, Covid deaths rose to their highest rate since March and deaths from all causes were 8.7 percent higher than in the corresponding weeks of 2015 to 2019.

For the week the most recent data was available, 20 per cent of all Covid deaths in the UK occurred in people aged 64 and under, with the youngest victim between one and 14 years old.

Professor Nick Wilson

Professor Nick Wilson says that until we have a sterilizing vaccine, we may need to continue with the elimination strategy.
Photo: RNZ Insight / John Gerritsen

Such factors were why Professor Nick Wilson, a public health expert at the University of Otago, said we had to be prepared for some restrictions until at least tweens could get vaccinated, and potentially beyond.

“Things like prolonged Covid can be very serious conditions, there is even a certain risk that they are for life. So when you think about that kind of thing, it means that the amount of health loss in a society could really grow.” .

That’s why some changes in behavior are likely to remain for the foreseeable future, and only the development of a vaccine that provides sterilizing immunity will allow a return to normal for 2019, he said.

“It may be that we are in the long term to maintain the elimination strategy until we have a sterilizing vaccine; it is completely effective, like the measles vaccine, and it does not spread. Coverage and it would not need to have other control measures.

“So the world should really put forth a huge effort – and it is, we’ve made great strides with vaccine technology, but that’s the vaccine we want. A completely effective one where there is no transmission when someone is exposed.”

None of the current crop of vaccines fits that bill.

Wilson said New Zealand was not the only area pursuing an elimination strategy, as China, Hong Kong, Taiwan and several Australian states were also going down that path.

New Zealand’s response meant not only that it had had far fewer Covid deaths than other countries, but that its economy had overtaken most of the OECD and the healthcare system was also able to recover well from the lockdown, he said.

Denmark also had some degree of travel restrictions and the use of masks in certain situations, so the situation had been exaggerated, Wilson said.

“They will have children who will get sick from Covid and possibly suffer very long-term consequences,” he said.

“I think that just as it would have been a mistake to copy Sweden last year, it would be a mistake to blindly copy Denmark today.”

Covid-19 modeler Professor Michael Plank said, in a nutshell, that when it comes to vaccination rates, there is no magic number today.

“I think we should aim to get as close to 100 percent as possible. We are not going to get to 100 percent, but we should aim to get as high as possible and the greater the vaccine coverage, the better we will position ourselves.” in which we will be, the more options we will have and the better protected we will be against the health impacts of Covid-19 “.

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