14 March 2022 Covid 19 Novavax Vaccine Letter V1.1

All District Health Boards 14 March 2022 Dear PHO Chief Executive Officers COVID-19 Immunisation Services through General Practice On 30 November 2021 Joanne Gibbs and I wrote to you outlining the funding rates and requirements for the expansion of the COVID-19 vaccination schedule to include the use of AstraZeneca as a primary course and the use of a third dose of BioNTech/Pfizer (Pfizer) COVID-19 vaccine as a booster.

The Government has now announced: • the introduction of the Novavax COVID-19 vaccine as a new addition to the vaccination schedule for primary course vaccination against COVID-19 Novavax COVID-19 Vaccine The Government’s COVID-9 Vaccine Implementation Programme will continue to use the Pfizer vaccine as its primary vaccine, and this has, to date, only been supplemented by the AstraZeneca vaccine which is available at a limited number of sites.

From 8 March 2022, two doses of the Novavax COVID-19 vaccine will be added to the schedule of approved vaccines for COVID-19 primary course protection and as such will provided as an alternative to the Pfizer vaccine for people who are: • •

unable to be vaccinated with the Pfizer or AstraZeneca vaccine, especially those who are required to be vaccinated by the Vaccination Order or their employer; or those hesitant to take an mRNA vaccine

Consumers may seek a consultation from General Practitioners or Nurse Practitioners to gain advice regarding the suitability of the Novavax vaccine for them and where necessary obtain a prescription for free should they wish to receive the vaccine in an “off-label” fashion. They will then book themselves into a clinic offering this vaccination option using Book My Vaccine, or by ringing Healthline. Booking availability is from 10 March 2022, and doses will be available to administer from 14 March 2022.

The Novavax COVID-19 vaccine is approved for use by Medsafe for consumers 18 years or over, as a two-dose course and as such does not require a prescription when used in this fashion.

If, however a consumer has become hesitant to receive a second primary dose of the Pfizer or AstraZeneca vaccine and wishes to receive a dose of the Novavax vaccine as a substitute this can also be achieved by a prescription to reflect its “off-label” use.

Vaccination settings providing the Novavax vaccine will all be able to prescribe to consumers and as such the number of settings will be constrained.

When consumers present to a General Practitioner, or a Nurse Practitioner to consult over an “off label” use of the vaccine, it is expected that the Practitioner will issue the prescription as part of this consultation when it is deemed appropriate for the consumer to receive the vaccine in this fashion.

All consultations regarding the suitability of any of the Ministry approve alternative vaccinations will be subsidised at $60. It is believed that this level of remuneration is commensurate with the effort required to deliver the services.

All Di st ri ct He a lt h Bo ar ds PO Box 23075 Wellington 6140

04 801 2430

The claiming conditions for this service requires there is: • no charge/patient co-payment for this service, including issuing a prescription if required • no claim for a GMS clawback • no simultaneous claim against any other funding stream for this service.

For the avoidance of doubt, all services provided under COVID-19 funding stream can be claimed as individual items, for example: the consultation, the vaccination and the vaccine certificate.

All guidance issued by the Ministry of Health must be followed, including obtaining a signed consent form where required.

Consultation coverage for Medical Exemptions and Adverse Events As stated in the letter dated 20 November 2021, in some situations workers under a government mandate to be vaccinated in order to continue frontline services and safeguard vulnerable populations may be able to get an exemption from being vaccinated against COVID-19. However, there are very few situations where vaccination is contraindicated and, as such, medical exemptions are rarely required.

The Ministry and DHBs acknowledge the paperwork required for medical exemptions in comparison with other COVID-19 consultations. All medical exemptions that can be submitted without a patient examination are funded at $60. All medical exemptions that require a patient examination are funded at $120.

The Ministry has emphasised the need for effective assessment of adverse reactions following COVD19 vaccination to manage very rare serious reactions. All suspected COVID-19 vaccine-related adverse event assessments that can be submitted without a patient examination will be funded at $60. All adverse event assessments that require a patient examination will be funded at $120.

Payment Schedule The PPD for all COVID-19 vaccination events have been aligned to the original pricing framework and requirements undertaken to support the implementing the Pfizer vaccine.

The fees associated with these COVID-19 vaccination events are shown in Table 1 below: Table 1:

Payment Schedule (excluding GST)

Event

Price Per Dose Fee ($) Standard Hours

Primary Course vaccination from the published approved list of COVID-19 vaccines Booster vaccination(s) with any vaccine from the published list of COVID-19 vaccines Extended Primary Course doses: 3rd or any additional dose required for effective coverage of at-risk people as covered in the published Immunisation Schedule specification.

Out of Hours

Consultation Fee ($) Standard

Complex

36.05

48.72

60

36.05

48.72

60

36.05

48.72

60

-

-

Event

Price Per Dose Fee ($) Standard Hours

Medical Exemption, Adverse reaction, or other COVID-19 specific consultation expressly covered by the Ministry’s published COVID-19 management protocols.

-

Out of Hours

Consultation Fee ($) Standard (No

Complex

Patient Exam)

(Patient Exam)

-

60

120

These amounts are currently contained in both the GP and the PHO Service Specifications related to COVID-19 Vaccinations, and as such require no variation in order for claims to be made.

If you have any questions, please contact your local DHB portfolio manager.

Yours sincerely

Dr Nick Chamberlain Chief Executive, Northland DHB Lead DHB CE for Primary Care and Public Health

cc:

GMs Planning and Funding, All DHBs Primary Care Portfolio Managers, All DHBs

Astrid Koornneef Director National Immunisation Programme Ministry of Health