​While we see this demand come through the request for vaccine, please do contact us if you are planning something different from your standard approach (for example, drive-through vaccination). This is so we are aware of the changes and can provide support if required. It is important that centres continue to comply with the Vaccination Operating Guidelines Version 20 during this time. We are also being approached on a daily basis by the media and need to be aware of what all our sites are doing.
Please remember that any new sites or alterations to your current delivery model (i.e. expansion in size, moving from a fixed to drive-through site) must be approved by Waikato DHB, through your PHO, Midlands Pharmacy Group or the DHB CVIP Operations Team. 
Operating at Alert Level 4
Just a reminder of the specific requirements for vaccinating under Alert Level 4 and Alert Level 3 conditions. These are designed to make sure your staff and our community stay safe. Requirements are identical at AL3 and AL4.
On upscaling of bookings, please be aware this will have a downstream effect when levels change again and also when people are due their second vaccination in six weeks. It may create the need to cancel and rebook appointments, which is inconvenient and potentially upsetting for the public.
We have had feedback from the public that physical distancing is not always being adhered to and we encourage you to ensure your site is compliant with the attached government guidelines.
Key requirements

• All waiting areas should be set out so people can easily stay 2 metres apart.
• Patient flow should be managed to avoid bottlenecks or people bunching up outside a centre. The Ministry suggests a one-in, one-out process.
• One-way flow through the centre if possible.
• Masks required at all times – medical masks for staff and face coverings for patients. Please have a supply of masks on hand for patients if they do not have their own.
• N95 masks are not required for vaccinators.
• Support people only in cases where language, cultural or disability help is needed.

Please see the attached information from the Ministry of Health for full guidance.
Walk-ins
The requirement during AL4 is for no walk-ins with all appointments booked in advance. Walk-ins continue to be an issue for many sites and these need to be carefully managed. We appreciate there are circumstances where it is appropriate to accept a walk-in e.g. families arriving together.
It is clear from the actuals we see at the end of the day that vaccinations are considerably higher than planned bookings each morning through bookmyvaccine.nz. Please ensure you are vaccinating in a safe environment for everyone.
Access to CIR
As many sites have scaled up and brought in additional staff, please ensure everyone has completed the CIR training. CIR is a live database with strict privacy controls and logins or passwords should not be shared.
Please feel free to contact me or other members of the team for support if required. We are here to help and, like you, we want to support our whānau and community to be fully vaccinated in a safe environment.
Booking streams in NIBS
Waikato DHB is committed to ensuring we are supporting our most vulnerable communities and working towards making vaccinations as accessible as possible. This is why we are working towards absolute equity for our Māori and Pacific peoples.
Additionally, you will be aware people in customer/client-facing roles during AL4 are now included in the updated definition of Essential Workers (Tier 2C).
Across DHB sites we have set up separate booking streams in bookmyvaccine for both Māori and Pacific peoples and Essential Workers to ensure these people are able to get bookings ASAP. Should you wish to have these streams set up for your site, please contact your PHO, MCPG or Operations Manager.
 
Thank you all for your outstanding mahi. 

We wish to clarify the instructions in the advice around when a P2/N95 mask might be applicable.
As we are all in Alert level 4 the following principles of access to central supply for P2/N95 apply:
Health professionals who:

• are fit tested (note: this fit- testing requirement for access to Ministry of Health central supplies of P2/N95 is currently exempted to general practice teams for 14 days, although fit-testing is strongly encouraged as it provides significant understanding of correct use. Everyone should always fit-check* when donning P2/N95)
• are undertaking a clinical assessment or swabbing of symptomatic people (those with clinical symptoms consistent with COVID-19, including less common symptoms),
• and are in a close, confined (poorly ventilated) space with the patient.

*Fit Checking:
Each box of 3M particulate respirators has fit check instructions. To fit check the particulate respirator, users can either perform a positive-pressure or negative-pressure seal check:
 
·       A positive-pressure check means covering the mask with your clean hands and exhaling. If the seal is good, the respirator will bulge slightly. If not, that indicates that air is leaking around the edges of the respirator.

•   A negative-pressure check involves covering the mask with your clean hands and trying to breathe in. The mask should collapse slightly as you inhale. If it doesn’t you do NOT have a good facial seal. Readjust the respirator and repeat the fit check process.
  •          If you are unable to achieve a good facial seal do not proceed with the activity.

 
Red streaming of all undifferentiated respiratory illness is necessary.
Ideally your Red Stream includes:

• Separate workforce
• Separate entry/exit
• Separate bathroom and break /kitchen facilities
• Good ventilation
• For many practices this actually means the Red Stream assessment and swabbing will be occurring outside.
• When the patient is in a car, ensure ask they open the opposite window to create air flow before opening the window towards you

 
 
Ngā mihi
​

COVID-19 Health Supply Chain
COVID-19 Health System Response, Ministry of Health  l www.moh.govt.nz