Covid 19 Delta outbreak: Auckland GP says vaccine booster shots for frontline workers urgently needed

An Auckland GP is calling on the Government to urgently allow frontline workers to receive their third dose of the Covid vaccine.

Dr Roy Knill, GP and director of CityMed in Auckland, says primary care workers in New Zealand need urgent protection, as their immunity will be waning from the first two doses of the vaccine, which they were one of the first groups to receive.

The medical practitioner says guaranteeing the safety of frontline workers is paramount as New Zealand moves away from its elimination strategy.

In a letter sent to Health Minister Andrew Little and Minister for Covid-19 response Chris Hipkins, as well as Associate Minister of Health Dr Ayesha Verrall and director general of health Dr Ashley Bloomfield, Dr Knill calls on the Government to allow the booster shots to be administered as a matter of urgency.

“There is very strong agreement that as many of us were vaccinated over five months ago, we urgently need the added protection that a third dose will provide,” Dr Knill wrote.

The GP cited the case of Israel, where administering a third dose, after an early aggressive vaccination campaign, proved effective in adding a layer of protection for the population, faced with a new wave of infections.

“Israel mounted an early aggressive Pfizer vaccination campaign. Delta struck at a time when many of those vaccinated had been vaccinated more than five months previously. When research showed that those who had been vaccinated earlier were three times more likely to get infected than those vaccinated more recently, Israel offered a third dose to everyone over 12 years old. Subsequent evaluation showed that two weeks after more than 1.1 million over 60s had received their third dose, they were 11.3 times less likely to become infected with delta,” the GP wrote.

“Third doses were also found to stimulate higher levels of neutralising antibodies meaning that they were much less likely to pass on the virus which is critical to reducing the R value,” he added.

Knill says data shows “third doses are highly effective at preventing people from getting Delta ” and “people infected with Delta were much less likely to transmit it”.

“Overall, third doses were thought to be not just an immune refresher but an immunological upgrade,” he added.

It has now been six months since GPs and their staff were vaccinated in New Zealand, in February and March, during the initial stages of the rollout. The GP says “it is likely that antibody levels are starting to drop”.

“GPs are an ageing workforce and many of us have underlying medical problems. Also many have unvaccinated children under 12 years old at home who are vulnerable,” he wrote.

Knill believes GPs will play a central role in easing the pressure Delta is expected to add to the hospital system.

“As case numbers in the community grow there will be increasingly complex medical situations to manage and GPs are the only community based specialists who have the training, experience and ability to manage this complexity . Also we have long-term relationships with our patients and know their medical histories. Every case that can be managed in the community takes the pressure off the hospital system,” he wrote.

'Sidelined and ignored'

Knill’s letter included scathing criticism of the Government’s failure to engage with community doctors during the vaccine roll-out, describing it as a missed opportunity.

“We know our patients’ medical problems and their ethnicities and earlier engagement with general practice could have seen us with 90 per cent full vaccination rates today,” he wrote.

“General practices are the community based experts in vaccine delivery and we have trusted one-on-one relationships with our patients that can be used to influence vaccine decisions, it is a core competency and yet we were sidelined and ignored in this roll-out. Aucklanders, of whom I am one, are now paying a big price for this error of judgement.

Knill told the Herald the issue is now “urgent”, particularly in Auckland where Covid continues to spread through the community.

“It is becoming a circus trying to manage patients in general practice now, let alone what could be ahead,” he said, adding that GPs are currently “being forced to tip unused Covid vaccines down the sink if not used”.

New Zealand has 160 new cases of Covid-19 today, a new record since the outbreak began.

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