‘Huge buzz’ for Great Barrier Island general practice to roll out COVID-19 vaccine to all islanders

“I think it’s an indicator for the mainland, to be honest. Where you’ve got general practice with a strong connection with the community, I would expect we would see similar immunisation rates”

The general practice on Great Barrier Island (Aotea Island) stepped up to the challenge of providing COVID-19 vaccination to the whole community in one go.

Aotea Health co-owner Leonie Howie says vaccinating about 500 residents in last month’s day-and-a-half clinic gave the health team “a huge buzz”.

“Because (a) we were allowed and (b) when it was it all over we felt this was such a positive thing we could do for this community as a whole,” says the veteran rural nurse specialist.

The island’s first 600 doses were flown in with a security guard escort in late May.

“And the police had to meet them at the airport and bring it up to me at the health centre to sign it in,” says Mrs Howie.

“I don’t know if they knew that the [distance] from the plane to the health centre is 50m,” she laughs. “Or they wouldn’t have thought about having the policeman!”

The island’s kuia and kaumata were invited to be amongst the first 35 residents to receive the vaccine during a clinic with DHB nurse support on Thursday 27 May.

The practice team then set itself up to deliver 500 vaccines over the Friday and Saturday morning at a rate of 10 patients every 10 minutes. “That’s a pretty fast pace,” says Mrs Howie. “And it all thankfully went as smooth as a tick.”

Stuart Jenkins, a GP and primary care clinical director for Auckland and Waitematā DHBs, praised Aotea Health’s “clearly very effective” vaccination campaign as a “tremendous success”.

“The key thing about Aotea Health is the strong sense of community trust and visibility and that’s particularly helpful when mobilising the entire community within a short time frame,” says Dr Jenkins.

He says it was decided to immunise the whole population at once as a remote island is at higher risk with a pandemic and the island has a high proportion of people with high needs.

It has an enrolled population of around 1150 patients, with about 950 of those aged over 18. Dr Jenkins says the aim was to immunise around 60 per cent, or a little under 600 people, which had been achieved.

“I think it’s an indicator for the mainland, to be honest. Where you’ve got general practice with a strong connection with the community, I would expect we would see similar immunisation rates.”

The Northern Region Health Coordination Centre’s vaccination programme director, Matt Hannant, says the centre was pleased with how many residents took up the opportunity.

He says the whole-of-community approach optimised the number of people vaccinated in a remote rural community, and reduced the risk of waste because of the vaccine’s complex logistics.

Mrs Howie says the practice, when planning the campaign, was very aware that island residents often don’t respond to text messages or are unable to receive them.

So the practice’s administration leader rang everybody she could, up to three times if they didn’t answer, to offer them the opportunity to have the vaccine.

It also publicised the vaccine availability in the local paper, radio station and on the Barrier Chitchat Facebook page with a focus on caring for the community.

“So [getting vaccinated] was not necessarily an individual decision but a community decision to keep us safe,” says Mrs Howie.

The practice also organised a bus to bring people from the north of the island to the main health centre clinic.

Having ordered 600 vaccines, the practice was concerned it would have to arrange the return of unused vaccines after the initial clinic. Mrs Howie had offered to fly them back herself to ensure the cold chain was maintained.

But in a piece of “perfect timing”, the decision to allow practices to store defrosted vaccine for 31 days, rather than five, meant they were given permission to keep the unused doses on the island.

That allowed Aotea Health to offer a mop-up clinic this week, including the nearly 70 people who were off-island during the main clinic sessions.

She says any island resident who missed either clinic was aware that, if they wanted the vaccine in the future, they would now need to get it done on the mainland.

“I don’t think we’d get the opportunity to bring it over again. It’s just too difficult. Cold chain is very difficult on an island.”

Mrs Howie says Aotea Health is delivering the second dose next week to the 500 people vaccinated in the first mass clinic.