Doctors are struggling to determine which of their patients is sufficiently immunocompromised to be eligible for a third primary dose of the Covid-19 vaccine.
Between 10,000 and 20,000 New Zealanders are estimated to be eligible, according to the Royal New Zealand College of GPs, but strict Department of Health criteria mean patient records must be checked before getting the green light. .
“There are some very easy to identify people who are taking ‘X’ drugs or who have had a kidney transplant, we know these numbers and have them in our books,” said Dr Samantha Murton, college president and physician. Wellington general practitioner.
“These are the nuanced drugs prescribed by a clinician in the hospital, or it may depend on when they received their vaccine versus certain drugs,” she said.
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Group 3 of the vaccine rollout included anyone with an autoimmune disease or taking drugs that suppress immunity, but the third dose is limited to people with severe immunosuppression, such as people with HIV or taking very specific drugs. .
The Covid-19 Technical Advisory Group recommends that people aged 12 and older who are severely immunocompromised receive a third primary dose of the vaccine, Dr Ashley Bloomfield said. (First published October 19, 2021)
Murton said his central Wellington practice had a list of 30 out of 3,500 patients considered eligible. “And it took a bit of effort to go through all the lists and all of the medications.”
Thing spoke to several GPs, all of whom said they were still working to identify eligible patients. They said people should contact their doctors if they thought they could do the trick.
One obvious candidate is Cromwell’s wife Jo McKenzie McLean – in her 39th week of chemotherapy for stage four bowel cancer. Specialists recently found spots on his lung.
âIt’s going to be a big fight,â said McKenzie McLean, who is a Thing journalist in the South Island.
Since her immune system was under constant attack from cancer drugs, catching Covid-19 would affect her ability to handle chemotherapy. Deciding to pass with a third jab was easy, she said.
“I’ll be screwed if I beat cancer just to have Covid kill me,” she said. “I am already facing a fight for my life anyway, I am willing to risk the side effects of a vaccine that I trust.”
McKenzie McLean was planning to have her third dose on Friday between cancer treatments.
The restrictions were overly cautious, said Dr Nikki Turner, director of the Immunization Advisory Center.
âOn an individual level, you don’t know how they’re going to react. There is some evidence for this, but it is small numbers, [most] data is for two doses and one booster.
Third injections are considered off-label, not approved by MedSafe, and only accessible under Section 25 of the Medicines Act. Thus, to access a third dose, patients must give their informed consent and obtain a prescription from a general practitioner.
Third doses are not considered boosters and are separate from the rollout of booster injections for the general population.
This is because severely compromised people are not considered fully vaccinated until they have received three doses because their response to the vaccine is weakened.
Therefore, anyone ready for a third dose would still be eligible for a booster six months after their third dose, Turner said. âSo instead of two, plus one, they’ll have three, plus one. “
Primary health organizations and district health boards were helping identify patients, but if people were unsure, they should ask their GPs, she said.
The Department of Health did not respond to requests for comment.
How do I know if I am eligible?
The eligibility criteria for a third primary dose were divided into four groups. The first includes people born without complete immune defenses, people with HIV or AIDS, people who had leukemia in the 12 months before vaccination, or anyone who received stem cell therapy in the past two years. .
The second group includes anyone who, in the six months prior to vaccination, received either: immunosuppressive therapy for a solid organ transplant, chemotherapy, radiation therapy, or targeted therapy for autoimmune diseases.
The third and fourth groups cover people who took high dose steroids in the month before vaccination; or long-term steroids, high dose immunosuppressive drugs, or a combination of certain immunosuppressive drugs in the three months before their vaccine.
Clarification: This story has been edited to indicate that anyone in the second group who has received immunosuppressive therapy for a solid organ transplant, chemotherapy, radiation therapy, or targeted therapy for autoimmune diseases is eligible. (November 22, 10:50 a.m.)