With the looming ‘no jab, no job’ vaccine policy for the education and health sectors, the process to issue vaccination exemption certificates is still non-existent – and doctors are being asked to keep out of it.
On Friday the 15th of October, Waitemata DHB issued a message via Medinz stating that there is almost no medical reason to issue vaccination exemptions and requesting that they be not issued.
New Zealand does not yet have a formal vaccination exemption certificate so this can be interpreted as the DHB asking doctors to not write exemption notes for their patients.
“The Immunisation Advisory Centre (IMAC) are in active conversation with the Ministry of Health about vaccine exemption certificates in the rare instance these may be required and they are developing a process. We will provide an update when this is available. In the interim, clinicians are requested not to issue exemptions. It is important to note that there is almost no medical reason to issue such an exemption.”
According to the DHB, even patients who experienced serious reactions to a first dose of the vaccine shall not be exempt from further doses. Instead, clinicians are advised to refer such patients to the high-risk vaccine clinic where they can be “successfully vaccinated under Immunology supervision”.
Mercifully, those who develop myocarditis or pericarditis attributed to their first dose of the vaccine are advised to defer further doses, although without any official vaccine exemption certificate it remains unclear how these people will work in the health and education sectors, let alone board an aircraft to leave New Zealand once airlines have implemented their ‘no double jab, no fly’ policy.
Our omniscient DHB goes on to suggest that a request for vaccination exemption could mean that the patient needs some counselling;
“If you are asked for a COVID-19 vaccination exemption, it is important to explore the reasons why the request has been made and to try to resolve any anxiety that the patient may have to support them to be vaccinated. Their reasons may be complex, and a request for an exemption may reveal other anxieties about work or home that may need further counselling and support.”
In other words, people requesting a vaccination exemption are likely to be neurotic anti-vaxxers who need mental help. Too bad if you happen to be one of the many New Zealanders suffering from serious side effects from a first dose of the vaccine.
We are now a little over 1 month away from tens of thousands of New Zealanders requiring vaccination to keep their jobs, yet there is still no process in place for doctors to issue official exemptions on medical grounds. Another day, another example of New Zealand being #ledbydonkeys.
See the Full, Unedited Message Below.
Published by Auckland, Counties Manukau and Waitemata DHBs on 15/10/2021 4:18:30 PM.
Following the recent vaccine mandate announcements, Primary and Urgent Care clinicians are likely to be fielding requests for vaccine exemptions.
The Immunisation Advisory Centre (IMAC) are in active conversation with the Ministry of Health about vaccine exemption certificates in the rare instance these may be required and they are developing a process. We will provide an update when this is available.
In the interim, clinicians are requested not to issue exemptions.
It is important to note that there is almost no medical reason to issue such an exemption.
Those with known PEG (poly-ethylene glycol) allergies or who have experienced serious reactions (eg anaphylaxis) to the first dose of Comirnaty should be referred through to the high-risk vaccine clinic using a standard E-referral to Immunology at ADHB. These patients are being successfully vaccinated under Immunology supervision.
Rarely, the first dose of Comirnaty may be delayed in patients with active/recent carditis or extensive immunosuppression. This should be done in consultation with the relevant specialty and IMAC.
People who develop myocarditis or pericarditis attributed to their first dose of Comirnaty are advised to defer further doses. They should be referred to IMAC for clinical advice about alternate vaccine options.
If you are asked for a COVID-19 vaccination exemption, it is important to explore the reasons why the request has been made and to try to resolve any anxiety that the patient may have to support them to be vaccinated. Their reasons may be complex, and a request for an exemption may reveal other anxieties about work or home that may need further counselling and support.
Patients with a history of multiple allergies and anxiety can be safely vaccinated in the community. It is recommended they are observed for 30 minutes post vaccination.
Those with needle phobias or anxiety can be supported to be vaccinated in the community. Please see the Needle Phobia and Vaccination HealthPathway for further guidance to manage these patients. This pathway is in the process of being localised for the Auckland region and in the interim can be used to manage these patients.
IMAC is available for any clinical vaccination queries on 0800 466 863.
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