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IMAC: Supporting vaccination in the Pacific

Initiative type:
Project
Sector:
Public Health
Website:
UniServices Contact:

Opportunity

Vaccination logistics are complicated at the best of times. Add in long distances, hot climates, closed borders and telecommunications limitations, and you get an idea of what had to be overcome to vaccinate Pacific Island countries against Covid-19.

The Polynesian Health Corridors programme, led by the New Zealand government to support better health outcomes in the Pacific, had been running prior to the pandemic, but Covid-19 focused attention on protecting these countries from the novel coronavirus.

The Ministry of Health contracted the UniServices-managed Immunisation Advisory Centre (IMAC) to provide Covid-19 vaccination education and support to health professionals not only in Aotearoa but also in seven Pacific countries – Cook Islands, Fiji, Niue, Samoa, Tokelau, Tonga and Tuvalu.

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Ellaine Ete-Rasch (third from left) and vaccinators in Samoa

Training the trainers and keeping vaccines cold

IMAC’s role in the Pacific focuses on vaccination training and support for the Comirnaty (Pfizer) vaccine. However, closed borders during the height of the pandemic forced much of the training to go fully remote. Local conditions also presented challenges.

“The internet connections on some of the islands did not permit everyone to use Zoom or in some cases to access the online learning platform at all,” says Moelagi Leilani Jackson, IMAC’s Pacific Islands programme manager. “We used a train-the-trainer approach where countries would select their leads, we’d train them, and they’d train the nurses who didn’t have access to the internet.”

IMAC shipped over equipment in advance to ensure learners had access to the items being demonstrated. It also provided printable materials.

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bernadette heaphy on ship with container freezer
“Being able to get [vaccines] there in the ultra-cold state is a huge gain for the Pacific Islands in terms of having more transport time to their outreach centres. It’s pretty cool, literally.”
Bernadette Heaphy,
IMAC cold chain lead

Working out how to keep vaccines cold was another challenge. For long-term storage, the Comirnaty vaccine must be kept at the ultra-cold temperature of -70 Celsius.

Initially, vaccines bound for Tokelau – the most isolated of the seven countries – were transported on a chartered naval ship, in a -20-degree freezer. Subsequently, a process to transport vaccines by flight and chartered boat was found to be possible with the vaccine stored at -70.

“Being able to get it there in the ultra-cold state is a huge gain for the Pacific Islands in terms of having more transport time to their outreach centres,” says Bernadette Heaphy, IMAC’s cold chain lead. “It’s pretty cool, literally.”

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Performance

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As of September 2022, IMAC’s Pacific programme had trained more than 850 healthcare workers, whether remotely or face to face, and supported the delivery of over 350,000 doses of paediatric and adult Comirnaty vaccines.

In the countries where IMAC works, more than 98 percent of the eligible population aged 12 and over has received at least two vaccine doses.

While other organisations supported the administration of other vaccines, IMAC contributed to the low Covid death rate in most of the countries.

“There has been a lot of learning both ways. It has been a pleasure helping nurses in the Pacific build on their strengths to support people in their respective countries during this pandemic.”

Ellaine Ete-Rasch, IMAC nurse educator

In addition to continuing to support Covid vaccination through professional learning and regular communications, IMAC is moving into supporting the Pacific with other vaccination programmes, such as for measles and standard childhood immunisations.

“There has been a lot of learning both ways,” says IMAC nurse educator Ellaine Ete-Rasch. “It has been a pleasure helping nurses in the Pacific build on their strengths to support people in their respective countries during this pandemic.”

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IMAC vaccinator training in Samoa
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