COVID-19 VACCINATIONS

Has your organisation yet developed its strategy for the vaccination of children and young people in care? What about those transitioning from care, kin foster carers, non-kin foster carers, residential workers, transitions workers and social workers? Do you anticipate any challenges and in addition to the wider societal impacts, what are the specific health, relational, placement, foster carer recruitment and retention, and employment implications if take up is not high?

 With the news about the Pfizer and Moderna COVID-19 vaccine trials over recent days, an end to this global crisis is now maybe in sight. While there are still important questions to be answered about these drugs and safety approval processes to be gone through, some populations in some countries could be vaccinated as early as late 2020. There are also several more vaccines on the horizon. As well as the ongoing social and economic impacts of the crisis, given that the number of infections and deaths in the US and much of Europe are again rising, an effective and safe vaccine cannot come soon enough.

 However, while New Zealand and Australia and no doubt many or most other countries have placed orders for vaccines, there has been a lot of recent commentary about how much time it will take to get everyone in a particular country vaccinated. It would seem that could take us towards the end of 2021 or even 2022. In the meantime, according to a TV One interview yesterday morning here in New Zealand with Helen Petousis-Harris, University of Auckland Associate Professor and former chair of the World Health Organization Global Advisory Committee on Vaccine Safety, governments are likely to identify priority groups based on those who are:

·       most at risk with underlying health conditions;

·       health (and social?) care workers

·       most likely to become infected; and/or

·       the most likely to spread it.

 However, Petousis-Harris also warns that misinformation about vaccines could derail efforts. Indeed, the same media organisation reported in September that their TV One NEWS Colmar Brunton poll had found that “one in five Kiwis wouldn’t take a Covid-19 vaccine if one became available” (10% definitely not and 11% probably not). New Zealand is by no means alone in this with for example the Guardian reporting that in the UK a similar survey there found that the corresponding figures were as high as 16% and 16% respectively.

 Some may have legitimate concerns about the speed of the vaccine development and approval process, and indeed Big Pharma more generally. However, while child welfare organisations have to periodically deal with issues about individual children and for example the measles, mumps, and rubella (MMR) vaccine (and misinformation about a claimed link to autism originally arising from a discredited 1998 Lancet medical journal article), vaccine mistrust seems to be growing fast.

 This may also be associated with a decline in trust in political leaders, experts and scientists. Another article in last month’s Lancet medical journal entitled The online anti-vaccine movement in the age of COVID-19 (the irony) suggested that over 31m people now follow anti-vaxxing groups on FaceBook while 13m subscribe to similar channels on YouTube. As such, with friends’ feeds, shares, likes and algorithms, many people are now regularly seeing anti-vaxxing messaging, many of whom will rely on social media as their primary source of news and information.

 So why is this a particular concern for our care systems? Earlier this year just before COVID-19 (in the west) the American Journal of Preventive Medicine published a Canadian systemic review entitled Immunization Coverage of Children in Care of the Child Welfare System in High-Income Countries. The review assessed the international research evidence on immunisation coverage of children in care from 33 studies that met their inclusion criteria. The review called for the need for more high-quality studies on the issue (systemic reviews almost always do, although interestingly this one also recommended more qualitative research in order to better understand barriers).

 The researchers’ overall conclusion was that “in most contexts studied, children in care of the child welfare system experience inadequate and lower coverage than children who have not been in care”; they also remind us that children in care often have greater developmental, physical, and psychosocial needs than those not in care.

 Fast forward to today. COVID019 is a highly infectious disease. We have particular challenges around group living, the age profile of kin and non-kin foster carers, a likely range of views amongst parents and families (and children, young people, kin and non-kin foster carers and workers), some disaffected and/or disengaged children and young people, and the particular complexities in some instances around gaining informed consent. Add to that the impact of social media misinformation more generally, child welfare organisations will need to quickly, and sensitively, work through their issues, get advice, check whether their existing policies and processes are ‘fit for purpose’ for our new reality, and likely have to develop, implement and monitor a COVID-19 immunisation strategy. Do you agree? What challenges might your organisation face?

I’d love to hear your thoughts! You can email me at: iain@betteroutcomes.co.nz

Kia kaha (Stay Strong).

Iain