Vaccine wastage & advertising the bivalent Covid vaccine

Performative spending, destroying vaccines due to low uptake, and the national health system expecting vaccinations for health care staff despite also admitting it only lasts 2 months.

This is a story of numbers to illustrate that while Covid appears over, it still costs hundreds of millions and some of the spending appears disconnected to actual results.

In July 2022 the Department of the Prime Minister and Cabinet (DPMC) transferred the responsibility for advertising vaccinations to Te Whatu Ora/Health NZ - the national health system. The Unite Against COVID-19 campaign transitioned from DPMC to Te Whatu Ora on the 16th of November 2022.

In total DPMC spent almost $80 million on the Unite against Covid campaign, and over $45 million on Covid vaccination campaigns. This comes to over $125 million on just advertising if you’re counting. Here is a breakdown by month of the spend until it was transferred.

This presumably doesn’t include regions or iwi providers doing their own advertising or various enticements to get vaccinated - for instance by the end of June 2022, the former Canterbury district health board had spent $369,356 on free gifts to the public to get vaccinated.

And since being transferred to Te Whatu Ora/Health NZ - you can add a few more million to those totals.

In preparation for winter this year, Covid vaccination advertising ramped up from $230k in April, to hit over $2.9 million in May, alongside over $1 million for running the Unite Against Covid campaign over summer and preparing it for the winter campaign.

Meanwhile, from July 2022 to the end of May 2023 - over 5.5 million Covid vaccine doses were purchased by the government. Yet 4 million doses of the original monovalent vaccine were destroyed once the adult bivalent vaccine became available in March 2023.

What’s curious about this wastage is Minister of Health Ayesha Verrall admitted it was due to, “…public uptake of COVID-19 vaccines falling short of the volumes committed to under Advanced Purchase Agreements with vaccine suppliers. Many of the doses that expired in 2022/23 were purchased prior to the 2022/23 financial year, however data is not available giving a breakdown of the number of vaccines which were destroyed because they had expired vs vaccines which had become surplus to requirements.”

Uh isn’t that the same thing as if doses expired - it meant they were surplus as they hadn’t been used due to low uptake?

In early 2022 the government had brought forward purchasing agreements they’d made thinking they’d come up short in their 1st booster push:

Yet the opposite happened - the 1st booster saturation had already been reached by the time they were doing this, and the push for a 2nd booster, starting a few weeks later in time for winter 2022, fell short of expected uptake.

In an April 2023 financing memo to the Minister of Finance Grant Robert and Minister Verrall - the Ministry of Health noted they’ve underspent due to that lower uptake:

Covid vaccination costs & health care policy

Since the bivalent vaccine became available in March - 394,129 doses have been administered as a 3rd booster. While more bivalent doses have been administered overall - it’s now the default vaccination for any dose, I can’t find the total number of bivalent doses administer to date.

But I’d place bets that it’s far, far less than the amount Minister Verrall was told they bought - they were expecting a total of 1.7 million bivalent doses to arrive by the end of June:

The 1.7 million doses to June is, I’ll admit, less than the total eligible population for the bivalent booster dose:

But how long do these bivalent doses last? We might still be paying for, yet destroying, doses again as while the last set of boosters had lower than expected uptake, the same briefing to Minister Verrall noted this was also true of the bivalent doses internationally:

I wonder if they used last year’s review of the failed winter campaign at all - which also noted 2nd booster uptake was poor?

To administer those bivalent doses $55.7 million had been spent from the start of January to the end of April 2023. That’s out of $228.54 million which was initially provided for Covid vaccination for just the 1st 6 months of 2023.

The Covid tagged contingency fund of $1.202 billion from Budget 2022 had $58.396 million left in June this year ($385.780 million was reprioritised from it).

This amount of money is despite the newly released vaccination policy of Te Whatu Ora (for hiring new workers, not existing staff) which states that vaccination only provides protection for 2 months:

And vaccination is for your personal benefit now, they’ve stopped pretending it will have any credible impact on transmission (which was the public health justification used for vaccination mandates and vaccine passes):

While government mandates were dropped from the health sector in September 2022 - within the national health system (such as public hospitals) - they were retained as workplace policy.

The new policy states it’s still expected that health care staff who interact with patients have 3 vaccinations. So this is a 2 month vaccine that is required to go work within a hospital and it doesn’t matter when you had it (heck you could have had your primary course and then a booster over 18 months ago at this point).

What’s doubly ironic to me is that due to staff shortages when the health care mandates were dropped in September 2022, some of the 1st employers that started hiring back unvaccinated nurses were aged care residential homes. You know, the group that is most at risk yet the national health service refused to consider it!

The ‘go well’ and ‘choose well this winter’ campaigns

Requiring a vaccination that lasts for 2 months and has little effect on transmission, yet costs hundreds of millions while admitting no one wants them, showcases the poverty of ideas that the New Zealand health system has left.

Earlier this year, Te Whatu Ora scrambled to create a winter preparedness campaign consisting of 24 points to try to reduce pressure on the health system.

Before I go on, it’s now getting boring for me to say hey, guess who helped prepare the government’s winter plan?

Yup. A big 4 consultant, Deloitte.

It makes it a joke when the former chair said they were going to crack down on the $200 million consultant spend at the same time as getting them to run almost everything I’ve managed to find on Covid - and now beyond Covid.

The latest government campaign for winter, consists of household flyers and advertising saturating all types of media telling people over winter to stay home if sick, wear masks and be up to date on all available vaccinations.

Unlike the recent MMR campaign when they at least gave it a go to identify what they were trying to achieve - Minister Verrall said there are no estimated cost-savings or other tangible benefits from this winter media campaign.

She instead said its, “…impact will be across demand for primary care, pharmacy, community radiology, urgent care, telehealth usage, ambulance, ED presentations, length of stay and waiting times, ED patients requiring admission or other services, hospital occupancy and length of stay, readmission rates, consumer experience of discharge, and data on needs assessment and aged residential care availability.”

Frustratingly I haven’t come across any indication, so I naturally doubt, that any of those are being actively measured and monitored. What are the baselines? How can you tell what and how it worked and if it was a useful way to spend money?

Minister Verrall also said the media campaign is simply to “inform and encourage” people by giving useful information and phone numbers and websites.

This is in the same patronising to inane category that led the government to do a cost of living campaign- telling people to reduce their shower length. The total cost of that entire campaign was $2.8 million.

The cost of sending just the 'Go Well' flyers was almost $400k to 1.9 million households. This cost excludes any other advertising spend, people involved, or regional spending on the campaign but based on that above campaign I’d assume it would be a similar total cost. The accompanying ‘choose well this winter’ campaign even features 6 90 second videos telling people what to do if they feel unwell.

The tens of millions spend on the Unite Against Covid campaign - included wear masks, wash your hands, stay home if unwell - so if I use their logic - why is is still necessary to spend money on the same messaging? If it worked, why does it need to be said again? If it didn’t work, why is it okay to do the same messaging again?

It shows performative spending, further evidence of the sprawling spin and PR, that was always present, but has become more visible in Covid, replacing the work of government itself - as perception, not actual results, is more important.

The constant rising spend year on year without equally rising results (or even attempts at measuring the results) has no upper bound at this point - especially when so much of that money is put into consultants and advertising.

On that note - to check if people are still listening - more behavioral surveys on Covid restrictions, with a budget of $300k, are planned in 2023 too!