Update on the Third primary extension dose for immunocompromised individuals

November 2, 2021

Information taken from Medinz

Published by Auckland, Counties Manukau and Waitematā DHBs on 1/11/2021 11:30:44 AM.

Further to The Ministry of Health’s announcement that a third primary dose of the Pfizer COVID-19 vaccine is recommended for severely immunocompromised patients aged 12 and older, here’s some more information.

Temporary process

This service can only be accessed through a consultation with a General Practitioner (GP) or Nurse Practitioner (NP) to assess the patient and issue a prescription and complete the consent form, if clinically indicated.

This is a temporary process and will remain in place until the use of a third primary Pfizer dose for severely immunocompromised people has been approved by Medsafe.

Guidance and consent form

You’ll find Ministry of Health guidance (including the policy statement and criteria, an example prescription and the consent form) on HealthPathways: COVID-19 Vaccination Resources. There is an IMAC and Ministry of Health version of the consent form available on HealthPathways. You can use either form.

Attached is a revised CIR Quick Step Guide and an example prescription (also at the above HealthPathways link) and the draft algorithm (awaiting final Ministry approval), which outlines the process and associated funding – see HealthPathways: COVID-19 Funding and Supplies.

Funding

This is a fully subsidised service:

GP or NP consultation with eligible patient but patient declines: ($60 plus GST) Record the outcome as ‘declined third dose’ (date and category noted).
GP or NP consultation with eligible patient who initially declines but subsequently wishes to proceed with 3rd dose: virtual consultation ($60 plus GST) or in-person ($120 plus GST). Record the outcome as ‘signed consent form and prescription for third dose’ (date and category noted).
GP or NP consultation with eligible patient and patient accepts: virtual consultation ($60 plus GST) or in-person ($120 plus GST). Record the outcome as ‘signed consent form and prescription for third dose’ (date and category noted).
Patient calls GP or NP for consultation believing they are eligible but they are not: virtual consultation ($60 plus GST). Record the outcome recorded as ‘virtual consultation but not eligible for third dose’ (date noted).

Conditions of claim

All the following conditions must be met:

Clinical notes must be provided.
No charge/patient co-payment for this service, including issuing the prescription.
No claims for clawback.
No simultaneous claiming against any other funding stream for the same activity.

Please note, you do not need to be an accredited COVID-19 vaccinating practice to claim this fee. However, if you are authorised and do provide the vaccination, the PPD POAC vaccine event fee will be paid in addition to this subsidy.

POAC process

Please submit a referral via a POAC form within PMS, using the following code from the dropdown box: ‘COVID-19 Vaccination – third dose for immunocompromised patients’ and include one of the following in the free text box as appropriate:

Include the consultation date and the immunocompromised category (see below), or;
Include the consultation date, the immunocompromised category (see below) and notes showing the consent form and prescription have been completed, or;
Include the consultation/contact date but that the person was not eligible.

Select the appropriate immunocompromised category:

Patients with primary or acquired immunodeficiency at the time of vaccination.
Patients on immunosuppressive or immunomodulating therapy at the time of vaccination.
Patients with chronic immune-mediated inflammatory disease who were receiving or had received immunosuppressive therapy prior to vaccination.

Submit your invoice using the following fee schedule (GST inclusive):

COVID Vax third dose – Virtual consultation ($69) ($60 plus GST)
COVID Vax third dose – In-person consultation ($138) ($120 plus GST).

See the link to the POAC website for the full claiming instructions.

Proactive patient contact

We encourage GP and NP to proactively contact patients to discuss their potential eligibility for the third primary dose. Attached is a generic letter for you to adapt and send to patients who may be eligible, along with an attachment detailing the eligibility criteria.

COVID_19_Vaccine_example prescription.pdf [1.4 MB]