‘Innovative’ nurse-pharmacist partnership can help with declining childhood immunisation rates

February 2, 2024

I write as a registered nurse (RN) and immunisation coordinator, deeply concerned about the declining childhood immunisation rates in Aotearoa.

The recent media release by NZNO on January 24 and the subsequent email dated January 27 urging members to Help keep childhood immunisations in primary health care caught my attention.


The Government and most health-care professionals are aware of Aotearoa’s rapidly declining childhood immunisation rates. Current ways of empowering whānau to consider and then access child immunisations are not working — this is the unfortunate reality backed by the Immunisation Taskforce Report 2022.

Gatekeeping the traditional nursing skill of vaccinating in primary care contradicts RN competencies, specifically domain 4 — emphasising interprofessional health care and quality improvement. RNs are expected to recognise and value the roles and skills of all health-care team members, contributing to coordinated care for optimal health outcomes—a principle aligned with the principle of partnership embedded within Te Tiriti.

The apprehension regarding the decision to allow pharmacist vaccinators to vaccinate children outside of the primary-care setting simply exposes the larger issues that contribute to the present state of the primary health-care sector.

Burn-out, lack of suitably qualified staff, pay disparity with Te Whatu Ora, and the increasing complexity of patient care has affected the ability of many general practices to offer their “business as usual” appointments in a timely manner.

Whānau should not have to wait until their pēpē is nine weeks old to get an appointment for their six-week vaccinations but unfortunately, due to a combination of factors outside RNs’ or GPs’ control, this is the current reality in general practices in Aotearoa.

Yes, vaccinating pēpē and tamariki can be complex. It requires time, active listening, and careful clinical practice. However, as nurses, I believe that our role naturally extends to supporting our health-care colleagues in pharmacy to mentor and work in an innovative partnership model.

Nurses are resourceful and constantly thinking outside the square in terms of service provision and delivery, and together we can maximise this opportunity to consider innovative ways of building a combined GP and pharmacy immunisation service model.

The concerns raised about pharmacist vaccinators warrant attention, and the evidence for their impact on childhood immunisation rates remains to be seen. However, we owe it to our tamariki and mokopuna to explore this avenue. By embracing this opportunity and fostering collaboration, nurses can collectively work towards improving childhood immunisation rates in Aotearoa.

Nicola Metcalfe, RN, MHlth