When immunisation is a health target, why isn't the flu vaccine free for kids?
On a Saturday in the July school holidays, Katie Iti died at Hutt Hospital from complications of Influenza B.
Katie was 15 years old, in year 10 at Naenae College and loved drag racing. Speaking to Radio New Zealand, her dad Shayne described Katie as a 'sister to everyone' in the close-knit drag racing community. He said her flu symptoms were routine – body aches, a runny nose and a cough. He also urged whānau to get vaccinated against the flu.
Immunisation is a health target and has been in the sights of the coalition government since the beginning of the term. The ink was drying on the coalition agreement in December 2023 when then minister of health Shane Reti announced $50 million to help Māori health providers lift immunisation rates. He noted that low immunisation rates put pēpi and tamariki at particular risk of life-threatening illnesses.
'It protects them from serious but preventable disease and reduces the risk of hospitalisation or worse – something that no parent wants to face.'
In Aotearoa, the National Immunisation Schedule details the vaccines babies and children receive through infancy and childhood, and boosters available for adults. The schedule includes vaccines against serious infectious and life-threatening illnesses such as pneumococcal disease, diphtheria and measles. Schedule immunisations and their administration are free, regardless of visa or citizenship status, given the benefits of high herd immunity within populations.
Despite being listed on the schedule and recommended annually for anyone aged over six months, the flu vaccine is less accessible.
The flu vaccine is not free for babies and children unless they meet certain criteria for being at higher risk of serious illness. This includes having a long-term health condition like asthma, diabetes or a heart condition, or having been hospitalised previously for a respiratory illness like pneumonia, bronchiolitis or Covid-19.
There are clear and obvious benefits to providing free vaccines to those most at risk.
However, there are also clear and obvious benefits to providing a vaccine to anyone who wants it, if vaccination can prevent serious and life-threatening complications should a person contract an infection.
The flu vaccine falls into this category. It is recommended by the immunisation schedule and strongly supported by clinical evidence. Many adults can access it for free, or have it reimbursed by their employer. Why don't we offer the same for pēpi and tamariki?
For a brief two-year period recently – we did.
Uptake of the flu vaccine for under-fives tripled once universal funding was introduced in 2022. Writing in May 2024, once the funding was cut, authors Samantha Marsh, Janine Paynter, Peter McInytre and Rajneeta Saraf noted: 'Focusing flu vaccination funding only on those at the highest risk is a step backwards for New Zealand and will likely reduce uptake. In contrast, Australia has funded flu vaccines for all children aged six months to five years since 2019.'
Marsh et al go on to cite a report from the Child and Youth Epidemiology Service that influenza accounted for 56% of all preventable hospitalisations in children in Aotearoa – more than varicella, measles, whooping cough and meningococcal disease combined.
Knowing that influenza can be serious, I had decided my son should receive the flu vaccine prior to starting daycare earlier this year. I had thought we could receive our shots at the same time from our local pharmacy – perhaps the start of an annual tradition.
I was aware he would require two doses, four weeks apart, as it was his first flu vaccine. I wasn't aware that our local pharmacy didn't have a vaccinator who could vaccinate a baby under one, meaning we would have to make an appointment with the GP nurse instead.
I also wasn't aware that each dose of the vaccine would cost $45. The Kids Health website advises each shot could be between $25 and $45, depending on the clinic – similar to the price for an adult, but $50-$90 in total if it is your child's first vaccine. Multiple children requiring two initial doses would quickly add up – putting this very basic protective health measure out of reach for many whānau.
Although it is a common illness, the flu can be very serious, requiring hospitalisation, and in rare and tragic cases, cause death – even in healthy and active young people.
If a vaccine is clinically sound, evidence-based, and recommended by the Ministry of Health in the National Immunisation Schedule – such as in the case of the influenza vaccine – it should be free for everyone, especially pēpi and tamariki.
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