3. Question No. 3—Prime MinisterHon SIMON BRIDGES (Leader of the Opposition) to the Prime MinisterQuestion No. 3—Prime Minister3. Hon SIMON BRIDGES (Leader of the Opposition) to the Prime Minister: Does she stand by all her Government's statements policies and actions?Rt Hon JACINDA ARDERN (Prime Minister): Again I still do yes.Hon Simon Bridges: Does she stand by her statement that the Northland meningitis vaccination campaign was successful" when a seven-month-old baby subsequently contracted meningitis?Rt Hon JACINDA ARDERN: Yes I did refer to that case when asked in my stand-up yesterday about Northland and the outbreak there of course. We simply responded to the clinical advice that was received at the time which was based on two factors—Hon Paula Bennett: Were there options?Rt Hon JACINDA ARDERN: —first trying to make sure that those who are most vulnerable were protected and that included vaccinating children.Hon Paula Bennett: Were there three options?Rt Hon JACINDA ARDERN: I've also referred to the fact that children of a—SPEAKER: Order! Order! Sorry I'm just going to interrupt the Prime Minister. A baby has died. The Prime Minister's answering the question and I think she should have the politeness of being able to finish the answer without inane interjections.Rt Hon JACINDA ARDERN: I will just clarify—Hon Paula Bennett: I raise a point of order Mr Speaker. I certainly was not inane and I certainly think it's fair that the Opposition ask questions. If there's to be silence in every answer that the Prime Minister is giving that is a new rule and one that I think would take away from the robustness of the debate in this House.SPEAKER: I am not proposing such a new rule. What I am proposing is that we have a degree of respect for families where there has been a death of an infant. I don't think that's unreasonable.Hon Paula Bennett: I raise a point of order Mr Speaker. I take immense offence that you would think I am not giving that degree of respect. It is us that have actually raised this very serious issue and I have nothing but respect for those families. I think it's offensive for you to actually infer otherwise.SPEAKER: Well I think the member would've made her position more obvious if she hadn't started chipping the Prime Minister partway through her answer.Rt Hon JACINDA ARDERN: Happy to continue with the answer. One thing I would like to clarify is that I am advised by the Ministry of Health (MOH)—and I know the whole House will be pleased to hear this—that the baby involved was released from hospital and did not pass but having said that that's not to trivialise a baby contracting the illness in the first place which of course we all take very seriously. However the guidance that I'm advised was received is around targeting those infants who are able to be immunised and again also targeting those young people who are most likely to spread the disease. We were given advice in November that those are the two target groups that should be focused on with an immunisation campaign. I believe roughly 25000 forms of the vaccine were able to be accessed. The Ministry of Health worked very quickly to roll that out. Given that school was to break very quickly they moved as quickly as they could and I think the outcome does speak for itself in that regard.Hon Simon Bridges: How can it speak for itself in that regard and be a successful campaign when people still contracted meningitis?Rt Hon JACINDA ARDERN: As I said we rely on clinical advice. The clinical advice at the time was to target those aged nine months to four years—I believe that's because as with other immunisations they have to be repeated if it's a baby of a particular age but you're best to ask probably the Minister of Health that particular question—and those aged 13 to 19. There have been outbreaks in other areas I believe. Other jurisdictions have followed similar guidance.Hon Simon Bridges: When was the Government made aware there were enough vaccines to vaccinate everyone under the age of 20 in Northland?Rt Hon JACINDA ARDERN: I'm advised that in May—keeping in mind—Hon Simon Bridges: November.Rt Hon JACINDA ARDERN: That was Ministers in May or at least the Minister of Health. Keeping in mind the outbreak was in November and I do want to clarify that my understanding is: I'm advised that Pharmac on 9 November was told that a drug company could potentially provide up to 33000 doses. However this was not available for a few weeks and also there were other jurisdictions seeking the vaccination as well. So I'm not sure it's fair to characterise that as a guaranteed amount. Again they were able to secure a total of 20000 doses; a bit more than that for the Northland campaign.Hon Simon Bridges: Given that one of the options presented to the Government by the Ministry of Health back in November last year was to fully vaccinate all under-20-year-olds and that her own Minister of Health has said in relation to back in November that then he was made aware by the Director-General of Health that additional vaccine was available if a wider vaccination programme was later required or there was an outbreak elsewhere why didn't the Government pursue that course of action?Rt Hon JACINDA ARDERN: Again I think the member's actually answered the question himself by reading that quote "if there was an outbreak that later required it elsewhere". We had an outbreak in Northland. Actions were taken to secure as much vaccine—then those 20000 doses to follow that clinical guidance. I haven't seen the full advice the member's speaking of but of course if there were an outbreak somewhere else then you would of course require that additional vaccination. Again it is important to point out of course that it wasn't guaranteed that the additional vaccine that was spoken of was available let alone available immediately and the MOH was working very quickly at that point.Hon Simon Bridges: Wasn't the vaccine clearly available from November according to the Ministry of Health to the drug companies and to the knowledge of her Minister?Rt Hon JACINDA ARDERN: Of course it's Pharmac that would've been involved. I'm advised that the drug company advised Pharmac as I've said on 9 November that it could potentially provide up to 33000 doses. However it was not available for a few weeks and that at that time was not an option. They did need to move quickly; the school year was ending and they needed to roll it out quickly. Again I would point out that even then the immunisation campaign wasn't focused on children under one at that point—I believe also because of clinical advice. So ultimately yes one baby was affected and of course no one wants to see that but otherwise that campaign where targeted has made a difference.Hon Simon Bridges: Does she agree with the Director-General of Health who said the vaccinations were "over twice the price and of course cost is an important element"?Rt Hon JACINDA ARDERN: Again as I've said my understanding is the decision was made on clinical advice.Hon Dr David Clark: Is the Prime Minister aware that the targeted approach that was taken followed suit from similar approaches that were taken when meningococcal W outbreaks happened in Australia and in the UK?Rt Hon JACINDA ARDERN: Yes that's certainly my understanding that we are not the only ones that have experienced those outbreaks and they did take a similar approach to New Zealand or indeed we took a similar approach to them.Hon Simon Bridges: Why didn't they vaccinate all under-20s if it wasn't about cost if it wasn't about international supply—as she inferred in a letter to Shane Reti in February—and if the drug companies and indeed the Minister knew that the drugs were available from November last year?Rt Hon JACINDA ARDERN: Again I refute the premise of that question.Hon Simon Bridges: Why didn't they rather than rationing the drug have blanket coverage to under-20s last year?Rt Hon JACINDA ARDERN: Again those who are most at risk of spreading the disease are 13- to 19-year-olds first of all. Those at most risk if they contract the disease are nine months to four-year-olds. We have a limited capacity to get those groups immunised quickly. If we had a blanket process we may have then sacrificed those groups being targeted first and quickly and that was key."