Latest update 20/04/2023
Current treatment options for COVID-19 for those with chronic kidney disease
The antivirals Paxlovid (oral) and remdesivir (IV) remain available for the treatment of COVID-19 in Aotearoa for people who meet the Pharmac clinical risk criteria.
1. Paxlovid remains the recommended first-line treatment in patients without contraindications.
2. Remdesivir is the recommended second-line treatment, where available, and the clinical risk is assessed to be very high.
Please Note: Evidence to date suggests that Molnupiravir likely has no clinical benefit (in highly vaccinated populations against the current Omicron variants)
Latest update 13/03/2023
There are 2 important updates on COVID-19 vaccines for people affected by kidney disease.
1. From 1st March, a bivalent vaccine replaces the existing Pfizer booster. The new bivalent vaccine is considered likely to be more effective against Omicron subvariants. Bivalent vaccines work by combining 2 strains of a virus, which prompts the body to create antibodies against both strains, providing a greater level of protection. Anyone who is currently eligible to receive a first or second booster will now receive the Pfizer Bivalent vaccine.
2. From 1st April, an additional booster dose will become available. This additional booster dose will be made available to:
For people under 30 who are not at risk of severe illness from COVID-19, a two-dose primary course and a booster dose provides very good protection from the risk of serious illness, hospitalisation or death from COVID-19. As such, people under 30 who are not at risk of severe illness from COVID-19 are not eligible to receive a booster.
If you are eligible and do not want to receive the bivalent vaccine for your booster dose, you can request the original Pfizer vaccine when you arrive for your vaccination.
We know vaccination is the best protection against the virus, and Manatū Hauora | Ministry of Health consider that these actions will provide added protection to a larger number of adult New Zealanders. The latest report from the Ministry of Health indicated 8,220 cases over the previous week so the virus is definitely still circulating out there.
Manatū Hauora | Ministry of Health encourages everyone to get their COVID-19 booster and flu vaccination at the same time to ensure that they are protected ahead of winter.
Vaccination against COVID-19 remains free.
For more information, see:
https://covid19.govt.nz/news-and-data/latest-news/new-booster-plan-in-time-for-winter/
Latest update 12/12/2022
Prevention (used when you're well and before you have COVID-19).
1) VACCINES
Vaccines show the body’s immune system a tiny piece of the COVID-19 virus, and so gets the body’s own immune defences ready in case that person catches the COVID-19 virus. These immune defences mean that the body can deal with the virus, and reduce the risk of severe COVID-19 even if you catch COVID-19.
- Some people with kidney disease don’t get a strong immune defence from a standard vaccine course (which is 2 initial doses and then 1 booster), and so these people can have more doses of the vaccine to get a stronger defence.
People who are at high risk of severe illness from COVID-19 can now get a 3-dose “initial” course and 2 “booster” doses of the vaccine.
The criteria for "people who are at high risk of developing severe disease" includes people living with a kidney transplant, people taking mycophenolate mofetil, and people receiving haemodialysis and peritoneal dialysis.
- In addition, a second booster is available for: all people aged 50 years and over, and health, aged care and disability workers aged 30 years and over.
First boosters are recommended after completing the “initial” doses. Most people should get their first booster 3 months after the last “initial” dose (although some people should wait 6 months e.g. people aged 16-17).
Second boosters are recommended for those at increased risk of severe illness from COVID-19. Second booster are recommended 6 months after a first booster.
The Pfizer vaccine is still the preferred COVID-19 vaccine in New Zealand, because it works well and has good safety data. The Novavax vaccine is available for people who prefer not to get the Pfizer vaccine. The AstraZeneca vaccine is no longer available in New Zealand. If you have had some doses of the AstraZeneca vaccine, then you can still get the Pfizer vaccine, or get the Novavax vaccine as an alternative.
You can get a booster dose the same way you got your previous COVID-19 vaccinations – including walk-in sites and drive-throughs.
Having COVID-19 does not provide the same level of immunity as getting vaccinated. We also know that your protection from the primary course of the vaccine decreases over time. To keep your immunity levels high, stay up to date with your vaccinations – including boosters. This will lower your chances of getting very sick from COVID-19 and ending up in hospital.
More information about COVID-19 vaccines can be found on the Health Navigator NZ website
2) EVUSHELD
Evusheld is not a vaccine, but is another medicine that protects from COVID-19, and reduces the chance of becoming very sick if you catch COVID-19.
Evusheld injections contain antibodies (made in the laboratory). These antibodies bind to the virus that causes COVID-19 infection (SARS-CoV-2), and prevent the virus from infecting healthy cells in your body.
Evusheld is given by two injections before a person gets COVID-19, or at least two weeks after their recovery from COVID-19. Evusheld is mostly used before you get COVID-19 rather than after but, in some circumstances, it may be used as a treatment.
Evusheld is for "people who are at high risk of developing severe disease" aged 12 and over, who don’t have COVID-19, but have medical conditions that mean that their immune system may not build strong defences after getting the vaccine. This group of people includes some people living with a kidney transplant, some people who have received some immune-system suppressing drugs (e.g. rituximab).
More information about Evusheld can be found on the Health Navigator NZ website
Treatments (generally used within 5 days of developing COVID-19 symptoms).
These treatments have changed since the COVID-19 pandemic started, as new medicines have been developed and as we learn more about what works.
Which treatment to use depends on the exact details of your kidney disease and overall health, as well as the treatment plans that your local healthcare teams have put in place for people living in your area.
COVID-19 antiviral medicines are given to people who are most at risk of becoming very unwell from COVID-19 infection. They may help you get better faster and stay out of hospital. These medicines are free for eligible people with COVID-19 within five days of their symptoms starting. To receive these treatments, eligible people must have either symptoms + a positive test for COVID-19, or symptoms + a household contact of a person with COVID-19.
These antiviral treatments are usually considered in the following order:
1) PAXLOVID
Paxlovid contains two antiviral medicines that you take together (nirmatrelvir and ritonavir). These two antivirals work together to reduce the amount of virus in your body. A course of Paxlovid tablets is taken for five days.
It is important to tell your usual healthcare provider or pharmacist of any illnesses, medicines, herbal remedies or supplements you are taking. Paxlovid may affect some of the other medicines or herbal remedies you are taking and cause serious side effects.
Some medicines that kidney patients take mean that Paxlovid can’t be used (e.g. tacrolimus)
Some medicines that kidney patients take need to be planned carefully by your doctor/pharmacist when using Paxlovid
Some people with more advanced kidney disease (people with a lower eGFR) may need a lower dose of Paxlovid or may not be able to use Paxlovid – this will also need to be planned carefully by your doctor/pharmacist
When people can’t use Paxlovid, other antiviral treatments are available (see below).
More information about Paxlovid can be found on the Health Navigator NZ website
2) REMDESIVIR
Remdesivir injection is also available. It's given by a slow injection (usually over 30-120 minutes) into your vein (called an intravenous infusion) once a day, usually for 3 days. It is only useful if started within 7 days of the start of your COVID-19 symptoms. You'll usually get the infusion at your local hospital or in a local health centre. Because treatment with Remdesivir usually involves a visit to the hospital to receive the infusion, demand may exceed infusion centre capacity or drug supply, so some referred patients may not receive Remdesivir. In some regions, some people living with a kidney transplant may be eligible to receive Remdesivir.
Further information about Remdesivir can be found on the Health Navigator NZ website
3) MOLNUPIRAVIR
For people who are at high risk of severe illness from COVID-19 and who are not eligible to receive either Paxlovid or Remdesivir, then the final option that’s often available is Molnupiravir. In New Zealand Molnupiravir is available as capsules, and the standard dose is 4 capsules twice a day for 5 days.
Further information about Molnupiravir can be found on the Health Navigator NZ website
As we understand more about using Paxlovid, the levels of eGFR when Paxlovid can be used are changing. Currently, Paxlovid needs to be used at a lower dose when eGFR is below 60, and in some circumstances may not be used at all when eGFR is below 30.
Latest update 6/12/2022
COVID-19 antiviral medication information offered in different languages.
Find the links below for information about antiviral medication available in New Zealand, offered in different languages.
Paxlovid (If you have kidney problems):
If you have advanced kidney disease or you're on dialysis:
Molnupiravir
Latest update 1/12/2022
COVID-19 antiviral medication eligibility.
COVID-19 antiviral medicines are free for people eligible under Pharmac’s access criteria, which was expanded in September and now includes:
To be eligible, a person must have COVID-19 and be experiencing symptoms, or be a household contact of someone with COVID-19 and be experiencing symptoms. The COVID-19 Health Hub (COVID19.health.nz) has information on the criteria and the list of high-risk medical conditions. This website is the best place to find Manatū Hauora advice on what to do if you test positive for, or are exposed to, COVID-19.
How to get COVID-19 antiviral medicines
Antiviral medicines are available from pharmacies. Many pharmacies can provide them without a prescription, after the pharmacy confirms the person is eligible and the medicines are safe for them to take. They can be prescribed by doctors and nurse practitioners, and some hauora and Māori health providers.
We’d like to remind people to have rapid antigen test (RAT) kits on hand, especially going into the holidays, so they can stay home and test themselves as soon as they feel sick.
The Healthpoint website lists pharmacies that offer antivirals, both with and without a prescription, as well as RAT collection sites. The Karawhiua website has an antivirals availability map.
Antivirals can be picked up from a pharmacy by whānau or friends or the pharmacy can have the medicines delivered for free to people who are isolating.
Latest update 20/07/2022
A second booster is recommended for those at increased risk of severe illness from COVID-19 – a minimum of 6 months after your first booster.
People recommended to receive a second booster as a priority:
- People aged 65 years and over
- Māori and Pacific peoples aged 50 years and over
- Residents of aged care and disability care facilities
- Severely immunocompromised people who received a three-dose primary course and a fourth dose as a first booster - noting this would be a fifth dose for these people.
For the Ministry of Health guidelines and information Click Here
Latest update 07/04/2022
During these uncertain and difficult times, we're working with the medical community and partners to provide you with date information about the coronavirus (COVID-19).KHNZ will ensure the needs and concerns of patients are being heard, and that the information we bring you is up to date and backed by the clinical community. Kidney Health New Zealand has in partnership with ANZSN and the RSA written to the New Zealand Government to make them aware that kidney patients and their whanau or household contacts/papakainga are priority groups. For updated advice for people living with kidney disease and how to stay safe click here.
Kidney Health NZ supports the Covid-19 vaccine for New Zealanders living with kidney disease.It is best advised that you speak with your treating doctor about the COVID-19 vaccine and what will be best for your health.
Kidney patients organisations, kidney doctors, nurses and transplant teams around the world support the Covid-19 vaccine for people living with kidney disease. Click here to read the main reasons why. For Covid-19 vaccine information A3 poster: Click here
Third Vaccination Dose
On the 21th of October the Government have announced that a third Pfizer vaccination (not a booster) has been approved for severely immunocompromised people. This includes everyone 12 and over and is to ensure that you get the best possible protection. The third dose will be available, free of charge, through your GP or Specialist. If you think you qualify, we recommend getting in touch with your usual health provider. If your GP or specialist does not provide vaccination services, you will be given a script and consent form which you can take to your nearest vaccination clinic.. For consent form click here
The third dose is recommended to be given 8 weeks and prior 4 months after your second dose. To optimise your immune response it is recommended that your discuss your current health and/or treatment with your GP or specialist.
For more information and most asked Questions about the third pfizer vaccine please click here.
Booster:
Booster vaccine doses are available since 29 November 2021, for anyone over 18 who has completed their primary vaccination course.
Pfizer booster interval shortened to 3 months
From Friday 4 February, those aged 18 and over, can receive a Pfizer booster 3 months (93 days) after completing their primary course to provide better protection against Omicron. The booster is now also available for 16-17 year from 7/4/2022 but 6 months from completion of their primary course
Bookings can be made by calling the COVID Vaccination Healthline on 0800 28 29 26 and or online BookMyVaccine.nz.
The booster is different to the third primary dose recommended for severely immunocompromised people( including dialysis patients).People eligible for a third primary dose can currently access a booster (fourth dose) 3 months after receiving their third primary dose. People can access a booster dose in the same way as any other dose and does not require a prescription
For more info click here.
The latest information on booster doses of the COVID-19 vaccine for those with severe immunocompromise updated 10/01/22; click here
See our videos about Covid vaccination :
We also share with you the launch of the navigational tool, #CatchOn. This community-led app is to aid the process of making an informed decision on the national vaccination roll-out to defend ourselves against Covid-19.With thanks to Le Va.
To see the CatchOn app Click here
Karawhiua is for whānau, hapū, iwi, and Māori communities to help prevent the spread of COVID-19.Karawhiua is led by Te Puni Kōkiri (Ministry for Māori Development), co-delivered by Te Hiringa Hauora (Health Promotion Agency) and supported by the Ministry of Health and the Unite Against COVID-19 teams.
To read more about the Karawhiua campaign click here.