The Ministry of Health has told an inquiry into the death of a Dunedin man that Covid-19 vaccinators were adequately informed about the risks of a rare side effect.
The coronial inquest into the death of 26-year-old plumber Rory Nairn is in its second day at the Dunedin District Court.
Mr Nairn died at his home that he shared with fiancee Ashleigh Wilson on November 17 last year, 12 days after receiving the first dose of the Pfizer vaccine.
Yesterday Coroner Sue Johnson told the packed public gallery her role was not about finding fault or evaluating the benefits or drawbacks of vaccination.
It was accepted that Mr Nairn had died of myocarditis, an inflammation of the heart muscle, likely due to receiving the Pfizer vaccine.
The purpose of the inquiry was to establish the facts and consider recommendations that could avoid future such incidents, she said.
Ministry of Health group manager national contracts quality and workforce Christine Nolan gave evidence today.
She said notifications about the risk of myocarditis were sent out since late July last year, including a notification placed on the Immunisations Advisory Centre (Imac) website.
A newsletter to vaccinators had also flagged myocarditis as a rare side effect that especially affected young men.
Ben Taylor, counsel for the pharmacy where Mr Nairn was vaccinated, asked what discussions about risks and potential side effects vaccinators were expected to have with clients.
She explained that risk was about the intersection between probability and consequence.
“The rare and serious also need to be explained”, she said.
“I think the communication that came though highlighted that this was a rare and serious risk.”
Training modules were updated to inform newly trained vaccinators about the risk of myocarditis and the importance of raising it, and those who had been trained previously received updates through several channels.
She was not aware of any other rare side effects of the Pfizer vaccine that needed to be raised with patients, and not every rare side effect was expected to be discussed, Ms Nolan said.
Counsel to assist the coroner Michael Parker cross examined her about the information given to those being vaccinated.
He asked her about the ‘Getting your COVID-19 vaccine: What to expect’ pamphlet, which patients were shown in the vaccination booth and offered when they left.
Mr Nairn declined to take a copy of the form with him after he received his vaccination, 12 days before his death.
The form was updated in October ahead of the ‘Super Saturday’ vaccination drive to include inflammation of the heart as a potential rare side effect but not noted as possibly fatal, the inquiry heard.
Mr Parker asked her if there was a disjunct between the written information given to patients, and the information clinicians were expected to discuss as part of the informed consent process, in particular why the risk of myocarditis was considered important enough to be raised verbally but not enough to be emphasised in the pamphlet.
"I can’t explain that," Ms Nolan replied.
Yesterday, the vaccinator who treated Mr Nairn told the inquiry she was aware that myocarditis could be a rare side effect of the vaccine, but she had been unaware it could be fatal.
Vaccinating staff had only informed clients of the more common, less severe side effects, with instructions to seek medical advice if they experienced any other symptoms.
After Mr Nairn died they had changed their processes to emphasise potential risks from myocarditis, and it was tragic he had to die for that to happen, she said, breaking down in tears.
The manager of the pharmacy spoke of a deluge of information coming from health authorities, with "millions" of emails being sent to those tasked with delivering the unprecedented vaccination drive.
Information could get lost in the noise, she said, with some important safety information being contained within "a link within a link within a link".
Both the names of the pharmacy and the pharmacist who administered the vaccine to Mr Nairn are suppressed.
