The coronial inquiry into the death of plumber Rory Nairn is in its second day at the Dunedin District Court.
Mr Nairn (26) 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 the inquest 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 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 took the stand 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 flagged myocarditis as a rare side-effect that especially affected young men.
Ms Nolan replied that a discussion about risks and potential side-effects was expected to happen as part of the informed consent process, but it would not have necessarily have covered all known side-effects.
She explained that risk was about the intersection between probability and consequence.
"The rare and serious also need to be explained", she said
It was put to her that if the risk of a specific rare side-effect had to be spelt out, it would be expected to be very clear.
Ms Nolan said information came to vaccinators through the various channels they had, but she could not say how they would have interpreted that.
"I think the communication that came though highlighted that this was a rare and serious risk," Ms Nolan said.
Training modules were updated to inform newly trained vaccinators about the risk of myocarditis and the importance of raising it.
Those who had been trained previously had received updates though several channels.
She said she was not aware of any other rare side-effects that needed to be raised with patients, and not every rare side-effect was expected to be discussed.
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’’.
The names of the pharmacy and the pharmacist who administered the vaccine to Mr Nairn are suppressed.
