Rory Nairn: Pharmacist blamed for not warning COVID-19 vaccine could cause myocarditis

The Health and Disability Commissioner has criticised a pharmacist for not providing enough information to Rory Nairn before he received the Pfizer Covid-19 vaccine.

The 26-year-old Dunedin plumber died on November 17, 2021, 12 days after he was vaccinated against the virus.

A 2022 coroner’s inquest found the cause of his death Caused by myocarditis Defined as inflammation of the myocardium.

“I find that Rory James Nairn, 26, died in Dunedin on November 17, 2021. His cause of death was myocarditis, triggered by the Comirnaty TM Pfizer/BioN Tech Covid-19 vaccine,” Coroner Sue Johnson said.

“My investigation into Rory’s death is not yet complete. I have not determined the circumstances of his death.”

But in further findings published on Monday, Johnson said the pharmacist who gave Nairn the vaccine did not tell him he had myocarditis because it was considered a “very rare side effect of the vaccine.”

In the days following the vaccination, Nairn complained several times that his chest felt “strange”.

On November 17, he told his fiancée that he had the same feeling in his chest.

They discuss going to the hospital, but he says he will see his own doctor later that morning.

He subsequently collapsed and died in the couple’s bathroom.

The pharmacist previously told investigators she was unaware of the need to inform patients of rare side effects.

“This is because we have received material from multiple sources detailing this risk.

“But she also said she was not aware of any requirement to discuss the matter specifically with clients on or before November 5, 2021.

“And based on instructions from (her operations manager), she did not advise vaccinated customers to be aware of rare side effects of the vaccine, such as myocarditis.”

The pharmacy manager gave similar evidence, explaining that she did not think Nairn should have been told about myocarditis before receiving the vaccine.

But she said if he develops symptoms after receiving the vaccine, he would need to be advised to contact a pharmacy or doctor.

An information sheet on the stand did not list myocarditis as a side effect, but did advise that if a person experiences “a racing heart or chest pain” within a few days of receiving the vaccine, they should seek medical attention.

A search of Nairn’s phone showed internet searches including “rapid heartbeat” and “myocarditis.”

Coroner Johnson said she was satisfied that because the Health and Disability Commissioner (HDC) had conducted a thorough investigation she did not need to make any recommendations.

Commissioner Morag McDowell said he should have been told about the rare but serious risk of myocarditis as part of the safety net advice and to be aware of any symptoms.

While this violated his right to be informed of the risks, she did not find that the code had been breached.

The report said: “She believes there are significant mitigating factors in this case, including that official sources of information did not adequately explain to vaccine recipients that consumers need to be informed about myocarditis before receiving the vaccine.”

But she pointed out that official guidance clearly states consumers must be informed about symptoms and criticised pharmacies for not taking note of this and amending their processes.

The Commissioner also criticised vaccination pharmacists Failure to inform consumers about myocarditisparticularly symptoms of myocarditis, as part of safety net recommendations,” the report states.

McDowell noted that since his death, pharmacies have changed their practices so the risk of myocarditis is specifically discussed.

She recommended that pharmacies update their informed consent processes and safety net recommendations for Covid-19 vaccines and send the updated procedures to the committee within three months of the report’s release.

She suggested Te Whatu Ora consider updating its guidelines to clarify when providers should discuss the risks and symptoms of myocarditis and other side effects.

“The lesson we can learn from this case is that in the context of novel vaccines and new risks, it is of vital importance to provide clear guidance to vaccinators on what information to provide to consumers.”

Te Whatu Ora said it made good faith efforts to obtain people’s informed consent before administering the Covid-19 vaccine, but accepted the commissioner’s findings.

Matt Hannant, acting national director of prevention at the National Public Health Service, said the New Zealand Ministry of Health remained committed to ensuring vaccinators had the training and materials they needed to do their job.

“We acknowledge the feedback we received from the coronial inquest and will carefully review any feedback from the royal commission to learn lessons from New Zealand’s response to COVID-19.”

He said serious Covid-19 vaccine side effects were rare but it was regrettable that Nairn was not aware of them.

“During the pandemic, there has been a good faith effort across the health system to get the COVID vaccine to our vaccinators.”

This includes (and will continue to include) discussing possible side effects before vaccination.

“We will continue to monitor the safety of all vaccines through collaboration and partnerships across the health system,” Hannant said.

“Our aim is to keep New Zealanders protected from preventable diseases and ensure information about possible side effects of vaccines is readily available.

“Prompt vaccination remains one of the best ways we can protect ourselves from serious illness caused by Covid-19.”

“A little bit of finishing”

Nairn’s partner said she did not blame the pharmacy or pharmacist who gave her the vaccine.

But Ashley Wilson said there was a deep sense of grief and anger at a system that had failed people.

“While this verdict brings some comfort, it is disappointing that no one has been held accountable for such a needless death,” she said.

She did not blame the pharmacy involved, which is withholding its name, but said it is common practice for pharmacies not to tell consumers about heart-related side effects.

“The pharmacy was simply following the practices and protocols set out by the Department of Health, but unfortunately the Department of Health did not clearly state the risks of the vaccination and that myocarditis could be a potential side effect,” Wilson said.

“At the coroner’s inquest we saw no documentary evidence from official sources suggesting myocarditis could be fatal, instead it was described as ‘rare and mostly mild’.”

She said they will miss Nairn every day for the rest of their lives.