A public health expert says the Covid-19 vaccination rollout is “racist and upholding privilege”, with rates for Māori about half overall and in one district a quarter of the national rate.
The Ministry of Health says it is “satisfied” with the rates for older Māori, stating the discrepancies are due to the Māori population being much younger and therefore not captured by the priority sequencing framework.
The Ministry says despite the overall rate being 8.5 per cent compared to 14.5 per cent overall six months into the rollout, the rates for Māori aged over 65 are actually “broadly equal between Māori and non-Māori nationally”.
However, despite multiple requests, the Ministry has refused to immediately provide data to support the claim, which was also made by Associate Health Minister (Māori) Peeni Henare during a press conference last week.
It has instead required the data be requested through the Official Information Act, meaning it would take up to 20 working days for a response, and much longer if extended.
Dr Rhys Jones, a public health physician and senior lecturer at the University of Auckland, said the Ministry’s justification fewer Māori were being vaccinated because of their younger age distribution was a “further example of racism and upholding privilege”.
“The fact that Pākehā on average live to older ages reflects privilege in society, and now they are being further privileged by being prioritised for the Covid-19 vaccine.
“Meanwhile Māori who have much greater risk of adverse outcomes from Covid-19 remain unvaccinated.
“This reflects the Government’s decision to ignore the expert advice they were given to lower the age for Māori, presumably in order to avoid a white backlash.”
Māori on average die seven years younger than non-Māori.
This, and evidence Māori were much more likely to catch Covid-19 and have more severe outcomes, were part of expert advice the Government rejected to give higher vaccine priority to Māori and Pacific peoples aged 50-64.
Australia is vaccinating Aboriginal people 55 and over at the same time as those 70 and over in the general population, while Canada is vaccinating First Nations adults at the same time as older people in the general population and in aged residential care.
“It is therefore unacceptable that vaccine coverage is lower overall for Māori than it is for, say, Pākehā, who are, as a population, at lower risk,” Jones said.
“What is even more disgraceful is that Ministry of Health officials are satisfied with the low overall vaccination rates for Māori.
“That shows a tolerance of inequity, and an acceptance of poorer access and quality of care for Māori, that reflects deeply entrenched racism in our government agencies.”
Jones said the rollout was “inequity by design” and reflected other systemic issues in the health system.
“The national bowel cancer screening programme is a recent example, where, despite compelling evidence and consensus from experts across the health sector, the Ministry has continued to roll out a racist programme.
“In the Covid-19 vaccine rollout to date, the Ministry has largely rejected approaches by Māori health organisations and networks to partner in the planning and delivery of the programme.
“What’s even worse is that these are the outcomes they planned for and are reportedly satisfied with – it’s inequity by design.”
The Herald reported last week vaccination rates varied greatly between the different district health boards (DHBs).
The lowest full vaccination rate for Māori was in Taranaki, 3.3 per cent compared to 6.4 per cent overall, where there were concerns recently about a potential outbreak after Covid-19 was detected in wastewater testing.
The largest discrepancies included Southern DHB 5.3 per cent of Māori have been vaccinated compared to the total rate of 12.6 per cent.
Nelson/Marlborough has the highest vaccination rate per capita at 18.1 per cent but Māori are well behind at 8.7 per cent. West Coast has 17.6 per cent of its population vaccinated, with Māori at 7.3 per cent.
In response to the low rates Henare said he was concerned about the variation between DHBs, which was why he was “excited” about a Māori Health Authority in the health reform work ahead.
“We do need to work with these DHBs, they’ve submitted plans and our job is to make sure we hold them to account to the plans they’ve submitted.”
But he said he was pleased with the fact the over-65 Māori population was tracking alongside or in some places ahead of non-Māori populations in vaccination.
He said 77 per cent of the Māori population was aged 16-54, and so as the programme expanded to Group 4, more Māori were expected to get the vaccine.
The Herald immediately sought the data behind the Associate Minister’s comments, but was eventually told it would only come through an OIA request.
In a statement Ministry of Health group manager equity for the vaccination programme Jason Moses reiterated comments made by Henare.
Moses said there were initiatives targeting Māori and Pasifika communities, in both urban centres and in remote locations.
These included hui at marae and outreach programmes in remote areas such as the upper reaches of the Whanganui River and remote towns on the East Coast, such as Te Araroa.
“All these efforts are great examples of DHBs working in real partnership with locally-based health providers and community leaders,” Moses said.
Taranaki DHB Covid-19 Vaccination Programme senior responsible officer Steven Parrish said their Māori Covid leadership group had met recently about the relatively low vaccination rates and increasing disparity.
“The group is fairly confident that the low vaccination rate reflects the low population in the sequencing framework groups that have been targeted to date, he said.
“We expect to see the rate increase as we ramp up vaccination into Group 4.”
Covid-19 Response Minister Chris Hipkins previously said that all advice for the sequencing framework was carefully considered to ensure it was “fair, balanced and risk-based”.
He said 40,000 vaccine doses were provided for Māori and Pacific health providers for group 2, to be used for older Māori and Pasifika cared for by whānau.