People working on the frontline to house people in Tauranga say they are facing major barriers to encouraging homeless people to get vaccinated.
One worker says she was abused on social media for providing information about how to get vaccinated and another says distrust of authorities and misinformation is hampering efforts.
Government departments and the Bay of Plenty District Health Board say they are working hard to make sure the homeless have accurate information and access to vaccinations, but no agency is monitoring how many Tauranga homeless are vaccinated.
Last Saturday, Under the Stars - a volunteer service providing food to those in need in Tauranga - helped facilitate a pop-up vaccination clinic specifically for the homeless and people in emergency housing
It was the second vaccine clinic targeting homeless people.
Operations manager Laura Wood said a group of people "slammed" their social media post informing people vaccines would be available at the hall where they had community meals.
Some of the posts falsely claimed that food would not be given to people who did not get vaccinated.
"It got quite heated," she said.
She cleared all comments and turned off the ability to comment, however, the post was shared elsewhere and attracted a stream of malicious comments.
Wood was astounded. She said she did not have a personal position on vaccinations but if homeless people wanted to be vaccinated, they needed somewhere they could feel safe.
An initial attempt to set up a pop-vaccination clinic earlier this year in conjunction with the DHB didn't go ahead because there was a lack of interest among the homeless community.
Wood felt this reluctance was driven by fear of authorities and misinformation about the vaccine.
"There's a lot of mistrust of authority so if authority says to get the shot, they're like, 'yeah, not me'."
Two weeks after the initial attempt, more people were keen. Wood went back to the DHB and 12 people were vaccinated at the hall.
Since then, there had been more interest and there was another pop-up centre last Saturday.
Tē Tuinga Whānau Support Services Trust director Tommy Wilson said most of the 200 families in the trust's emergency housing were not vaccinated.
"They have a fear of Government organisations ... they are the hardest to reach because they live a life of fear.
"If you're going in there saying 'you've got to get vaccinated because the world's going to end' - their world's already not good anyway."
Staff asked if residents wanted the vaccine but did not tell them they needed to get it - and Wilson feared the only information they got was through social media.
Wilson said the homeless and gangs were vulnerable and "potential super-spreaders", and needed information they could understand.
He said staff did not have the time or resources to target the homeless and a concerted effort was needed from the MOH to work with NGOs to reach the community's most vulnerable.
Manager of The People's Project (TPP), Simone Cuers, said 34 per cent of its clients have had their first vaccine and 10 per cent are fully vaccinated. He expected this to increase with an outreach vaccine option.
The project team worked with chronically homeless people to find a home and support them to be successful tenants.
Poor health, a compromised immune system and barriers to accessing health services were associated with homelessness, putting them at higher risk of harmful effects of the virus, she said.
TPP worked with the health board vaccination team and was advocating for an outreach vaccination team, which could get to clients where groups of them live.
Cuers said putting outreach teams where people are known to congregate was the best way to remove all barriers.
From next week, Te Manu Toroa and the project will work together to have mobile units offer vaccinations to clients.
The People's Project gave all clients details on how to access vaccines, offered help with transport costs, and had a system to text all clients when there were new ways to get vaccinations.
The Bay of Plenty District Health Board was working with central and local government agencies and community providers to help reach the homeless, with specific pop-up vaccination centres catering to that community.
The DHB's Covid-19 incident controller, Trevor Richardson, said it "does not keep a track of everyone that fits the definition of 'homeless'".
"An accurate number cannot be provided as the circumstances for many of these individuals change daily."
Richardson said 90 per cent of people in the men's shelter, Takitumu House, have been vaccinated and six women at the women's shelter, Awhina House, were either fully vaccinated or have had their first dose.
A DHB spokesperson said, through a Ministry of Health spokesman, that vaccinating the homeless was never a second thought.
It worked with the homeless community, local social, iwi and Māori providers throughout the vaccination programme and have given vaccines to a "number of our local homeless people".
The Bay of Plenty DHB has been running local advertising campaigns since May and the Shot Bro is being used in the region.
Ministry of Social Development Bay of Plenty regional director Kim Going said it had been sharing vaccination information since May, including on emails, on its website and via the holding message on its 0800 numbers.
It also had videos and information on digital signs at service centres, and was organising flyers and posters to distribute to the foodbank.
The Ministry of Health's Covid-19 vaccination and Immunisation programme optimising delivery lead, Vince Barry, said it did not generate reports of homeless vaccine rates.
"It is unlikely vaccination rates for homeless and rough sleepers will be able to be monitored by the ministry through data at the national level because no single dataset is held for the homeless and it can't be developed easily."
A multi-agency approach was needed to ensure equal access, he said.
The health board and Ministries of Health, Housing and Urban Development and Social Development had been working together to make vaccinations available for homeless communities.
They were facilitating testing and vaccinations for clients in emergency and transitional housing, he said.
This was to help the homeless "make informed decisions" and "encourage take-up".
He said health boards worked closely with transitional housing providers and built on other existing relationships to support the homeless to make sure the information was delivered by familiar faces and people they trusted.