The 90% Project: The vaccine roll-out in rural communities

Awanuiārangi Nursing supporting Poutiri mobile vaccinations at Moko Marae Te Puke. Photo / Supplied

The uptake of the Covid-19 vaccination in rural communities has been described as "really positive" by two health providers.

But one professor has called for vaccination and testing data in rural areas to determine if there were "inequities or disparities" in the vaccine rollout.

Poutiri Trust general manager Kirsty Maxwell-Crawford said the vaccine uptake during alert levels 3 and 4 had "increased significantly".

But now that people were going back to school and work, the next challenge was making sure vaccinations were accessible in "everybody's day-to-day lives".

"We've started to do vaccinations outside of business hours and also walk-in vaccinations now."

The trust had offered a mobile vaccination service since June 1 on a range of marae, and had partnered with several Hauora organisations.

"It was never about launching into this on our own – it was about being able to extend our nursing workforce to work in partnership with other Hauora organisations across the Western Bay.

This meant hard-to-reach communities, who may not find driving to Baypark or First Ave accessible, "can be vaccinated at a location that they're really comfortable with and is home for them".

Poutiri Nurses vaccinating with Maketu Hauora at Whakaue Marae Maketu. Photo / Supplied

Maketu Health and Social Services chief executive Shontell Peawini said there had been a "really positive uptake" of the vaccine in the rural community.

The health and social services provider collaborated with the Poutiri Trust to set up a vaccination clinic at its premises in Maketu, she said.

"Working out in the rural communities - our whānau can't access any services on a daily basis so we make sure we bring them to them."

"All the barriers and overcoming everything really from transport to cost of everything - so it was really good that we've worked with Poutiri to get this up and running."

The provider also set up a drive-through vaccination clinic during lockdown which was "really successful" and led to two more venues being set up in Maketu at a reserve and the local marae, she said.

Poutiri and Pacific Island Community (Tauranga) Trust vaccinating at The Warehouse in Tauranga during alert level 4. Photo / Supplied

Federated Farmers Bay of Plenty provincial president Darryl Jensen said getting to vaccination clinics was "a bit of an issue" for those living in rural areas who had limited access to vehicles or relied on public transport.

But vaccination buses could be "a good call" for remote communities, he said.

"People can all come along if there's some sort of vaccination bus or centre where they can all turn up to be vaccinated because for some people. It's just an issue to travel to get to the vaccination centres."

"Moving forward, we do have to get as much of our population vaccinated as we can," Jensen said.

"We'll all benefit from being Covid-19 vaccinated."

University of Otago associate professor in general practice and rural health Dr Garry Nixon said while data was produced at a DHB level, there was no data comparing urban and rural areas within any given DHB boundary.

"There is no doubt that people living in rural areas have poorer access to healthcare and many of their health services are chronically understaffed," he said.

"This sort of thing just really exacerbates that pre-existing disparity when it comes to rural health services."

Measuring this data and identifying any disparity would help fix this, he said.

Nixon said the ministry had "started thinking about it and working on it" and he encouraged the ministry to release such data when available.

He recognised this was an "important piece of work" but understood the ministry's priorities lay with Auckland.

University of Otago associate professor in general practice and rural health Dr Garry Nixon. Photo / Supplied

The Ministry of Health's Covid-19 vaccination and immunisation programme acting group manager of operations Christine Nolan said "a significant piece of work" was under way to "adequately map" vaccination rate differences between rural and urban areas.

"This work would enable us to provide a new level of data that can be applied to vaccination, testing and other measures related to the Covid-19 response," she said.

"The new data set is critical for the vaccination rollout programme as it will ensure we have equity of access across New Zealand."

The data would be made publicly available when work was complete.

DHBs with higher proportions of remote and rural populations had been rolling out events where people could get vaccinated close to where they lived and worked, Nolan said.

"These have taken the form of permanent and pop-up sites, such as at marae and other large community sites, which have been established to ensure there is a range of easy-to-access locations where people can get their vaccinations."

The Ministry of Health's Covid-19 testing and supply group manager Darryl Carpenter said the ministry was testing the use of "a new healthcare-specific rural-urban classification" developed by researchers at the University of Waikato.

"We are looking to incorporate this in our regular surveillance reporting," he said.

"Such data is valuable because it will help the Ministry identify inequity and improve services and health outcomes for all of our communities."