Northland iwi and Māori health providers are in full swing as the region's Māori population is set to start the Covid-19 immunisation programme this week.
They will join frontline healthcare workers and Northland's Pasifika community to make up the 9000 people aged 16 and over set to receive the Pfizer/BioNTech vaccine as the programme progresses on schedule.
Te Hau Ora O Ngāpuhi chief executive Te Ropu Poa said the rollout to Northland's remote and vulnerable Māori communities was complex but iwi providers were playing an essential role to ensure its success.
"We do know that everyone wants to be vaccinated and the attitude from our communities is,'What is the bloody hold-up?'," she said. "That's how ready they are."
The 2018 Census revealed around 36 per cent of the region's population at the time – around 179,076 – were Māori and 4.2 per cent identified as Pasifika.
Since then, the Ministry of Health has reported a population growth in the region of more than 14,000 people. Currently there is a much higher proportion of Māori and lower proportion of Pacific people living in Northland compared to the national average.
An ethnic composition for the next round of vaccinations will only be available once registrations of interest have been received.
Poa said they were using a by Māori for Māori vaccine response to overcome challenges in effective messaging around immunisation, infrastructure and transport barriers, and other vulnerabilities such as power outages.
Currently, Māori clinical experts were hosting webinars to provide relevant and meaningful information related to the vaccine that translated to a Māori audience.
She said they had also proposed a mobile vaccine clinic to go into communities where people may not be able to afford to travel to receive the jab.
Associate Minister for Health (Māori) Peeni Henare said there was a flexible and whānau-centred approach on the vaccine rollout to protect kuia, koroua, and people with long-term health conditions.
"Māori health providers and communities know what's best for their people, it's important that there is flexibility in the roll-out of the programme to ensure Māori do not miss out on the vaccination."
Dr Bart Willems, Ngā Tai Ora – Public Health Northland public health medicine specialist, said they aimed to shift the delivery of vaccinations to a community-based model from central locations run by the Northland District Health Board.
"A shared model is envisaged with the Northland DHB providing cold chain and infrastructure support, often at a larger site, with vaccinators from primary care, Māori providers and other providers working alongside Northland DHB vaccinators."
For harder-to-reach populations limited outreach services such as a whānau immunisation may be an option, Willems said.
Because of the constraints on location caused by the cold chain and distribution chain requirements for the Pfizer vaccine venues to receive the jab were heavily influenced.
Vaccinations will be delivered throughout the next phases in Northland through large centralised venues in the main centres and smaller satellite venues in remote locations.
The Northland District Health Board (NDHB) was working alongside iwi health providers to mitigate barriers beyond transport that included people not knowing they were eligible for the vaccine, people being unable to use the booking system, and people in aged residential care being unable to consent.
NDHB's proposed solutions to booking the Covid-19 vaccination were to scan a QR code and complete an e-form that appears on the screen of a smartphone or tablet, an online form provided via a link, a workplace kiosk where staff can complete the online e-form, or people who cannot access any of the above may be able to request manual forms.
The upcoming community vaccinations were still likely to be multiple weeks away as authorised vaccinators who are part of the next phase needed to receive their jabs first.