Children of high-income families have the lowest vaccination rate on record against serious diseases like whooping cough, measles and pneumococcal disease.
Health authorities are concerned about Northland's low child immunisation rates - with less than half of all six-month-olds fully immunised - as the border opening and cold season looms.
For more than two years the pandemic has affected the vaccination rates for children which had already been critically low before Covid-19 hit.
Only 66.8 per cent of five-year-olds in Northland are fully vaccinated compared with 80.6 nationally.
At six months, children should have received at least seven vaccine doses against several potentially severe diseases currently circulating in the community.
In 2021, 56 per cent of children in that age group were fully immunised – the lowest vaccination rate among all district health boards and far behind the second least vaccinated region, Bay of Plenty with 62.6 per cent. The national average was 74.1 per cent.
Ministry of Health data reveals high-income families as having the lowest vaccination rate (48 per cent). Decile 3-4 households have the highest immunisation rates (69.6 per cent).
Children in low-income families show an immunisation rate of 58.3 per cent.
In terms of ethnicity, NZ Europeans make up just over a third of the eligible children and Māori more than half.
Of those eligible, 67.5 per cent NZ Europeans were vaccinated compared to 79.4 nationally and 44.1 per cent of Māori received all recommended shots compared to 53.4 per cent nationally.
The trend continues through all age groups, with Northland repeatedly ranking among the least vaccinated regions.
Northland District Health Board is aware of the concerning numbers and says Covid exacerbated the issue.
"Our vaccination numbers are nothing to be proud of," Dr Nick Chamberlain, Northland DHB chief executive said during yesterday's board meeting .
Jeanette Wedding, NDHB general manager for rural, family and community health services, added there was a "real reluctance" towards vaccines in Northland.
"There is no one key driver that relates to this – childhood immunisation rates in Northland, and now nationally, has been a challenge and this has been exacerbated over the last two years with Covid-19."
The Ministry of Health has written to all DHBs to refocus their efforts on childhood immunisation and meet the target of 95 per cent coverage at eight months.
The Northland DHB annual report 2021 says parents who are well-informed, as well as those who remain adamantly opposed to immunisation, were slowing down vaccination efforts.
Other factors include barriers to accessing services and families who are under so much socio-economic stress.
In February this year, 12 per cent of children missed their eight-month immunisation appointment while 10 per cent of parents declined to have their children vaccinated.
A further two per cent opted out, meaning their children's names won't appear in the National Immunisation Register.
The decline rate has increased over the past five years. In 2014-2015, only six per cent refused childhood vaccinations.
Wedding said there were various reasons why families are declining immunisations; "some want to delay, some are hesitant, some are opposed".
"Northland has a strong anti-vax movement and a few years ago this had a significant negative impact for declines in Northland. This has continued," Wedding said.
"We are focused on strategies that aim to build confidence and trust in our communities that immunisation is safe, rather than strategies to address the anti-vaccinators."
Wedding said the DHB had deployed several strategies over the years to improve coverage rates including external reviews, reviews of their systems, approaches in primary care, a monitoring and predictive tool and tracking of individual children to facilitate an immunisation event.
Chamberlain also noted public immunity was low after two years of closed borders. With tourists soon on Northland's doorstep, an influx of infections could hit the region.
Influenza, RSV (respiratory syncytial virus) and measles are the biggest concern for the health authorities.
"With the last few years focused on Covid the ministry is highlighting the need for DHBs to be prepared for 'possible' outbreaks and is ensuring that uptake of the MMR [Measles/Mumps/Rubella] vaccination programme escalates as well as childhood immunisation focus," Wedding said.
Children aged four or under who have been hospitalised for respiratory illness, measles or have a history of significant respiratory illness are at risk of the flu.
The regional vaccination programme for the flu kicked off on April 1.
Other than the flu and measles, there is no vaccine to protect children from RSV.
Similar to Covid-19, good hand hygiene can reduce the spread of RSV.
Wedding indicated that whānau wellbeing events that offer more than one health service rather than isolated vaccination clinics would be the way forward to boost vaccine numbers.
Tools such as mobile clinics would also be used more frequently to bring vaccination services into remote communities.
"The Northland experience of Covid has seen more vaccinators throughout many organisations. We hope this continues into the future as winter comes upon us, where multiple providers can offer multiple points of access for vaccinations – whether it be childhood immuniations, Covid, MMR or flu."
Childhood immunisations are free and available at GPs or Hauora clinics.
"We encourage parents to make sure their child is up to date with all their immunisations. If a parent needs to check what vaccinations their children have had they can talk with their GP or NIR@northlanddhb.org.nz," Wedding said.
-If you or your child is sick, you should stay at home until your symptoms have gone
-Stay away from people who have coughs and colds
-Wash your hands well and often
-Cough and sneeze into your elbows, and carefully throw away dirty tissues
-Do not share cups, glasses or cutlery
-Practice physical distancing
-Shared toys should be washed in warm water and detergent at the end of the day, or if they are sneezed on or mouthed.
Pregnancy:
-Influenza
-Tetanus/diphtheria/whooping cough
6 weeks:
-Rotavirus (oral)
-Tetanus/Diphtheria/Whooping cough/Polio/Hepatitis B/Haemophilus influenza type b
-Pneumococcal
3 months:
- Rotavirus
-Tetanus/Diphtheria/Whooping cough/Polio/Hepatitis B/Haemophilus influenza type b
5 months:
-Tetanus/Diphtheria/Whooping cough/Polio/Hepatitis B/Haemophilus influenza type b
-Pneumococcal
12 months:
-Measles/Mumps/Rubella
-Pneumococcal
15 months:
-Haemophilus influenza type b
-Measles/Mumps/Rubella
-Varicella (Chickenpox)
4 years:
-Tetanus/Diphtheria/Whooping cough/Polio
11/12 years:
-Tetanus/Diphtheria/ Whooping cough
-Human Papillomavirus (HPV)
Mahuta Haunui-Tipene will represent NZ in an U17 netball tournament in Melbourne.