A New Zealand serious about health equity would have pushed for greater vaccination of Pacific people from the start of the rollout, a South Auckland GP says, as the community bears the brunt of another Covid-19 outbreak.
The latest Ministry of Health data show Pacific peoples now make up 70 per cent of infections in the Delta outbreak - or 104 of 148 cases - largely as a result of an infected person attending a church service.
Dr Debbie Ryan, the ministry's former chief advisor Pacific, said that Pacific people could account for so many of the cases - yet made up just 7 per cent of the population - was "depressingly familiar".
Pacific people also made up nearly 60 per cent of the community cases in the August 2020 Covid-19, and more than 60 per cent of the measles cases in the 2019 outbreak that affected more than 2000 children and young people.
Previous modelling has also shown Māori and Pacific people are more than twice as likely to be hospitalised for Covid-19 - partly as a result of health inequities.
Pacific health advocates have now renewed calls for a rethink about how the vaccination rollout - which only targeted older Māori or Pacific people, along with people in the Counties Manukau DHB area with underlying health conditions or disabilities - in Group 2.
As at this month, 47,733 of 260,475 identified Pacific peoples had received both doses of the Pfizer vaccine - most of them older individuals - along with 70,298 of 511,311 Māori.
Dr Dianne Sika-Paotonu, of the University of Otago, said vaccination rates for Pacific peoples across the country were "of significant concern".
"The implications for the Covid-19 vaccination campaign and priority-setting moving forward is that more work and support is needed to ensure Pacific and Māori peoples and communities are indeed being prioritised," she said.
"Pacific health staff, Pacific health providers, Pacific community, family and church leaders, and many others who have already been working incredibly hard behind the scenes to encourage and ensure Pacific peoples and their families to get vaccinated and tested for Covid-19, also need to be supported to continue doing this work.
"Delta virus cases continue to surge in other countries and we cannot allow the same to happen in Aotearoa New Zealand."
At the height of the pandemic last year, Pacific people were consistently getting the highest Covid swab testing rates per head of population for the country.
"Again, it was the Ministry of Health working with trusted Pacific health providers in the community, and using the church ministers who called on their congregations to heed the health message and get tested," Manukau GP Dr Apisalome Talemaitoga said.
This approach had "sadly been lacking" with the vaccination rollout, although things were beginning to change.
"This week the 0800 Pacific vaccination phone-line allowing families to make group bookings in their languages for their bubbles, and the announcement of ethnic community vaccination clinics, are great examples."
Talemaitoga, who chairs the Pasifika GP network, and the Pacific Chapter of the Royal NZ College of GPs, said it was already known Pacific peoples carried a higher burden of disease and at - on average - a lower age.
"This is why if we as a country were serious about 'equity', then the push for vaccination for Pacific peoples right at the start would have been done - but this approach unfortunately wasn't used," he said.
"Now in addition to carrying the burden of Covid cases in this most recent outbreak, the Pacific community are bearing the brunt of targeted racist vitriol from a few racist small-minded key-board warriors on social media."
Ryan, who also directs consultancy firm Pacific Perspectives, was confident the Pacific community would get through the crisis, as it had done before.
"But we need a circuit breaker to address these unacceptable disparities."
Policy statements about health equity, such as those set out in a Health Quality and Safety Commission report released this year, needed to be backed up with real action at all levels of the health system, she said.
"Clear accountability for action along with measures that demonstrate change, are required.
"Urgent action must be taken now to ensure that Pacific communities have the same right to good health as the rest of the team of five million."
Yesterday, Director-General of Health Dr Ashley Bloomfield said he recognised concerns about Māori and Pasifika communities, given these groups often had higher rates of pre-existing health conditions.
He said there'd been "enormous" engagement with Māori and Pacific providers, and that initiatives had been in place since the start of the rollout to ensure the groups could access the vaccine.
"I can provide an assurance to the Pacific community that not only have we and will we continue to work with you, but secondly that, based on the track record of the Pacific community, we will get to the bottom of it and we will make sure that we get rid of Covid in that community."