Structural racism in New Zealand's vaccination plan has contributed to an inequitable rollout for Māori, older people and those in low socio-economic areas.
That's according to a new study, yet to be peer reviewed, which found communities with larger proportions of these populations had poorer access to vaccination services - despite Māori and older people being considered priority groups in the Government's rollout plan.
One expert says he's not surprised by the study's findings and claims not enough mahi was done prior to the rollout to ensure these populations had equitable access.
Ministry of Health Covid-19 vaccination and immunisation programme equity group manager Jason Moses said priority was given to at-risk communities through partnership between district health boards and local providers.
However, he did not provide a direct response when asked whether he believed the rollout was equitable.
The study, conducted by University of Waikato researchers, used Healthpoint's national list of vaccination services - as at August 18 - to measure how many locations were within a 30-minute drive of different communities.
Researchers then used population data to establish demographic profiles and examined the accessibility different populations had to vaccination services.
They found poorer neighbourhoods and those with higher proportions of Māori and people over 65 years old had less access to a vaccine than communities which were wealthier, whiter and younger.
Conversely, neighbourhoods with a high proportion of Pacific residents had, on average, slightly better access to vaccine services than areas with a low proportion of Pacific residents.
People over 65 years old were in the rollout's second priority group, while the Government's plan to prioritise vaccination for Māori has been widely reported.
"... that more than a quarter of Māori live in areas with low access to vaccination services, indicates structural racism in Aotearoa's Covid-19 vaccination rollout," the study read.
"When considered alongside our results, this underlines that the Ministry of Health led Covid-19 vaccination rollout has failed Māori..."
In May, the same researchers analysed how far different populations lived from potential vaccination centres and warned the rollout would be inequitable without targeted intervention.
In their latest study, it found more then two-thirds of vaccination services were run from GP clinics, pharmacies and hospitals - suggesting authorities relied on an inequitable distribution of services.
Study co-author Dr Jesse Whitehead said the results indicated postcode vaccination had been present during the rollout.
"It's clear evidence that if you live in a certain neighbourhood ... you've got objectively worse access to vaccination services."
He did acknowledge the study's limitations, namely it did not include any vaccination services not listed with Healthpoint and this data was gathered before the latest Delta outbreak.
Moses cited initiatives aimed at vaccinating Māori, including supporting marae-based hui and engaging Māori health providers to run vaccination clinics.
"We are committed to ensuring Māori have access to the vaccine and that they're being prioritised to receive it."
Pasifika leader Dr Collin Tukuitonga said the results were not surprising but he was glad it validated predictions made before the rollout and anecdotal evidence from various communities.
"This is what we've been saying from the beginning," he said.
"If we knew this at the beginning, why was this not built into the rollout plan from day one?"
Tukuitonga, the Associate Dean (Pacific) and Associate Professor of Public Health at the University of Auckland, believed vaccination events at marae and churches hadn't been sufficiently explored to service at-risk populations.
It comes as he, and other leaders in the medical community, have confirmed a vaccination event targeting the Niuean community will be held across September 23-25 at a church in Māngere - staffed by vaccinators who could speak Niuean.
He quoted DHB data which said there were 12,000 Niueans in Auckland - roughly 4000 of whom had had one dose and about 2500 were fully vaccinated, leaving roughly 8000 unprotected.
Tukuitonga said events like these often relied on innovation from community leaders, instead of being led by district health boards.