The Ministry of Health's equity manager for the vaccination rollout is "absolutely confident" Māori and Pasifika child vaccine rates will be higher than Pākehā.
The head of one of Auckland's most prominent iwi providers said an equitable rollout of childhood vaccinations required planning that included parents and the community.
Medsafe last week granted provisional approval for the vaccination of children aged 5 to 11. The rollout is expected to begin before the end of January.
In an exclusive interview with the Herald, Covid-19 vaccination rollout equity manager Tāmati Shepherd-Wipiiti said work is under way to ensure the larger percentage of children in the Māori and Pasifika populations, compared with Pākehā, is reflected in vaccination levels.
"I'm absolutely confident, I think the settings we've got for Māori and Pasifika are right and they're going to be lapped up by the community."
Covid-19 Response Minister Chris Hipkins earlier told the Herald paediatric vaccines were expected "very early" in 2022.
Earlier in the rollout, vaccine supply restricted distribution across the country. Hipkins said this would not be a factor in 2022 and said communities with low vaccination rates would be prioritised with extra workforce and mobile clinics.
Shepherd-Wipiiti said engagement was ongoing with paediatricians, schools, GPs, Māori/Pasifika health providers and more to achieve high levels of vaccination in the 5 to 11-year-old age group.
"Our thinking is if we design by Māori, for Māori, it'll be better for all but some of those design elements, they are so fitting with our Māori and Pasifika way that I'm confident that in January and February, we will have a great result in terms of our 5 to 11s."
His comments come as New Zealand reaches a historic milestone in its vaccination rollout - 90 per cent of Kiwis 12 years and older are fully vaccinated.
It was a target first set by the Herald's 90% Project - a campaign to reach 90 per cent by Christmas.
Vaccination levels for Pasifika are very close to national figures at 87 per cent double dosed. Full vaccination levels among disabled Kiwis is reportedly higher than 90 per cent.
For Māori however, 76 per cent are fully vaccinated with a further 10 per cent having had one dose.
Shepherd-Wipiiti highlighted the levels in the disability community as a real success considering the Ministry was unaware of the community's true number - about 1.2 million people - until months into the rollout.
On Māori, Shepherd-Wipiiti said reaching 86 per cent partial vaccination was among the highest level achieved across any vaccination drive for Māori in the past decade.
However, he was under no illusions Covid vaccinations had lagged for Māori.
"We're behind, there's no dressing it up, we are behind the whole-of-country statistic and on the estimations that we've had, we will cross that 90 per cent Māori across all of our DHBs by the end of January."
A contributing factor was the age of New Zealand's Māori population. About 280,000 Māori had been precluded from getting vaccinated until 12 to 15-year-olds became eligible in August and people under 35 became eligible in September.
Since then, Māori had been vaccinated at 2-3 times the rate of Pākehā, increasing from 2000 per day in July to as high as 5700 from September.
When the Government introduced its rollout group priority scheme and the Book My Vaccine appointment scheduling tool, Māori health advocates called for younger Māori to become eligible earlier - recognising the advanced risk posed by Covid-19 to Māori at younger ages.
At the unveiling of Book My Vaccine in June, Prime Minister Jacinda Ardern said such measures weren't necessary as Māori and Pasifika would be targeted through other methods.
Shepherd-Wipiiti said the Ministry of Health was in favour of bringing young Māori into the programme sooner but the Government decided against it.
He did clarify the use of different age brackets by ethnicity wasn't as effective on its own - as evidenced in Australia and its approach to Aboriginal vaccination - but also required good implementation alongside such measures.
Asked what surprised him during the rollout, Shepherd-Wipiiti referenced the success of the drive-through events as a win - something echoed by the heads of Auckland's rollout.
He also cited the incorporation of celebration and festivities into the rollout, such as with Super Saturday where 130,000 people were vaccinated on October 16, one of the highest daily totals per capita in the OECD.
Such events were even effective at encouraging disabled Kiwis to be vaccinated. Super Saturday saw a 3-4 per cent rise in vaccination among that community.
"We thought the last place you would want to go if you have a disability is a big mass event crowded with people, but actually the surprise was they came out in their numbers."
On the rollout's flaws, Shepherd-Wipiiti was upfront in his belief vaccination efforts failed to engage gang communities.
"In hindsight, we would have spent more time thinking about our gang whānau and the fact that they have families connected to them that need access to the same protections as everyone else.
"I think if there was ever a regret for me personally, it would have been not engaging a lot earlier with our gang whānau."
During the Delta outbreak, positive cases were seeded among gang communities, prompting gang leaders to seek out public health experts for educational sessions and running their own vaccination drives.
Shepherd-Wipiiti said outreach to gangs needed a much more nuanced approach, treating different gang chapters similar to different hapū.
Another community he felt needed more support were those struggling with alcohol and drug addiction, where engagement could have been more sensitive and responsive.
One of the more common criticisms from vaccination providers has been about the slow activation of primary care and Māori health providers, operators which would soon become among the most popular facilities for vaccination.
Auckland iwi provider Ngāti Whātua Ōrākei has been heavily involved in many aspects of the rollout, from operating a vaccination site in East Auckland to running a successful Got Ya Dot/Ira campaign to encourage vaccination in young Māori.
Chief executive Rangimarie Hunia doesn't believe organisations like hers were brought into the fold early enough and as a consequence, Māori vaccination levels trail national figures.
She cited a proposal from the Whānau Ora Commissioning Agency to the Ministry of Health in March, which outlined the need for targeted and mobile vaccination services, but was not acted upon until weeks later.
"Today that's normal, all of us are doing [targeted and mobile vaccination] but it should not have taken until about six weeks into this [rollout] for this country to realise we had to do it all at that stage."
Nevertheless, Hunia was buoyed by the number of Māori who had been vaccinated.
"It says to me that Māori people want to be well, Māori people want to keep their kids and communities to be safe, Māori people - given the opportunity and the right styles and approaches - will engage."
Looking ahead, Hunia hoped health officials had learned their lessons through the rollout and would involve providers in planning from the outset.
"We need to be a part of the planning because usually what happens is they decide what they're going to do and they tell you they're going to do it.
"I hope what they've learnt in this watershed moment is that it's best done with us, not at us."
Parents were essential, Hunia said, should the rollout to 5 to 11-year-olds gain traction.
Despite the challenges ahead, Hunia believed vaccination for Māori and Pasifika in that age group could and should thrive.
"Our babies deserve us to have thought really deeply and thought really well about how we look after them."