Māori in one district are being fully vaccinated against Covid-19 at a quarter of the national rate, according to Herald analysis that has found "deeply concerning" vaccine discrepancies across the country.
It comes as from today the country moves on to vaccinating the general population, despite just 10 per cent of Group 3, those most vulnerable, being fully vaccinated.
Meanwhile across the Tasman, New South Wales wrestles with an explosion of cases that has forced a pause in quarantine-free transtasman travel.
Stranded Kiwis have been given seven days to return to New Zealand without having to go into managed isolation and quarantine, potentially putting the country at risk.
Herald analysis of vaccination data, as of July 20, and current District Health Board-level population estimates has uncovered highly uneven vaccination rollouts across the country.
Experts have highlighted poor communication between the DHBs, Ministry of Health and local populations, along with differing numbers of health and MIQ workers across districts, who made up Groups 1 and 2.
The worst performer per capita is Taranaki, with a rate of 6.4 per cent overall and just 3.3 per cent for Māori.
This compares to a national rate of about 11 per cent overall, and 7.6 per cent for Māori. The national rate for European/Other is 12.9 per cent.
It comes amid fears of a local outbreak after two vessels docked at the local port loaded with mariners infected with Covid-19, and as the district ramps up testing after the virus, believed to be the highly-infectious Delta variant, was found in wastewater sampling.
About a third of the Taranaki District Health Board population identifies as Māori. Multiple studies have identified Māori particularly vulnerable to Covid-19 due to the higher rates of comorbidities and socioeconomic factors.
The Government received expert advice to prioritise Māori and lower the age range through the rollout to boost vaccination rates, which it rejected.
Health experts and iwi leaders have slammed the rollout in Taranaki as a "failure", meanwhile the Ministry of Health refused to say if it had concerns with the low vaccination rates, nor if it had been in contact with those DHBs.
In most DHBs the rate for Māori is about half the general population, while some are well below half.
There was expected to be a gap initially, given Māori were underrepresented in the medical workforce who were first to be vaccinated. But now Group 3 was being targeted the gap was expected to rapidly narrow.
However, this has not occurred, with the gap continuing to widen over five months into the rollout.
In Southern DHB 5.3 per cent of Māori have been vaccinated compared to the total rate of 12.6 per cent.
Nelson/Marlborough has the highest vaccination rate per capita at 18.1 per cent but Māori are well behind at 8.7 per cent. West Coast has 17.6 per cent of its population vaccinated, with Māori at 7.3 per cent.
Even some districts with very high Māori populations are also struggling to keep Māori rates up. Bay of Plenty, with about a third of the population Māori, the general rate is 13 per cent, yet 6.4 per cent for Māori.
The closest to equity was Capital and Coast and Hutt Valley DHBs, with a general rate of 9.2 per cent and 7.7 per cent for Māori.
Auckland Metro – Counties Manukau, Waitematā and Auckland DHBs – which has vaccinated by far the most people - sits close to the national rate, with 13.5 per cent fully vaccinated, and Māori at 7.5 per cent.
Example of 'systemic racism'
Te Paati Māori co-leader Debbie Ngarewa-Packer, also a leader with South Taranaki iwi Ngāti Ruanui, said the poor rates for Māori were symptomatic of the systemic racism in the health system.
"They are just continuing a formula that has never worked for Māori. The Government even ignored advice from medical experts showing due to our lower life expectancy there were going to be less Māori in those older groups."
Ngarewa-Packer said there were also higher rates of vaccine hesitancy in some rural Māori communities, meaning a different set of communications were required.
"There just has not been that through much of the rollout."
The mass vaccination event planned for Manukau this weekend has also come under criticism for its poor communications with its target Māori and Pasifika audience, with less than a quarter of those invited booking a slot.
Speaking to RNZ, South Auckland general practitioner Dr Api Talemaitoga said the mass rollout was a great initiative but the event lacked Māori and Pasifika input.
Māori health expert and GP Dr Rawiri McKree Jansen said the per capita figures were "deeply concerning".
"In Taranaki, it's a sign of failure. With a risk of outbreak from returning travellers, boat crews, to have it that far behind in the vaccination programme is deeply concerning."
Ministry of Health surveys show decreasing rates of vaccine hesitancy as the rollout progresses. In May, overall 80 per cent of respondents said they were likely to get vaccinated – up from 69 per cent in March, including 75 per cent for Māori - up from 64 per cent in March.
"There is increasing goodwill to be vaccinated. It is now on the health services and planning and capacity to deliver, and so far we have not done that," Jansen said.
Associate Professor Nikki Turner, director of the Immunisation Advisory Centre, said while the low rates were concerning it was difficult ahead of the general rollout to say what the issues were.
Each DHB designed its own rollout based on what it believed was necessary and what it could deliver.
Some had higher rates of MIQ and health workers and vulnerable populations, which would account for some of the variation, she said.
However, as the rollout moved into Group 4 she said it would be very concerning if the rates between Māori and non-Māori did not narrow.
Minister not 'comfortable' with low rates
The Ministry of Health declined to answer specific questions from the Herald about if it was satisfied with the low rates for Māori and vast discrepancies across the country.
In an email response, Covid vaccination equity group manager Jason Moses said the low rates were "largely attributed" to the lower proportion of Māori in Groups 1 and 2 of the vaccination programme – particularly among the frontline healthcare workforce - and lower age demographic.
This was expected to narrow as they moved further into Groups 3 and 4, which both had higher proportions of Māori, he said.
The sequencing framework gave DHBs, which knew their communities best, the "flexibility to respond to their area's particular needs and tailor approaches that work best for their different populations", he said.
The Government had also set aside $39m to boost Māori vaccination rates, including nearly $30m to health providers for equity programmes.
Covid-19 Response Minister Chris Hipkins made a similar statement a month ago, yet the gap has widened over the same period.
Last week Hipkins said the numbers for Māori were "lower than I am comfortable with", and there was a lot happening with Māori and Pasifika health providers, and building up Māori and Pacific vaccinators.
Hipkins was not available to comment for this article, and an offer for comment from other ministers was turned down.
The Herald contacted several DHBs for comment with questions, including about the low rate for Māori, whether they had a specific strategy and had identified issues with communication, and only one responded by deadline.
Bay of Plenty DHB CEO Pete Chandler said achieving equity was a priority and they were working closely with iwi and Māori health providers to reach remote areas with higher Māori populations.
"As we move into the full-scale rollout we are expecting the equity gap will close, but this is something we all need to work together on."
National's Covid spokesman Chris Bishop said the vastly different vaccination rates showed the DHB plans were "meaningless".
Taranaki for example was performing at 130 per cent of its plan, despite having the lowest per capita rate by a long way.
"Both things cannot be true," Bishop said.
"The plans are designed to give the appearance of progress when the reality has been very slow."
Bishop said given the vast differences showed there has clearly been a breakdown somewhere in communication between the DHBs and the Ministry.
- additional reporting Chris McDowall