Tamariki Māori need to be prioritised in the roll out of the paediatric COVID-19 vaccine, multiple health experts say.
A New Zealand Medical Journal editorial penned by Dr Owen Sinclair, Dr Jin Russell, Dr Danny de Lore, Dr Erik Anderson, Dr Teuila Percival and Dr Siouxsie Wiles says the government needs to prioritise tamariki Māori otherwise there will be a repeat of the issues that have been shown in the roll out for the current eligible population.
They argue for a vaccination programme for all New Zealand children to be rolled-out as soon as possible after regulatory approval, and that the design of the paediatric vaccine roll-out should be underpinned by equity to uphold the Crown's obligations for Māori under Te Tiriti o Waitangi.
The article states that "it is vital that health equity for Māori is kept in mind when making decisions regarding the paediatric vaccine roll-out in Aotearoa".
"We must not repeat the failures that led to the existing vaccination inequities for Māori, inequities that are not a matter of chance but the result of structural racism and inequity by design."
It states the decision to phase the vaccination roll-out according to age and diagnosed pre-existing conditions failed to account for the younger age structure of the Māori population, the greater burden of Māori disease, both diagnosed and undiagnosed, at younger ages, the significant barriers for Māori accessing healthcare and their justified distrust of the health system.
"The paediatric roll-out is an opportunity to learn from previous errors and protect Māori."
One of the authors, Dr Owen Sinclair, said they were hoping people would realise getting tamariki Māori vaccinated will create a layer of protection for vulnerable communities.
"This will create a web of protection in an already vulnerable population that has suffered COVID the most."
"If we can allow tamariki Māori to be part of the solution to empower them to be an immunised non-infected reservoir within Māori communities that will help everyone.
The roll out in schools could be a bit tricky because the roll out was meant to start at the end of January and a lot of schools did not start till February, Sinclair said.
"A programme that is rolled out entirely in GP's and vaccination centres like last time, it will result in inequality."
There were good networks created with iwi and community health providers and they should be integrated into the roll out from the beginning, he said.
"Those providers have gone out and done the hard mahi and integrated with maori and Pacific communities."
The major advantage of a school based programme was that it was known where children between the ages of 5 and 11 were between 9 in the morning and 3 in the afternoon.
"Schools are a trusted part of their community. Having the programme rolled out in schools particularly lower decile schools I think is an excellent way to address some of the access issues we saw in the adult programme," Sinclair said.
"We're advocating for that, I don't think New Zealand has a good track record or any track record to achieving equity for Māori."
The key part of the puzzle was that to achieve equity one side needed to get more and the other side needed to get less, he said.
"The risk of a school based programme is that it's a general one and if that happens, all the very wealthy schools that are non-Māori and Pacific will instantly access all of those services very quickly and will create an inequity."