A new report co-authored by the University of Waikato and the Waikato District Health Board has highlighted the lack of access rural residents have to covid-19 vaccination services.
The Spatial Equity of Covid-19 Vaccination Services in Aotearoa report examined the spatial equity, and associated health equity, implications of the geographic distribution of covid-19 vaccination services in New Zealand.
As well as rural residents, Māori people over the age of 65 and people living in areas of deprivation also had lesser access to vaccination services.
“Spatially accessibility to vaccination services varies across Aotearoa and appears to be better in major cities than rural regions,” it said.
“Furthermore, priority populations including Māori, older people and residents of areas with socioeconomic constraint have, on average, statistically significantly lower spatial access to vaccination services. This is also true for people living in rural areas.”
It also found that vaccination services also varied significantly by District Health Board (DHB) region.
The report was compiled in August prior to the latest lockdown and the outbreak of the Delta variant in NZ and has been sent to the Ministry of Health (MoH) to be peer reviewed.
The Rural GP Network’s clinical director of rural health Jeremy Webber says while its findings are no surprise, it was important to put it into context.
“Things are moving so quickly that when this was done we were very much on that staged rollout of vaccinations, which has changed a lot with Delta coming through,” Webber said.
He says it highlights the lack of access to vaccinations rural communities faced in the initial response.
“Rural communities weren’t prioritised as they perhaps should have been,” he said.
“The important distinction now is that since the delta outbreak, the Ministry has really ramped up the vaccination programme.”
The report also highlighted the variability of access in rural areas, he said.
“It’s not just poor in rural compared to urban. There’s a discrepancy between areas. You have a farmer in one area saying they had no trouble getting a vaccine and somewhere else says they can’t even book in.
“It creates that angst and uncertainty about whether they can get the vaccination or not.”
While it was important to prioritise those at risk people on the front line, he says there was also a differentiation between population groups who are more likely to die of the disease.
“That certainly applicable to Māori, to rural to low socioeconomic,” he said.
Some rural communities had already taken the initiative and established pop-up vaccination services.
Community halls in some rural areas had also been utilised as vaccination centres, particularly on marae.
In his region of Taupō, he knew of one in Reporoa and another in Turangi where iwi had utilised marae to vaccinate and educate people on covid.
“We do have these little pockets where people are being really proactive.”
The MoH’s group manager of covid vaccination operations Astrid Koornneef says that while no farmer-specific vaccination events had been set up so far, DHBs with a high proportion of remote and rural populations had rolled out events for people in rural communities.
“One example is the Canterbury District Health Board running a clinic recently in Ashburton for migrant communities, many of whom work on dairy farms in the district, ‘’ Koornneef said.
“General practice and pharmacy-based clinics have also been established in Akaroa township and in the Hurunui, Waimakariri, Kaikōura, Ashburton and Selwyn districts.”
Pop-up clinics had also been set up in South Canterbury and another was set to be rolled out in Taranaki later this month.
Webber says administering the vaccine was also putting further pressure on a rural health force already struggling with staffing shortages.
He had also heard anecdotally from some rural doctors concerned with some who had escaped the lockdown in urban areas to their holiday homes and had taken up some of the vaccines from rural communities.
There were also challenges in people with poor internet service in rural communities struggling to use the online booking system.
“That’s been frustrating for some of our rural communities,” Webber said.
The answer was to contact their local GP by phone to arrange a time to get vaccinated.
Rural doctors were also aware it was a busy time of the year for farmers.
“I would suspect that getting a vaccination is down on their (farmers) priority list, but what we need to do is make sure that there is some good consistent messaging around prioritising them when they are available and making sure we get them vaccinated,” he said.
