Vaccine rollout on track to achieve equitable uptake for Māori and Pacific Peoples

The Ministry of Health continues to review and analyse the data for the number of Māori and Pacific Peoples vaccinated to assess whether the vaccine rollout is on track to achieve equitable outcomes for Māori and Pacific populations.

The latest data provides insight into the numbers of 1st and 2nd vaccine doses administered to Māori, Pacific Peoples, and Non-Māori, Non-Pacific peoples, by age band. The results also include the uptake number per 1,000 people in the population.

The national sequencing framework has focused on vaccinating those most at risk of getting COVID or becoming very sick from the virus. This meant prioritising border and frontline workers, elderly, disabled and those with underlying health conditions.

The Ministry acknowledges the on-going commitment of iwi, Māori and Pacific providers, DHBs and communities that continue to lead and support vaccination programmes in the most effective way for their communities.

We are now vaccinating the wider population of Aotearoa – more than two million people.  We are using age bands because it’s simple and easy to understand, we are starting with older people first because they are more at risk if they catch COVID-19.

Māori and Pacific populations have a younger age structure than the non- Māori non-Pacific population. Seventy seven percent of the Māori eligible population and 79 percent of the Pacific eligible population are under the age of 54. The opportunity for significant numbers of the Māori and Pacific people to be vaccinated will not occur until vaccinations start for this age group. People in our younger age bands have not yet been eligible to be vaccinated unless they were included in rural vaccinations, are border and frontline workers, elderly, disabled and those with underlying health conditions.

Percentage of individuals receiving a first dose self-identifying as Māori split by sequencing framework up to 01 August

Group 1	8.7%
Group 2	9.1%
Group 3	8.4%
Group 4	11.7%

The Ministry of Health will regularly publish ethnicity data in relation to the vaccine rollout.  

Caveats and Context

Vaccination data is sourced from the COVID-19 Immunisation Register (CIR) and valid up to 23:59 01 August 2021.

Approximately 0.9% the COVID-19 vaccinations have been administered to patients of unknown ethnicity and have been included in the non-Māori non-Pacific group.

Rate Ratio has not been adjusted for other factors.

The Health Service User (HSU) data includes people enrolled with a primary health organisation (PHO), or where the Ministry of Health has a record that they have used other health services such as hospital admissions, the emergency department, or filled a prescription anytime during 2020.

Ethnicity data comes from a patients NHI as at 5th July 2021, and is prioritised in the order: Māori, Pacific, Asian, MELAA, European, Other, Unknown in accordance with Ministry Standards. Approximately 0.5% the HSU population is of unknown ethnicity and have been included in the non-Māori non-Pacific group.

Base population estimates are subject to finalisation and there may be minor changes to the statistics as this work is completed. A full description and finalised aggregate dataset will be published on the Ministry of Health website in the near future.

Understanding the data

In the table below, rate ratios tell us the rate Māori or Pacific People per population are being vaccinated compared with non-Māori non-Pacific. This comparison can be split by age group.

• A rate of 1 means the groups being compared are being vaccinated at the same rate.
• A rate over 1 means Māori (or Pacific) are being vaccinated at a higher rate than non-Māori non-Pacific, positive for equity.
• A rate under 1 means non-Māori non-Pacific are being vaccinated at a higher rate than Māori or Pacific Peoples, negative for equity.

National COVID-19 Vaccine Uptake per 1,000 HSU

by Prioritised Ethnicity and Age band Unadjusted Rate Ratio vs Non-Māori Non-Pacific

Non-Māori Non-Pacific

Age Band	Vaccines Administered		Population	Uptake per 1,000		Rate Ratio
		Dose 1	Dose 2	HSU	Dose 1	Dose 2	Dose 1	Dose 2
65+	476,882	302,313	713,129	669	424	N/A Reference Group
55-64	175,911	98,135	509,989	345	192
45-54	121,776	73,017	520,298	234	140
35-44	96,760	60,296	503,737	192	120
16-34	140,021	96,116	930,596	150	103
Overall	1,011,350	629,877	3,177,749	318	198

Māori

Age Band	Vaccines Administered		Population	Uptake per 1,000		Rate Ratio
	Dose 1	Dose 2	HSU	Dose 1	Dose 2	Dose 1	Dose 2
65+	33,110	24,424	49,290	672	496	1.00	1.17
55-64	27,719	18,262	67,782	409	269	1.19	1.40
45-54	18,215	10,148	82,857	220	122	0.94	0.87
35-44	11,032	6,173	82,022	135	75	0.70	0.63
16-34	18,808	11,291	229,360	82	49	0.54	0.48
Overall	108,884	70,298	511,311	213	137	0.67	0.69

Pacific Peoples

Age Band	Vaccines Administered		Population	Uptake per 1,000		Rate Ratio
	Dose 1	Dose 2	HSU	Dose 1	Dose 2	Dose 1	Dose 2
65+	16,550	12,641	25,989	637	486	0.95	1.15
55-64	15,595	11,104	30,455	512	365	1.48	1.89
45-54	13,660	7,853	41,072	333	191	1.42	1.36
35-44	11,585	6,273	45,783	253	137	1.32	1.14
16-34	17,846	9,862	117,176	152	84	1.01	0.81
Overall	75,236	47,733	260,475	289	183	0.91	0.92

Please note this information is sourced from the Ministry of Health Health Service User (HSU) data rather than Statistics NZ population data, based on the Census. We are using HSU data because it is health specific and provides greater consistency when estimating vaccine uptake, in particular for specific ethnic groups and locations.

HSU data includes people enrolled with a primary health organisation (PHO), or where MoH have a record that they have used other health services such as hospital admissions, the emergency department, or filled a prescription anytime during 2020.

The information above should be read in the context that there are differences between the way health data and Census data are collected. One result of this is that there is a small difference (approx. 2%) between the number of people who identify as Māori people in HSU data and in Stats NZ population data.

High level summary

• 108,884 Māori people have received at least one dose, and of those 70,298 have received a second dose and were fully vaccinated.
   
• 75,236 Pacific people have received at least one dose, and of those 47,733 have received a second dose and were fully vaccinated.
   
• 1,011,350 Non-Māori, Non-Pacific people have received at least one dose, and of those 629,877 have received their second dose and were fully vaccinated.
   
• As at 01 August, relative rates for the Māori and Pacific eligible populations over 16 are low, however uptake for Māori and Pacific people aged 65 and over is by and large equitable.
   
• Broadly speaking, the younger the age group, the less equitable the uptake for (Māori in particular which is likely to reflect)
  • adherence to the Sequencing Framework and age banding
  • potentially lower uptake of younger-age Māori with underlying health conditions and disabilities.
     
• Differences in Māori and Pacific vaccination rates by age is likely to reflect events that have been held specifically for Pacific populations (eg Hawke’s Bay’s vaccination of a large number of RSE workers and border workers, disproportionately working-age-Pacific)
   
• Analysis at a DHB level suggests regions taking an event/festival-based strategy (eg Capital Coast, Hutt Valley, Hawke’s Bay) are performing best for equity.

Population comparisons

• Māori and Pacific populations have a younger age structure than the non- Māori non-Pacific population.
• 15 percent of the Māori population and 15 percent of the Pacific population are aged over 60 years compared with 30 percent of non- Māori non-Pacific.
• 77 percent of the Māori eligible population and 79 percent of the Pacific eligible population are under the age of 54. The opportunity for significant numbers of the Māori and Pacific people to be vaccinated will not occur until vaccinations start for this age group.