Māori health providers have urged the government to fund and train their workforce to administer the Covid-19 vaccine to secure coverage of their remote communities, and to overcome vaccine hesitancy.
Iwi-run mobile testing clinics were credited with boosting the flu vaccination rates for Māori over 65, closing the gap between non-Māori and Māori vaccination rates from 12 to 9 percent.
These outreach services are crucial in the Tairāwhiti region, where many of the 25,000 Māori residents live in remote areas with limited access to health services, Turanga Health chief executive Reweti Ropiha said.
"Our approach here was that ... we went into the communities, we worked alongside kaumātua, we had kaiāwhina connected to those communities and they disseminated the information, we worked alongside the marae committees we went in there a week, two weeks before [and] we got them involved in the logistics so it was a win-win situation and [then we] used those as mechanisms to get the information out - hence the uptake," he said.
While there may be some challenges to using this approach with the Covid-19 vaccine, Ropiha said marae could still be used to accommodate the vaccine rollout if they put "the right infrastructure in place".
The Pfizer BioNtech vaccine's being kept in ultra-low temperature freezers but can survive at normal refrigeration for up to 5 days.
GP and Immunisation Advisory Group member Dr Rawiri Jansen said it would be possible to deliver the vaccine to remote communities in that time.
"We've got five days, 120 hours, to get that vaccine into the right places and deliver it so that is completely possible to do in mass vaccination centres and satellite clinics and in some pop-up clinics, or even in some mobile clinics.
"There's some complexities but I think we can definitely have that full range of services."
National MP and former Northland GP Shane Reti said it was a no brainer to make use of Māori and iwi networks, but they mustn't be set up to fail, which means giving them the right IT.
"Let's not have iwi do the vaccines, put it on paper and then hand it to a GP or someone else to do it, tool them up - give them the equipment, give them the training and capacity so like everyone else whose giving the vaccine they can data enter it when it's done and it can go to centralised repository - that's the sort of capacity building I'm hoping we'll give iwi providers and Māori health providers so they can do as good a job, if not better than mainstream."
So far, only nurses and pharmacists are being trained to administer the vaccine, but Māori health providers rely heavily on community workers.
Dr Rawiri Jansen said they're already doing Covid-19 tests and flu vaccinations so should be trained for Covid vaccines.
"They deliver immunisation programmes to 95 percent of those who're eligible so the evidence for Māori when we do a good job of informing and consenting and answering questions and making a good job of the offer, we see some really great immunisation rates," he said.
"It is really sensible to think about that workforce potentially being trained and authorised to give vaccines... it's not part of our system right now but it's sensible to think about that because we've got the biggest immunisation programme in our history."
Covid-19 Response Minister Chris Hipkins hasn't yet committed to funding Māori run mobile clinics but said they will be involved with the vaccination rollout.
"They will be doing vaccinations, we'll be working very closely with them.
"One of the things that we know about reaching our Māori communities - but also our Pacific communities - is that they will be more likely to go to the places they already trust for their health advice and so Māori and iwi providers are really integral to that."
The government has been reluctant to talk about anti-vaxxers, opting instead for "vaccine hesitancy" or those people who weren't opposed but worried about risk.
A Ministry of Health commissioned survey found Māori and Pasifika were less confident about the safety and quality of the covid vaccine, but marginally more likely to take it if they can talk to someone first.
Dr Reti said it was as simple as GPs taking a bit of extra time, and building trust.
"My observation with Māori is pause, hold your breath for a minute and just let the room go quiet - quiet is okay, you don't need to fill that space - and just let them ponder, let them think for a bit, let them digest at their own speed.
"With the information I have to my hand at the moment, and the knowledge I've garnered over time, I will have the vaccine when it's offered to me... so for those who do have vaccine hesitancy, I would ask for some degree of trust, and if they trust me that's my recommendation."
Ministry of Health deputy-director general of Māori health John Whaanga said they would be using Māori networks to reassure tangata whenua the vaccine is safe.
"[We'll be] utilising our communities, our leadership, getting messages out in more than one way, finding ways to work our way around health literacy, there's a big area of work we have to do there in terms of communicating with our people and getting them to feel comfortable."
The details of the specific Māori Covid-19 vaccine plan have yet to be released.
Dr Rawiri Jansen said if it is to to form a meaningful part of the rollout, it needed to be made available to Māori leaders and the public as soon as possible.