Journal of Tropical Diseases & Public Health

Barriers to immunisation in the northland region of New Zealand

15^th International Conference on Preventive Medicine & Public Health

September 15-16, 2025 Webinar

Ineke Crezee

Auckland University of Technology, New Zealand

Scientific Tracks Abstracts: J Trop Dis

Abstract:

Statement of the Problem: The Northland region of New Zealand, where 38% of the population identify as Māori, has had low rates of childhood immunisation, placing the population at greater risk of preventable, vaccinable diseases. This presentation will report on a 3-year research project conducted in the Northland region of New Zealand between 2021 and 2024. In this fairly remote and isolated region, 38% of the population identify as Māori, the indigenous people of New Zealand. Immunisation rates had been low prior to the COVID-19 pandemic and were the main impetus for the research, which aimed to explore barriers to immunisation in collaboration with community and primary care research partners in Northland. Interviews, focus discussion groups and feedback sessions involved 62 community members and health professionals from around Northland, with the majority of community members identifying as Māori. Focus groups and interviews revealed distrust as the main barrier to immunisation, revealing that the COVID-19 vaccine mandate introduced by the New Zealand government between May and November 2021, had exacerbated historically grown distrust versus the government. Geographical isolation, shortage of health professionals and high turnover of family doctors, before patients and doctors have been able to build a relationship of trust. Another issue mentioned during interviews and focus group discussions involved a lack of internet coverage, making it difficult to book appointments and lack of access to healthcare and immunisation providers. Suggested solutions include better planning to support the local communities, working on solutions with the community, and incorporating a culturally appropriate approach to healthcare, involving a Māori world view. Some of the approaches which have now been implemented included utilising navigators from the community to overcome historical distrust, and training immunisation staff in Kaupapa Māori, a framework which emphasises Māori perspectives and practices, to ensure a culturally appropriate approach. Recent Publications 1. Charania NA, Kirkpatrick L, Paynter J, Turner N. Childhood vaccination uptake among children born in Aotearoa New Zealand based on parental nationality. Human Vaccines & Immunotherapeutics. 2023 Aug 1;19(2):2240688. 2. Gauld N, Martin S, Sinclair O, Dumble F, Petousis-Harris H, Grant CC. Mapping the maternal vaccination journey and influencing factors for Māori women in Aotearoa New Zealand: a qualitative study. Journal of Primary Health Care. 2022 Sep 30;14(4):352-62. 3. Howe AS, Gauld NJ, Cavadino AY, Petousis-Harris H, Dumble F, Sinclair O, Grant CC. Increasing uptake of maternal pertussis vaccinations through funded administration in community pharmacies. Vaccines. 2022 Jan 20;10(2):150. 4. Marek L, Hobbs M, Wiki J, McCarthy J, Tomintz M, Campbell M, Kingham S. Spatial-temporal patterns of childhood immunization in New Zealand (2006–2017): an improving pattern but not for all?. European Journal of Public Health. 2021 Jun 1;31(3):561-6.. 5. Pointon L, Howe AS, Hobbs M, Paynter J, Gauld N, Turner N, Willing E. Evidence of suboptimal maternal vaccination coverage in pregnant New Zealand women and increasing inequity over time: a nationwide retrospective cohort study. Vaccine. 2022 Mar 25;40(14):2150-60

Biography :

Ineke Crezee, ONZM, has dedicated her professional career to improving equal access to healthcare for cultural and linguistic minorities and developed the first dedicated healthcare interpreting and translation programmes in New Zealand. Her book Introduction to healthcare for interpreters and translators has appeared in 7 different language iterations, including Spanish, Russian, Chinese, Japanese and Turkish. In 2020 she was made an Officer of the New Zealand Order of Merit (ONZM) for services to interpreter and translator training. Between 2021 and 2025 she led the Vaccine Trust Programme which aimed to uncover barriers to immunisation in the Northland region of Aotearoa New Zealand, working closely with organisations involved in delivering community and primary healthcare in Northland.