National | Novel Coronavirus / COVID-19

'No privilege in dying early' - Māori doctors address vaccine anxiety

New Zealand’s first batch of Pfizer/BioNTech COVID-19 vaccine landed on local airport tarmac on Monday.

The government expects to start offering the vaccine to border and MIQ workers on Saturday, starting in Auckland. This week on Te Ao with Moana, Moana Maniapoto talked to three Māori health professionals about vaccines and why some people feel anxious about immunisation.

Maia Brewerton (Ngati Kahungunu, Ngati Porou) and Anthony Jordan (Ngati Wai) are the only two Māori clinical immunologists in Aotearoa. They treat patients whose immune systems are compromised, making them particularly vulnerable.

While vaccines will not be mandatory, Brewerton is on a mission to protect her patients by encouraging the rest of the population to be vaccinated.

“People have to remember history always repeats,” Jordan said. “There are vaccinable diseases here that we will see re-emerge if we see vaccine hesitancy grow over time.”

Dying early

GP Rawiri Jansen (Ngati Raukawa, Ngati Hinerangi) was vocal in challenging the government’s Māori response to Covid-19 for last year. He is now a member of the newly formed Immunisation Implementation Advisory Group and on a mission to prioritise Māori.

And Jordan was scathing of any criticism of such a strategy as “privileging” Māori. “There’s no privilege in dying early.”

Jansen was critical of how the health system had dropped the ball on measles vaccines for 15-30-year-olds. “We know what happened when we exported that virus elsewhere, and that was catastrophic for another country.”

Jordan described how vaccines worked differently in different age groups, and “now we’re seeing different strains developing in the UK and South Africa. We know vaccines are similarly less effective for those”.

Evolving situation

He acknowledged people could feel confused by the changing position of scientists studying Covid-19.

“Now this is really frustrating for people because they feel like we are making it up as we go but we are constantly tacking from side to side as new data comes in, and we’re responding to an evolving situation.”

Rawiri said the immunisation programme “will have different vaccines in it”. He said all decisions would be based on science and described how, if things changed, the programme would adjust.

He said while it was important for people to understand that while vaccines were not a magic bullet, they did offer an “important layer of protection” against the coronavirus.

Concerned about myths circulating on social media, Maniapoto asked Brewerton to describe to Te Ao with Moana how vaccines work.

She began by explaining how the spike protein in the coronavirus is targeted. She emphasised that DNA is not touched.

Herd immunity

“Pfizer vaccine is what we call an mRNA vaccine. It does not go into your nucleus where all your DNA is stored. So that's quite safe and separate. It just delivers this genetic recipe to ourselves to produce the spike protein, no other part of the virus is introduced.”

Asked how many people needed to be vaccinated for it to be effective, Maia replied: “We think it’s in the vicinity of 80% of the population group but in the short term we need to focus on keeping the virus out (of the country). So the first action to do is vaccinate border workers to keep them safe.”

Jordan described how some had mixed up the idea of herd immunity.

“There's an individual protection that when I vaccinate Maia [Brewerton], I protect her from getting moderate, severe Covid-related death. So, she gets that. What happens when I vaccinate Maia and Rawiri [Jansen] is that you and I may get protected from them not getting sick with Covid-19 and being able to pass it on. And that's where you hear this term herd immunity coming about. People out there read about herd immunity from natural infection. There is a myth, okay. The term was designed for vaccination and how vaccination protects people who can't be vaccinated.”

Natural hesitation

He also said those who were sceptical or suspicious about receiving a vaccine should trust experts they know, rather than anonymous sources circulating on social media.

Jansen said some of that hesitancy makes perfect sense, “when you look at a racialised health system that has delivered very badly to you, your life experience, your lived experience, your whanau’s experience -of course you’re going to be hesitant. And then you look at really great Māori providers who can deliver 95% of Māori kids getting immunised. We can be proud of that. I want to see an immunisation programme that has protected the Māori community as it’s number one feature.”

Although immunisation will not be mandatory, all three experts agree on one thing.

“There has never been a pandemic that has served Māori well," Jordan said.

Watch the full episode of Te Ao with Moana at the top of this story.