Are ‘priority groups’ just guinea pigs for rest of us?

New Zealand’s Covid vaccination programme is structured around four ‘‘priority groups’’, chosen by the Ministry of Health.

The definitions of these groups mean those at the front of the queue will include many people with Ma¯ ori and Pasifika backgrounds, starting with Group 1 – MIQ and border workers and their families.

South Auckland, home to Auckland Airport, is the main gateway into the country during this global health crisis. It is also home to the largest Polynesian population in the country and a high number of Ma¯ ori. Many MIQ and border workers are from Ma¯ ori and Pasifika backgrounds.

Group 2, which covers frontline healthcare workers and their families, also includes people over 65, people who are pregnant, and people with chronic health conditions or disabilities living in the Counties Manukau District Health Board area, which includes South Auckland.

The third group includes anyone throughout the country with a chronic condition or other vulnerable health status – again propelling many Ma¯ ori and Pasifika higher up the priority list.

Many of the people included in the higher priority groups are used to being last in line for healthcare.

So why are these groups now at the front of the queue?

Some have already expressed their concerns they are merely ‘‘guinea pigs’’ for everyone else.

But the Government’s vaccination plan is structured to protect those most at risk from contracting the disease, and their families. The higher priority groups (Groups 1-3) have been chosen because they are at higher risk of contracting Covid-19 or are more likely to suffer serious or fatal consequences if they do.

During the 1918 flu pandemic, Ma¯ ori death rates were seven times higher than Pa¯ keha, and during the swine flu (H1N1 influenza) spread in 2009 Ma¯ ori were 2.6 times more likely to be hospitalised or die.

Modelling from Te Pu¯ naha Matatini research centre, and published in the NZ Medical

Association Journal, suggests Ma¯ ori are twice as likely to die of Covid-19 compared to non-Ma¯ ori. The rate is even higher for older Ma¯ ori and Pasifika people and those with underlying health problems.

According to the modelling, approximately one in four Ma¯ ori and 45 per cent of Pacific peoples live in crowded housing, and many are multi-generational households, potentially accelerating transmission.

Ma¯ ori and Pacific populations also have a shorter life expectancy and face increased exposure to infectious disease and respiratory conditions.

For these reasons, rather than treating the vaccine with suspicion, some Ma¯ ori and Pasifika health leaders have called for the Government to make all Ma¯ ori and Pasifika people a priority during the vaccine rollout.

Structural health and social inequities mean Ma¯ ori and Pasifika people are more likely to suffer serious illness or die from Covid-19 than Pa¯ keha¯ – and that is why they feature so strongly in the priority groups for vaccination.