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• W3199206750 abstract "Few studies inform us about the New Zealand public intentions to get a COVID-19 vaccine, even as the vaccine rollout has been slow—a pattern similar to Australia, unlike several other developed countries [[1]Daalder M. What's behind NZ's slow vaccine rollout?.Newsroom [Internet]. 2021 Aug 5; ([cited 2021 Aug 10]; Available from:)https://www.newsroom.co.nz/page/whats-behind-nzs-slow-vaccine-rolloutGoogle Scholar]. Such low vaccination rates pose an increasing threat from the new COVID-19 variants to New Zealand, which has been able to evade the pandemic so far [[2]Cardwell H. Covid-19: Delta in NZ community would “risk collapsing or compromising our health system.”.RNZ [Internet]. 2021 Aug 11; ([cited 2021 Aug 12]; Available from:)https://www.rnz.co.nz/news/national/448987/covid-19-delta-in-nz-community-would-risk-collapsing-or-compromising-our-health-systemGoogle Scholar]. Given the brittle health care system in New Zealand—with second-fewest intensive care beds per capita among developed countries—health experts say it is important to vaccinate a very large proportion, about 80-90%, of the population to safely open the borders [[2]Cardwell H. Covid-19: Delta in NZ community would “risk collapsing or compromising our health system.”.RNZ [Internet]. 2021 Aug 11; ([cited 2021 Aug 12]; Available from:)https://www.rnz.co.nz/news/national/448987/covid-19-delta-in-nz-community-would-risk-collapsing-or-compromising-our-health-systemGoogle Scholar]. A recent study by Prickett and colleagues [[3]Prickett KC Habibi H Carr PA. Covid-19 vaccine hesitancy and acceptance in a cohort of diverse New Zealanders.The Lancet Regional Health – Western Pacific [Internet]. 2021 Sep 1; ([cited 2021 Aug 10];14. Available from:)https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(21)00150-4/abstractSummary Full Text Full Text PDF PubMed Scopus (34) Google Scholar] in the Lancet Regional Health – Wester Pacific found that while a majority of New Zealanders (71%) say they are likely to take a COVID-19 vaccine, a significant minority were unsure (15%) or unlikely (14%) to get a vaccine. Young and less educated were more likely to decline a vaccine. Moreover, women were more likely to be unsure than men who were more certain about getting a vaccine or not. However, they did not find ethnicity as significantly associated with COVID-19 vaccine hesitancy in a multivariate model, suggesting that “public health focus on perceived hesitancy in the Māori and Pacific populations—subgroups that are particularly at-risk of COVID-19 infection and morbidity—may be misplaced” (p. 2). Supplementing their findings, only age and education were significantly associated with COVID-19 vaccine intentions in online national surveys conducted in March 2021 (Wave 1=1083) and May 2021 (Wave 2=650). Similarly, ethnicity was not significantly associated with vaccine intentions in the presence of other socio-demographic variables; neither was gender or income. In longitudinal online nationally representative surveys conducted between March 1Full Wave 1 (N=1083) (compared to longitudinal Wave 1): 56% ‘Yes, definitely’ (61%), 22% ‘Unsure, but leaning towards YES’ (19%), 12% ‘Unsure, but leaning towards NO’ (12%), 10% ‘No, definitely not’ (9%). The reinterview response rate was 60% between March and May 2021. Compared to the full wave 1 sample, the longitudinal wave 1 sample had slightly higher vaccine acceptance rate (61% as mentioned above) but similar hesitancy and refusal rates. and May 2021 (N=650), there is a six-percentage point increase among the New Zealand respondents who will ‘definitely’ take COVID-19 vaccine to protect themselves from 61% in March 2021 to 67% in May 2021 (67%). However, a quarter remained unsure (26%), and another 8% were sceptical. The vaccine uptake is at its highest in over a year across multiple public opinion surveys [[4]COVID-19: Vaccine research insights [Internet]. Ministry of Health New Zealand. 2021 [cited 2021 Jun 7]. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-vaccines/covid-19-vaccine-strategy-planning-insights/covid-19-vaccine-research-insightsGoogle Scholar,[5]Thaker J. The persistence of vaccine hesitancy: Covid-19 vaccination intention in New Zealand.J Health Commun. 2021 Feb 1; 26: 104-111Crossref PubMed Scopus (55) Google Scholar]. This finding is consistent with the Ministry of Health surveys that showed an uptick in May [[4]COVID-19: Vaccine research insights [Internet]. Ministry of Health New Zealand. 2021 [cited 2021 Jun 7]. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-vaccines/covid-19-vaccine-strategy-planning-insights/covid-19-vaccine-research-insightsGoogle Scholar]. A large majority (92%) of those who had made up their mind to ‘definitely’ get a vaccine in March continued to do so in May. A small minority became more hesitant (7%), while 1% became more sceptic. The biggest shift was among those who were ‘Unsure, but leaning towards YES’ in March to ‘definitely’ in May (42%), even as about half continued to be unsure (47%) and just over 11% became more hesitant or sceptic. The second largest shift was among those who would ‘definitely’ not get a vaccine in March: while a majority still continued to say so (64%), 21% shifted to ‘Unsure, but leaning towards NO,’ 4% to ‘Unsure, but leaning towards YES’, and 11% to ‘definitely’ getting a vaccine (See Figure 1). The uptick in COVID-19 vaccine intentions, compared to those who did not change their intentions between March and May 2021, was primarily due to uptick among Māori and Asians. Māori respondents were 2 times (Odds Ratio [OR] = 2.28, [1.22, 4.26]) more likely to become more enthusiastic about COVID-19 vaccination in preceding three months compared to European New Zealanders, holding other socio-demographic variables constant. Asians (Odds Ratio [OR] = 2.19, [1.15, 3.91]) were also twice as likely as European New Zealanders to become more motivated to get a COVID-19 vaccine in three months. Gender, age, education, gender, and income were not associated with change in COVID-19 vaccine intentions. In other words, At the same time, there were no significant association between socio-demographic factors and a decline in intentions compared to those who did not change their intention, except for a minor increase in vaccine hesitancy among younger aged groups. Consistent with findings from other Ministry of Health surveys [[4]COVID-19: Vaccine research insights [Internet]. Ministry of Health New Zealand. 2021 [cited 2021 Jun 7]. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-vaccines/covid-19-vaccine-strategy-planning-insights/covid-19-vaccine-research-insightsGoogle Scholar], the COVID-19 vaccination campaign should seek ways to understand and engage the young and less educated groups. The uptick among the ethnic minorities of Māori and Asians is good news. It implies the success of both community-led COVID-19 protective measures as well as government outreach [[3]Prickett KC Habibi H Carr PA. Covid-19 vaccine hesitancy and acceptance in a cohort of diverse New Zealanders.The Lancet Regional Health – Western Pacific [Internet]. 2021 Sep 1; ([cited 2021 Aug 10];14. Available from:)https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(21)00150-4/abstractSummary Full Text Full Text PDF PubMed Scopus (34) Google Scholar,[6]Cram F. Mahi aroha: Māori work in times of trouble and disaster as an expression of a love for the people.Kōtuitui: New Zealand Journal of Social Sciences Online. 2021 Feb 17; 0: 1-15Google Scholar]. Māori and Pasifika health advocates leading the fight against vaccine misinformation [[7]Triponel T. Advocacy group to tackle vaccination fears among Māori.NZ Herald [Internet]. 2021 May 3; ([cited 2021 Aug 31]; Available from:)https://www.nzherald.co.nz/nz/covid-19-coronavirus-advocacy-group-to-tackle-vaccination-fears-among-maori/PSHHJR52ROI5VNK2GAOJ464EW4/Google Scholar], promoting vaccination through pop-up clinics, and organising vaccination centres at and during community events has helped close the vaccination gap between Māori and non-Māori [[8]Johnsen M. Gap between Māori and non-Māori vaccination rates closing [Internet].RNZ. 2020; ([cited 2021 Aug 31]. Available from:)https://www.rnz.co.nz/news/te-manu-korihi/416541/gap-between-maori-and-non-maori-vaccination-rates-closingGoogle Scholar]. Several studies show that ethnic minorities have lower intentions to get a COVID-19 vaccine, in part due to historic inequalities, differential access to health care, among others [[9]Kadambari S Vanderslott S. Lessons about COVID-19 vaccine hesitancy among minority ethnic people in the UK.The Lancet Infectious Diseases [Internet]. 2021; (Aug 9 [cited 2021 Aug 12];0(0). Available from:)https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00404-7/abstractSummary Full Text Full Text PDF PubMed Scopus (30) Google Scholar]. Even prior surveys in New Zealand show vaccination intention is generally low among minorities [[4]COVID-19: Vaccine research insights [Internet]. Ministry of Health New Zealand. 2021 [cited 2021 Jun 7]. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-vaccines/covid-19-vaccine-strategy-planning-insights/covid-19-vaccine-research-insightsGoogle Scholar,[5]Thaker J. The persistence of vaccine hesitancy: Covid-19 vaccination intention in New Zealand.J Health Commun. 2021 Feb 1; 26: 104-111Crossref PubMed Scopus (55) Google Scholar], even as their risk of hospitalization and death is higher than others [[10]Steyn N Binny RN Hannah K Hendy S James A Kukutai T et al.Estimated inequities in COVID-19 infection fatality rates by ethnicity for Aotearoa New Zealand.The New Zealand Medical Journal. 2020; 133 (1521)PubMed Google Scholar]. Continuing the government's focus to engage with at-risk groups will help build trust to resolve other persisting public health issues (Table 1).Table 1Longitudinal analysis of change in COVID-19 vaccine intentions between March and May 2021 in New ZealandLess hesitant to get a COVID-19 vaccinevs.no change in intentionMore hesitant to get a COVID-19 vaccinevs.no change in intentionBS.E.Sig.Exp(B)95% C.I. for EXP(B)BS.E.Sig.Exp(B)95% C.I. for EXP(B)Constant-2.050.500.000.13-3.730.780.000.02GenderMale0.060.230.811.060.671.67-0.090.310.770.910.501.68Age18-25-0.110.510.830.900.332.421.370.650.043.941.1014.0826-350.380.390.321.460.693.120.850.600.152.350.737.5736-450.490.400.221.630.743.591.570.580.014.821.5415.0446-55-0.260.390.500.770.361.650.800.560.162.220.746.6656-650.410.360.251.510.753.060.820.570.152.270.746.96EducationNo qualification0.740.460.112.090.855.100.410.640.521.510.435.25School qualification0.320.320.331.370.732.580.430.420.301.540.683.48Tertiary diplomas/Certificates0.340.300.251.410.782.540.260.390.511.300.602.81EthnicityMāori0.820.320.012.281.224.26-0.050.490.910.950.372.46Pasifika-0.050.650.940.960.273.41-0.360.800.650.700.153.31Asian or Another0.750.310.022.121.153.91-0.360.460.430.700.291.71IncomeLess than $19,9990.010.430.981.010.442.32-1.060.810.190.350.071.70$20,000 to $39,999-0.360.430.410.700.301.630.400.650.541.490.425.36$40,000 to $59,999-0.200.410.630.820.361.850.520.620.401.690.505.68$60,000 to $79,999-0.630.430.140.530.231.240.700.600.252.010.626.52$80,000 to $99,999-1.190.620.050.300.091.020.620.680.371.850.497.09Pseudo R20.070.07Note: N=650; Female compared to male. Those 66 years and above were reference category for age. Bachelors or higher degree was the reference category for education. Ethnicity dummy coded with reference to European-New Zealanders. Individuals with $100,000 or more annual income was the reference category for income. Open table in a new tab Note: N=650; Female compared to male. Those 66 years and above were reference category for age. Bachelors or higher degree was the reference category for education. Ethnicity dummy coded with reference to European-New Zealanders. Individuals with $100,000 or more annual income was the reference category for income. It is also important to highlight that there is a vaccination uptake gap among Māori and Pacific people compared to the general population and the gap is slow to narrow down [[2]Cardwell H. Covid-19: Delta in NZ community would “risk collapsing or compromising our health system.”.RNZ [Internet]. 2021 Aug 11; ([cited 2021 Aug 12]; Available from:)https://www.rnz.co.nz/news/national/448987/covid-19-delta-in-nz-community-would-risk-collapsing-or-compromising-our-health-systemGoogle Scholar]. Understanding the shifting public intentions to get a COVID-19 vaccine will better help increase vaccination uptake, particularly important as almost all COVID-19 deaths are now among the unvaccinated in other countries [[11]Johnson C Stobbe M. Nearly all COVID deaths in US are now among unvaccinated.AP NEWS [Internet]. 2021 Jun 24; ([cited 2021 Aug 12]; Available from:)https://apnews.com/article/coronavirus-pandemic-health-941fcf43d9731c76c16e7354f5d5e187Google Scholar]. On the one hand, health care system should be more embedded with at-risk communities. On the other, we need more participation from local groups—from community and local councils, business groups, unions, and others—encouraging vaccine uptake among their group members. The authors declare no conflict of interest. Table A1.Table A1Sample Demographics(Full sample, March 2021)(Panel, May 2021)TotalN = 1083%n = 650%GenderFemale5525132450Male5314932650Age18-251551453826-35215201151836-4517416811346-55193181382156-65162151101766 and above1841715324EducationNo qualification878457School qualification2862617727Tertiary diplomas/Certificates3353119931Bachelor's degree or higher3753522935EthnicityEuropean New Zealander6896445770Māori175166911Pasifika434254Asian or Another176169915Annual incomeLess than $19,9992081912119$20,000 to $39,9992612416425$40,000 to $59,9991971812419$60,000 to $79,9991841711017$80,000 to $99,9999496310$100,000 to $119,999666305$120,000 or above666345Intentions to get a COVID-19 vaccineYes Definitely3946143367Unsure but leaning towards YES1241910316Unsure but leaning towards NO7612629No Definitely not569528 Open table in a new tab The importance of addressing social inequalities and targeting the undecided to promote vaccination against COVID-19As vaccines against COVID-19 are distributed across the Western Pacific, it is vital to investigate the barriers and enablers of vaccine acceptance in countries across the region. A paper in the latest issue of The Lancet Regional Health - Western Pacific presents the first multivariate analysis of attitudinal and sociodemographic predictors of vaccine intentions against COVID-19 in New Zealand (1). Full-Text PDF Open AccessCOVID-19 Vaccine Hesitancy and Acceptance in a Cohort of Diverse New ZealandersAlthough a majority intend to take the COVID-19 vaccine once available, a sizeable minority who were more likely to be young, female, and less educated, were unsure about or unlikely to get the vaccine, primarily due to perceptions of unknown future side effects. Ethnicity was not statistically associated with vaccine hesitancy, suggesting that public health efforts aimed at increasing vaccine acceptance among Māori and Pacific peoples—subgroups most at-risk of COVID-19 infection and morbidity—should focus on inequities in health care access to increase uptake. Full-Text PDF Open Access" @default.
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• W3199206750 title "Shifting COVID-19 Vaccine Intentions in New Zealand: Next Steps in the Vaccination Campaign" @default.
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