Exploring the impact of the COVID-19 pandemic on perceptions of national scheduled childhood vaccines among Māori and Pacific caregivers, whānau, and healthcare professionals in Aotearoa New Zealand

ABSTRACT

In Aotearoa New Zealand, there has been a marked decrease in the uptake of routine childhood vaccinations since the onset of the COVID-19 pandemic, particularly among Māori and Pacific children. This Māori and Pacific-centered research used an interpretive description methodology. We undertook culturally informed interviews and discussions with Māori and Pacific caregivers (n = 24) and healthcare professionals (n = 13) to understand their perceptions of routine childhood vaccines. Data were analyzed using reflexive thematic analysis and privileged respective Māori and Pacific worldviews. Four themes were constructed. “We go with the norm” reflected how social norms, health personnel and institutions promoted (and sometimes coerced) participants’ acceptance of routine vaccines before the pandemic. “Everything became difficult” explains how the pandemic added challenges to the daily struggles of whānau (extended family networks) and healthcare professionals. Participants noted how information sources influenced disease and vaccine perceptions and health behaviors. “It needed to have an ethnic-specific approach” highlighted the inappropriateness of Western-centric strategies that dominated during the initial pandemic response that did not meet the needs of Māori and Pacific communities. Participants advocated for whānau-centric vaccination efforts. “People are now finding their voice” expressed renewed agency among whānau about vaccination following the immense pressure to receive COVID-19 vaccines. The pandemic created an opportune time to support informed parental vaccine decision-making in a manner that enhances the mana (authority, control) of whānau. Māori and Pacific-led vaccination strategies should be embedded in immunization service delivery to improve uptake and immunization experiences for whānau.

KEYWORDS:

• Māori
• Indigenous
• Pacific
• COVID-19 pandemic
• childhood vaccines
• perceptions
• equity
• caregivers
• healthcare professionals

Acknowledgments

The authors thank the participants for their valuable time and contributions. The authors also extend their thanks to the members of the Advisory Group for their guidance throughout the study, including: Dr Anna Howe and Professor Nikki Turner (Immunisation Advisory Centre), Dr Janine Paynter (University of Auckland), Professor El-Shadan (Dan) Tautolo (Pacific Islands Family Study, AUT), Taima Campbell (Te Korowai Hauora o Hauraki), and Dr Natasha Saunders (Institute for Clinical Evaluative Sciences). The authors also thank Dr Mary Hedges and Tamara Tesolin (New Zealand Work Research Institute) for supporting this research.

Disclosure statement

The authors have no potential conflict of interest to report.

Author contributors

NC, LI, GD, GP, and DW conceptualized the study and applied for funding. DT, TBU, and GD conducted data generation and analysis with input from NC, LI, GP, and DW. NC, DT, TBU, and LI co-wrote the manuscript draft with intellectual information from all authors. All authors read and approved the final manuscript.

Availability of data and materials

The datasets generated and analyzed during the current study are not publicly available due to privacy and ethical reasons. The collected data is of a sensitive and personal nature, and was collected from participants on the basis that strict confidentiality would be maintained. Data can be available from the corresponding author on reasonable request and will require completion of relevant confidentiality agreements.

Ethical approval and consent to participate

Auckland University of Technology Ethics Committee (22/266) granted ethical approval for this study. All participants provided informed written consent prior to participation.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2023.2301626

Notes

[a] Please refer to Supplementary Table 2 for a full list of Māori and Pacific terms and an English interpretation.

Additional information

Funding

The Ministry of Health funded this work. The funder had no role in the study design, collection and interpretation of the data, or the decision to submit the manuscript for publication.