A growing number of families living in communities most vulnerable to infectious disease outbreaks are refusing to have their children vaccinated.

Immunisation experts fear this worrying trend will make it impossible to reach the Government’s target of 95% coverage by 2030.

At Ngā Mataapuna Oranga primary health organisation in Western Bay of Plenty, health workers are not passively waiting for whānau to bring their babies in for vaccination.

A manager and kaiwhakahaere, Jackie Davis, said it had managed to boost immunisation rates by 10% in the past year through the heroic efforts of nurses, community workers and GPs.

“[We’ve even had] community teams lurking in bushes, waiting to ambush mums coming home from shopping,” she said wryly.

In a league table of primary health organisations (PHOs) published by Health NZ, Ngā Mataapuna Oranga has the highest decline rate, with 25% of families refusing immunisation.

As a small PHO, with just four general practices, it only took a handful of families to decline immunisation to drop its rates below target, Davis pointed out.

However, she admitted it was up against persistent anti-vaccination propaganda, which spread like contagion via social media.

“I guess their promotion is just as good as our promotions are, so they counter a lot of the work we do.”

Nationally, 79.3% of 2-year-olds were fully vaccinated in the first three months of the year – marginally better than at the same time last year.

In some regions, however, rates were much lower: Northland had just 66.4% coverage, while in Tairāwhiti/Gisborne and Bay of Plenty, it was around 68%.

Davis said the Covid pandemic damaged trust in the health system and it was taking time to rebuild those relationships.

“I think too that we have to balance our attempts at immunisation in relation to our relationships with our families.

“To put it bluntly, sometimes we’re going two or three times to the same families. And at the end of the day, from their perspective, they’re over us.”

Decline rates threaten 95% target – expert

Infectious disease expert Professor Peter McIntyre, from Otago University, said before Covid, decline rates for childhood immunisation were around 5%.

However, for about one in three PHOs in those Health NZ figures, the decline rate was now more than 10%.

“This substantial increase in the proportion of families declining, effectively makes that impossible.”

Unfortunately, vaccine distrust had got a stronger hold among Māori and Pacific communities, which already had more “delayed” immunisations, he said.

“What the decline figures are telling is that these are people who are indicating they just don’t intend to get their child immunised full stop, which is a development that’s really worrying, because decline is a whole lot worse than delay.”

Full coverage remained a worthy goal, he said.

“But if we really have to choose – which maybe at this stage we do – we want to focus on: How good is our protection against measles? What’s that looking like? What do we have to do about it? And maybe whooping cough as well. And meningococcal B.”

More younger parents and caregivers vaccine sceptical

Ngāti Porou Oranga in Tairāwhiti recorded the lowest coverage, with just 38.5% of 2-year-olds fully vaccinated in the first three months of the year.

No one from the PHO was available to comment.

Eastern Bay Primary Health Alliance in Bay of Plenty said its figures had improved: 58.4% of enrolled tamariki were fully immunised as of July 1, up from 52.5% in the previous quarter.

Chief executive Katarina Gordon said, however, it was also seeing a growing number of whānau “expressing hesitancy or choosing to decline immunisation”.

“We’re seeing a steady increase in vaccine hesitancy, particularly among younger parents and caregivers.

“Some are actively declining, but many are simply unsure or misinformed. Social media misinformation, past experiences of the health system, and general mistrust all contribute to this hesitancy.”

Many whānau were living in rural or remote areas, with limited access to transport, housing instability and economic hardship, which meant day-to-day needs often took priority over preventive healthcare like immunisations, she said.

Health providers were struggling themselves with limited clinic availability, workforce shortages (especially nurses and outreach staff) and high demand, which meant some whānau faced long wait times or limited options for appointments.

“Mobile outreach services help, but capacity is stretched, and funding is not always available and or sustainable.”

Despite these challenges, Eastern Bay Primary Health Alliance continued to work with its practice network, outreach teams, Hauora Māori partners, the National Public Health Service and Te Whatu Ora Health NZ to boost immunisation rates.

“We remain committed to ensuring all interactions with whānau are timely, respectful, and culturally safe.”

-RNZ