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Whatunga Rangahau Oranga Ahuwhenua

Rural Health Research Network | Whatunga Rangahau Oranga Ahuwhenua

Rural–urban variation in COVID-19 vaccination uptake in Aotearoa New Zealand: Examining the national roll-out.

Liepins T, Davie G, Miller R, Whitehead J, De Graaf B, Clay L, Crengle S and Nixon G (2024). Rural–urban variation in COVID-19 vaccination uptake in Aotearoa New Zealand: Examining the national roll-out. Epidemiology and Infection, 152, e7, 1–8.

2024-01-16

This paper led by Talis, a PhD candidate with the Rural Section at University of Otago, is the first of three exploring the COVID-19 vaccine rollout in rural Aotearoa NZ using mixed methods and funded through the Ministry of Health COVID-19 and National Immunisation Programme research. Here a statistical approach was taken to link the national Health Service User data with COVID-19 immunisation records and the Geographical Classification for Health categories. Further publications from Prof. Garry Nixon’s team will be posted as they become publicly available & describe i) the development of an interactive tool to support these findings https://gch-nz.shinyapps.io/covid_vaccine/ and ii) a qualitative paper on rural health provider perspectives of the COVID-19 vaccination rollout in four rural sites with a focus on Māori and Pasifika communities.

OPEN ACCESS https://doi.org/10.1017/S0950268823001978

Abstract

This study aimed to understand rural–urban differences in the uptake of COVID-19 vaccinations during the peak period of the national vaccination roll-out in Aotearoa New Zealand (NZ). Using a linked national dataset of health service users aged 12+ years and COVID-19 immunization records, age-standardized rates of vaccination uptake were calculated at fortnightly intervals, between June and December 2021, by rurality, ethnicity, and region. Rate ratios were calculated for each rurality category with the most urban areas (U1) used as the reference. Overall, rural vaccination rates lagged behind urban rates, despite early rapid rural uptake. By December 2021, a rural–urban gradient developed, with age-standardized coverage for R3 areas (most rural) at 77%, R2 81%, R1 83%, U2 85%, and U1 (most urban) 89%. Age-based assessments illustrate the rural–urban vaccination uptake gap was widest for those aged 12–44 years, with older people (65+) having broadly consistent levels of uptake regardless of rurality. Variations from national trends are observable by ethnicity. Early in the roll-out, Indigenous Māori residing in R3 areas had a higher uptake thanMāori in U1, and Pacific peoples in R1 had a higher uptake than those in U1. The extent of differences in rural–urban vaccine uptake also varied by region.