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POVERTY AND DEPRIVATION

Like almost all health issues, low immunisation rates can be linked to higher levels of poverty and deprivation.

But economic deprivation does not tell the entire story.

There have always been communities that have refused to vaccinate. These are often those who live “alternative” lifestyles, seen in parts of the Coromandel, Raglan, Waiheke Island, Hokitika, and Golden Bay. It also includes the West Coast community of Gloriavale.

This makes it a unique health challenge. We don’t tend to see affluent pockets of New Zealand that suffer from high smoking rates, or poorly managed diabetes, for example.

Vaccination rates are dropping across communities, irrespective of income.

This also suggests that vaccine hesitancy is driving the recent drop in immunisation rates.

If it was all about poverty and access, why did rates fall in one quarter of New Zealand’s least deprived neighbourhoods between 2016 and 2018?

Our biggest city provides an interesting case study. Overall, rates in Auckland have not fared as poorly as some parts of the country. But there are plenty of pockets that have seen decreases. These are at both ends of the socio-economic spectrum.

Herne Bay, one of the wealthiest places in the country has seen rates for all milestone ages fall from 93 to 84 per cent in two years.

A few kilometres across the city to the east in Glen Innes – among the bottom quarter of most deprived suburbs in the country in 2013 – rates rose about three percentage points in the same time.

Compare these two maps of Auckland. In the first one, the darker red marks the poorest areas.

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In the second map, the darker red marks areas with the biggest drops in immunisation rates.

They’re not the same. If social deprivation was the main driving force behind the changes in rates, we’d expect the darker red to appear in similar places in both maps.

PUBLIC HEALTH CHALLENGE

Although vaccine rates in New Zealand remain relatively high as a whole, national data glosses over the pockets of vaccine refusal that exist in many communities.

Anti-vaccination sentiment tends to group together, so we can have geographic or social groups of very high rates of decline.

Nikki Turner, head of the Immunisation Advisory Centre

They all share the concerns together and create their own little patches and then there is real risk of disease spreading in these groups.

For herd immunity to work, coverage needs to be at least 90 per cent.

In areas with low rates, vaccine-preventable diseases like measles and pertussis can quickly take hold. In the poorest parts of the country, where rates might already be low due to poverty or access issues, increasing numbers of people who choose not to vaccinate puts an already vulnerable population further at risk.

This is what is unfolding in the worsening measles epidemic in South Auckland right now.

Misinformation harms everyone, but it is lower-income people who suffer the most.

The most vulnerable, experts say, are increasingly targeted and swayed by fake science and misinformation.

Vaccination is the safest and most effective way to protect people from contagious and life-threatening disease. Each decision not to vaccinate makes the next person weaker.

Our social networks could save us. Or they could cost us lives.

As the country wrestles with the worst measles outbreak in more than two decades, it has to be asked; what are we going to do about it?

Immunisation rates where you live

Reporter

Michelle Duff

Data Editor

Andy Fyers

Design&
Development

Sungmi Kim

PROJECT EDITOR

John Hartevelt