By Jordan Green* and Dr Jess Berentson-Shaw*
Comment - Over the course of the Covid-19 pandemic, we have been repeatedly shown that when Māori lead, we get things done, we keep our communities well, and we get our whānau vaccinated.
Out on the East coast, Jordan's iwi Te Whānau ā Apanui are a stand-out example of the power of iwi and hapū-led vaccination.
The Te Araroa community similarly shows us how Māori-led communications about the vaccine can resonate strongly across both Māori and tauiwi audiences.
What these iwi and hapū-led approaches to vaccination show is that supporting whānau across the vaccination line is much more effective when programmes to do so are designed and implemented by trusted leaders within our Māori communities. It reflects what research from around the world shows: people get vaccinated when vaccination programmes, including the provision of information, are community-led.
We know that there is a complex interplay of factors that drives people's vaccine concerns or hesitancies. This is contrary to the common misunderstanding that hesitation is driven by not enough good information or too much bad information. The factors that are important to vaccine hesitancy include individual and social factors such as beliefs, attitudes and culture; social and political economies and histories. For example experiences of racism from core public institutions; and vaccine specific issues such as the novelty of the vaccines, previous experiences, and fear of needles.
An effective programme to encourage people over the line will be designed around the drivers unique to each group or community. Which is what grassroots vaccination programmes are uniquely placed to do: know the drivers and needs of their particular community. It's not simply about delivery of vaccination facts or data by "trusted messengers". It is about giving all our communities what they need to be reassured, giving them what they need to have their particular concerns addressed in the context of what is driving those concerns. It's about knowing what the needs of that community are to help get vaccinated and meeting them.
Information from Prime Minister Jacinda Ardern, Director-General of Health Dr Ashley Bloomfield, or even scientists meet the need of some but not all communities
For much of this pandemic we have seen an information approach from the government that has sought to establish our prime minister, the director-general of health, central government and indeed science itself as an authoritative trusted source of information: "The one source".
Such an approach mostly meets the needs of those who they reflect. That is, people and communities who share values, worldviews, culture and lived experience with them. People who have positive or at least not entirely negative experiences with the institutions these figures represent. These experts and sources for instance reflect Jess' community and experience, so broadly speaking they are able to give people like Jess what they need to feel reassured about vaccination.
However, what Māori vaccination rates clearly show is that relying on a one-size-fits-all approach, where policymakers assume that meeting the needs of one (larger) part of the population, will meet the needs of all parts, doesn't work.
Understanding drivers of hesitancy to ensure we have what we need to support our whānau across the vaccination line
Ensuring whānau Māori have what we need to get over the vaccination line means understanding what is driving our concerns. This is a lot more than just asking what worries people about vaccination. It means listening to connect. Listening to how our communities are thinking, reasoning and talking about vaccination - and the narratives and stories they are telling about science, government, health and immunity and more. Which is what we did in our research exploring how whānau Māori are thinking and talking about the Covid-19 vaccine in online conversations.
What we learned about how whānau Māori are thinking and talking about the Covid-19 vaccine
Firstly, we wanted to identify ways of thinking and talking about Covid-19 vaccinations that whānau were drawing on that tended to open the doors to false information and anti-vaccination kōrero and encourage vaccination hesitations. Narrative research suggests that communicators need to understand and recognise these ideas and narratives in order to avoid amplifying them and ensure people are not subjected to false information.
Secondly, we wanted to identify ways of thinking and talking about Covid-19 vaccinations that whānau were drawing on that appeared to encourage support for getting vaccinated. This will allow us to amplify these supportive ways of reasoning, using evidence-based narrative techniques. This helps people find, reflect on and understand the good information about vaccination, in turn reassuring them that getting vaccinated is the right thing to do for their community in this pandemic. It will also help sideline anti-vaccination kōrero and ideas.
Anti-vaccination proponents exploit Māori experiences of systemic racism and discrimination
For Māori, our lived experiences driving hesitation have been shaped significantly by past and present racism with mainstream systems, our experiences of neglect in past pandemics, in addition to the ongoing violation of our rights (in this case tino rangatiratanga) guaranteed by Te Tiriti o Waitangi. In our research we observed that these experiences interacted with common anti-vaccination narratives used by proponents of vaccine denialism globally.
However, we found worldviews and values such as freedom, choice, and purity which are often drawn on by those who deny the vaccine science, looked different for Māori communities discussing vaccination. In Aotearoa, we saw experimentation and safety concerns wrapped up with our painful history of colonisation, and we also saw personal freedom and choice being associated with mana motuhake and protecting our rights as Māori by saying no to vaccination. The information and narrative environment our whānau navigate, has been significantly shaped by people spreading false information and narratives about vaccination, in ways unique to our experiences as Māori.
Counter narratives situate vaccination as core to whānau aspirations
However, just as our information environment has been impacted by false information and anti-vaccination narratives, our people were also drawing on collective and mana enhancing kōrero to support others in their vaccination journey. These included counter narratives like oranga motuhake and leading our own, collective hauora journey; using vaccination as a tool and ordinary part of keeping ourselves and our whānau well; and importantly, considering vaccination as a key way we can be good tīpuna and protect our kaumātua, descendants, and whānau who can't get vaccinated or need extra protection from the virus.
Overwhelmingly, our wider research on Covid-19 vaccination messaging has found that when we lead with collective values of care and manaaki for each other, avoid individualising health decisions through the language of choice, and instead focussing on understanding the issues driving hesitancy, we see more people move from vaccine hesitancy through to acceptance. These narratives and narrative techniques are ones our Māori leaders are sharing, and are reflected in whānau thinking. We are drawing on these principles in a way that is meaningful and relevant to our experiences as Māori.
When counter narratives like these are repeated often and over time, by the trusted messengers for our people, within our iwi and hapū, it will help to sideline anti-vaccination messages that are impacting on our Te Tiriti rights as Māori to access good information about the vaccine. It will help meet our needs about the vaccination, including access to information, to support our whānau over the vaccination line.
What are the roles and responsibilities of people in government to support Māori-led vaccination?
What our research shows is that we should be concerned about the exploitation of our people and their experiences by those who use false information. However, the solutions to overcoming these narratives already exist within our communities. Our communities know what we need. It is now up to people in the central government, mainstream health and science to awhi people within iwi and hapū in practical ways to continue to do their work with their communities to get the vaccination rate up and keep whānau Māori (and the rest of Aotearoa) well.
Regardless, leaders within our communities will continue to get the message out to whānau who need it: we get vaccinated to awhi each other and protect our people and whakapapa.
* Jordan Green (Te Whānau-ā-Apanui, Ngāti Porou), and Dr Jess Berentson-Shaw (Tangata Tiriti), are researchers at The Workshop.