Study highlights need for tailored responses

Visible gaps between rural and urban Covid-19 vaccination rates highlight the need for tailored health responses, University of Otago researchers argue.

Results of the first study to analyse vaccination uptake in rural versus urban settings during the peak period of New Zealand’s national vaccination rollout in 2021 found different population groups had varying levels of vaccine uptake.

Department of general practice and rural health PhD candidate and lead author Talis Liepins said the findings suggested opportunities for improvements in vaccination delivery models for rural and urban communities, and further highlighted the urban-rural divide when it came to equitable healthcare.

"It is important we advance general awareness around equity of access for rural populations and how health interactions for rural communities differ from urban communities."

The study, published in Epidemiology and Infection, used a national dataset of 4.3 million health service users.

"By the end of the study period there was a clear urban-rural gradient apparent for all ethnic groups, with greater rurality associated with lower levels of vaccination uptake.

"Rurality further exacerbated the lower vaccination rates for Māori."

The researchers also found "considerable variance" in uptake between rural older and younger people, and the rural-urban differences were much more apparent in those under 45.

Department of general practice and rural health rural section head and co-author Prof Garry Nixon said these differences, visible across different population groups, suggested different barriers to access.

"This further emphasises the importance of health policy responses tailored to meet the needs of rural populations."

Funded by the Ministry of Health Covid-19 and National Immunisation Programme, the study is the first of three exploring the Covid-19 vaccine rollout in rural New Zealand.

They aim to help show how effective the rollout was for different rural populations, identify the barriers and facilitators and guide future policy decisions.

"Policy makers and programme funders need to be aware of the urban-rural divide and work to address it through policy development, service or programme development, and funding rural services to meet the needs of the communities they know so well," Prof Nixon said.


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