Lakes health leaders say an "unconventional" approach is needed to lift Māori vaccination rates, as fears of a Delta outbreak in the Rotorua region grow.
One says there is not an "ice cube's chance in hell" Māori vaccinations will reach 90 per cent, in his view, but Te Arawa Covid-19 Hub says it is aiming for 95 to 100 per cent no matter how long it takes.
It comes as Covid-19 was detected in wastewater in Taupō on Friday, with residents of the Lakes district encouraged to get tested.
At a Lakes District Health Board (DHB) meeting on Friday before the test results were made public, DHB quality risk and clinical governance director Dr Sharon Kletchko stressed the importance of vaccinating as many people as possible against Covid-19.
"It's getting upwards of 99.9 per cent being suggested if we're really going to get on top of it," she said.
In a report, Kletchko said modelling by the University of Auckland's Te Pūnaha Matatini estimated Covid-19 deaths in 2022 could be 27 total, with 13 Māori, which she described as "inequitable".
She preferred people were immunised by the vaccine rather than by contracting the virus, because infected people put "pressure not only on the health system currently, acutely, but on the future health system".
"We need to do something radically different to get on top of our vaccination of our young Māori in particular."
DHB member Lyall Thurston said he wanted to know what needed to change to increase rates.
"It will be the unvaccinated who will be stalked by Covid and … they are the ones who will have the biggest impact on our DHB and our hospital services.
"It could be here today, it could be here tomorrow but it's definitely going to be in our DHB area shortly."
Kletchko said the DHB was working on "mobility … to knock on doors basically".
Young people, however, appeared to feel "invincible" - a trend noted overseas as well.
"Young people feel that Covid is a mild disease that they can just ignore and if they catch it so what. We need to be much more frank with them and upfront."
She said long Covid – chronic issues following recovery from even a mild case - was one of those factors.
DHB member Dr Rees Tapsell applauded the work to date but agreed the DHB needed to "do something different".
"Human beings respond to carrot and stick.
"Either there needs to be more carrot or more stick.
He said the DHB needed to think "more openly" about "carrot" approaches, but was surprised by the Te Pūnaha Matatini modelling and thought it would be "much worse".
"While I totally agree we as an iwi should say 100 per cent, I don't think we've got an ice cube's chance in hell of even getting to 90.
"It's absolutely great to have an aspirational goal ... but we need to be realistic."
The latest vaccination data showed 53 per cent of eligible Lakes Māori were fully vaccinated, and 70 per cent had at least one dose.
DHB equity and outcomes director Mapihi Raharuhi said it had been working with Te Arawa Covid-19 Response Hub collective where rangatahi (young people) were involved in strategy.
"I'm really impressed at how our community have put some of the politics to the side … and focused on how do we increase our vaccination rates for Māori."
"The [vaccine] rollout itself in terms of age groups almost put us in the position that we're in. Rangatahi came off the rank last."
Lakes DHB chairman Dr Jim Mather said it was "no coincidence" the DHBs struggling to reach the 90 per cent target had high Māori populations, such as Lakes, Tairawhiti, Taranaki, Waikato and Northland.
He said DHBs were only part of the solution and he supported direct funding to iwi and community providers to implement methods they knew worked.
Te Arawa iwi DHB representative Aroha Morgan believed rangatahi rates were improving due to education in schools and polytechnics.
"I think it's the conspiracy theorists [who've] got to our people."
Ngati Tūwharetoa iwi DHB representative Trudy Ake said "huge work" had been done but "in the same way of thinking that's gone on a long time, that hasn't served us well".
As vaccination was only available for most young people in September, it "gave a good run for many of the conspiracy theories and communication to go through".
She said engagement and incentives had to be "unconventional" and approached "community by community".
After the meeting, Te Arawa Covid Response Hub collective kaumatua Monty Morrison said being more creative was "a no brainer", and was already the collective's response.
Morrison said the collective was aiming for 95 to 100 per cent vaccination for Māori but welcomed all people.
"We want to limit the obvious damage that the Delta strain could wreak havoc on our people.
"We want to make sure we are in a position to get our people over 90 per cent, 95 per cent is our goal, even 100 per cent better still."
He said the aim was to do "the best we can as soon as we can, the sooner the better".
"It has to take as long as it will take."
Te Rōpū Whakakaupapa Urutā the National Māori Pandemic Group co-leader Associate Professor Sue Crengle agreed urgency was needed to vaccinate as many people as possible before Covid spread in communities outside Auckland and Waikato.
She said people needed more aroha (compassion) for young people since they only became eligible for the vaccine in September.
"It's really important we don't have that rangatahi-blaming discourse going on."
Young people needed to be reached where they were, by people they liked and trusted, and vaccination needed to be made as easy as possible for them, she said.
Hearing information from trusted sources also helped combat misinformation and conspiracy theories.
University of Otago epidemiologist Professor Michael Baker said when Māori vaccinations were low there would be higher rates of infection and a higher percentage of Māori would get sick and die.
"We don't want that. The virus exploits uneven vaccination rates."
He said there was a "whole spectrum of misinformation and disinformation" and some were benefiting from spreading false information, some from the natural remedies industry.
"Social media providers need to take responsibility. They are not just a platform but a publisher.
"Their algorithms allow them to profit from the spread of misinformation."