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New tool to tackle vaccine hesitancy in NZ

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Professor Nikki Turner

The Minister of Health, Hon Andrew Little, today announced $68.3 million in new project and programme grants awarded by the Health Research Council. Here we feature one of those newly funded projects led by Professor Nikki Turner.

A new tool to gauge why some New Zealanders are refusing or delaying vaccinations will help healthcare professionals target interventions to increase vaccination uptake and reduce the likelihood of more outbreaks of vaccine-preventable diseases.

Director of the Immunisation Advisory Centre at the University of Auckland, Professor Nikki Turner (pictured), has received a Project Grant from the Health Research Council of New Zealand (HRC) to support the development of the Vaccine Barrier Assessment Tool in collaboration with Australian colleagues and the World Health Organization.

It will be the first comprehensive tool to accurately predict vaccine uptake, measure and monitor vaccine acceptance, and identify practical barriers limiting access to vaccines.

There is currently no regular national assessment of vaccine concerns or a tool to measure or monitor such concerns in New Zealand.

Professor Turner and Hauora Māori lecturer Dr Esther Willing (Ngāti Toarangatira) from the University of Otago will co-lead the New Zealand arm of this research, which is part of a larger Australian study designed and led by Associate Professor Margie Danchin and her team from the Murdoch Children’s Research Institute and the University of Melbourne.

The New Zealand research will have a specific focus on understanding and predicting vaccine hesitancy and access barriers among Māori whānau to ensure vaccination services are responsive to their needs.  

Child immunisation rates in New Zealand are low by comparable international standards and have been decreasing since 2016, with rates dropping further due to the COVID-19 pandemic. The percentage of fully immunised children is particularly low among tamariki Māori and children living in high deprivation areas. The 2019 outbreak of measles in New Zealand that saw more than 2000 reported cases was caused by a mixture of historical low vaccination coverage, poor access to services and a lack of confidence in the vaccine.

HRC Chief Executive Professor Sunny Collings says we urgently need tools to better understand, monitor and tackle vaccine hesitancy, which is threatening achievements the world has made in reducing the burden of infectious diseases.

“This research is extremely timely as we need more effective strategies to support and maintain the uptake of New Zealand’s childhood vaccination programme if we are to achieve herd immunity and prevent disease transmission,” says Professor Collings.

Professor Turner says it is important to note the difference between vaccine hesitancy and anti-vaccination, and that the reasons for people refusing or delaying vaccines are complex and vary considerably by country and populations.

“We estimate that between 2 and 4 percent of the New Zealand population may be highly suspicious of vaccinations, and they are unlikely to change their minds. However, the group of people we call ‘vaccine hesitant’ can vary hugely from 5 to up to 20 percent of the population and there are a range of barriers as to why they do not get vaccinated, including their social environment and distrust of health services. It is this group of people that we are targeting with this tool,” she says.

The most recent NZ Attitudes and Values Study, covering the period from 2013-2017, reported a concerning increase in vaccine scepticism in 30 percent of those surveyed, but Professor Turner says this does not tell the whole story.

“Although surveys like this help provide insights into how New Zealanders view vaccines, like vaccination coverage statistics, they cannot distinguish between the specific concerns New Zealanders have about vaccines or identify any barriers that caregivers and whānau experience in accessing vaccines. Also, only 12 percent of participants in this survey identified as Māori, which limits the applicability of survey findings to this priority group.”

Professor Turner says the Vaccine Barrier Assessment Tool will provide a more systematic account of people’s concerns with vaccinations, covering three main areas: capability (e.g. lack of knowledge about schedules); opportunity (e.g. infrequent contact with health services) and motivation (e.g. concern about side effects). The questions will be validated within a New Zealand context, particularly for Māori.

“If we get good, validated data about vaccine hesitancy that we can apply to the national childhood vaccination programme, then this will have benefits across the whole health sector. We will be able to guide policymakers, public health services and clinicians to develop the most effective strategies for ensuring ongoing vaccine acceptance and high vaccine uptake. This work will also be crucial as we move forward with a regular COVID-19 vaccination programme, which has not yet been defined,” she says.

Professor Turner’s research is one of 31 general Project grants (with a combined value of $36.64 million) announced today, alongside five Rangahau Hauora Māori grants ($5.91 million), five Pacific Project grants ($5.79 million), and four Programme grants ($19.99 million).

See below for the full list of 2021 Project Grant recipients. To read lay summaries about any of these research Projects, go to and filter by proposal type ‘Project’ and year ‘2021’. 

2021 Project Grant recipients

Dr Emma Best, The University of Auckland
Understanding measles: severity and sequelae
36 months, $1,104,966

Professor Vanessa Burholt, The University of Auckland
Improving continence management for people with dementia in the community
36 months, $1,199,981

Dr Penelope Carroll, Massey University
Tackling ableism to remove barriers to participation in sport and recreation
36 months, $1,105,429

Professor Larry Chamley, The University of Auckland
How does preeclampsia in pregnancy lead to early cardiovascular disease?
36 months, $1,199,914

Dr Lisa Connor, Research Trust of Victoria University of Wellington
Harnessing lung resident immune cells for mucosal vaccines
36 months, $1,199,975

Professor Sue Crengle, Waitematā District Health Board
Optimising the potential benefits of lung cancer screening in Māori in New Zealand
36 months, $1,186,187

Professor Start Dalziel, The University of Auckland
RCT budesonide-formoterol vs salbutamol reliever therapy in preschool asthma
36 months, $1,439,689

Dr Jack Flanagan, The University of Auckland
Lymphocyte specific kinase inhibitors for controlling immunotherapy toxicity
36 months, $1,199,974

Professor David Grattan, University of Otago
Visualizing and controlling the cause of hot flushes at menopause
36 months, $1,198,704

Professor David Grattan, University of Otago
A novel brain pathway involved in pathogenesis of obesity and type-2 diabetes
48 months, $1,199,664

Professor Parry Guilford, University of Otago
Targeted drug delivery to the stomach
36 months, $1,191,527

Dr Laura Gumy, University of Otago
Novel targets to enhance axonal repair after spinal cord injury
36 months, $1,199,242

Dr Jason Gurney, University of Otago, Wellington
The growing crisis of diabetes and cancer co-occurrence
24 months, $799,777

Associate Professor Christopher Hall, The University of Auckland
Uncovering the earliest events leading to tophaceous gout
36 months, $1,194,917

Professor Anne La Flamme, Research Trust of Victoria University of Wellington
Understanding how heparan sulfate mimetics control neuroinflammation
36 months, $1,199,969

Dr Cameron Lacey, University of Otago, Christchurch
Te Pu Korokoro: Improving the physical health of Māori with psychosis
36 months, $1,199,991

Dr Michael Maze, University of Otago, Christchurch
Aetiology focused treatment: a new paradigm for empiric pneumonia treatment
36 months, $1,192,690

Professor Peter McIntyre, University of Otago
Measuring and boosting waning immunity to measles in young adults
36 months, $1,163,259

Associate Professor Rinki Murphy, The University of Auckland
Predicting cardiovascular risk from diabetic eye screening photographs
36 months, $1,198,293

Associate Professor Lianne Parkin, University of Otago
Utilisation and safety of ondansetron during pregnancy: a national cohort study
36 months, $1,199,993

Associate Professor Roshini Peiris-John, The University of Auckland
Intersectional ethnic minority youth: harnessing creativity for health gains
36 months, $1,199,984

Dr Toni Pitcher, University of Otago, Christchurch
Parkinson's in New Zealand: Genes and environmental exposures
36 months, $1,199,252

Dr Mihi Ratima, Te Pou Tiringa Incorporated
Te Kura Mai i Tawhiti - kaupapa Māori early years provision and health outcomes
36 months, $1,199,860

Professor Stephen Robertson, University of Otago
Improving genetic diagnosis for tamariki in Aotearoa
36 months, $1,199,920

Professor Franca Ronchese, Malaghan Institute of Medical Research
Skin dendritic cell specialisation determines disease outcome
36 months, $1,199,943

Professor Nikki Turner, The University of Auckland
Developing an assessment tool to gauge barriers to vaccination
36 months, $896,195

Dr Jason Turuwhenua, The University of Auckland
A device for monitoring visual acuity progression in young children at home
36 months, $1,198,558

Associate Professor Charles Unsworth, The University of Auckland
Neural chip platforms for drug translation in paediatric brainstem gliomas
36 months, $1,199,977

Associate Professor Natalie Walker, The University of Auckland
Effectiveness of alcohol warning labels: research to reduce alcohol-related harm
36 months, $1,199,999

Associate Professor Natalie Walker, The University of Auckland
Combining cytisine and nicotine vapes: a randomised trial in smoking cessation
36 months, $1,439,365

Associate Professor Alan Wang, The University of Auckland
IMPRESS: Intelligent Multimodal imaging platform to PREdict Stroke motor outcomeS
36 months, $1,146,922

Dr Isaac Warbrick, Auckland University of Technology
Te Maramataka - restoring 'health' by reconnecting with Te Taiao
36 months, $1,125,098

Professor Denise Wilson, Auckland University of Technology
Kei roto tō tātau rongoā: A community-whānau-based approach for wellbeing
36 months, $1,197,919

Dr Ross Wilson, University of Otago
Measuring the health state preferences of New Zealanders
36 months, $1,167,512

Dr Annika Winbo, The University of Auckland
Neurocardiac coculture approach to the long QT syndrome
36 months, $1,199,932

Dr Jichao Zhao, The University of Auckland
Targeting the right atrium, the forgotten chamber of the heart
60 months, $1,199,999