While the world has been dominated by the COVID-19 pandemic, another deadly threat to tamariki has been growing.
And COVID-fatigue could be one of the reasons thousands of children are left vulnerable.
Immunisation rates for killer diseases such as measles are dropping, particularly amongst Māori.
For example, the latest Health NZ figures in Counties Manukau - the centre of the last measles outbreak in 2019 - show that just under 35 percent of six-month-old Māori pēpē are fully immunised.
The Hui commissioned an exclusive Horizon Research poll of Māori about childhood immunisations. It found the overwhelming majority of Māori (92 percent) believed immunisations are important, but only 54 percent said the babies in their wider whanau had been immunised on time. Another 19 percent immunised their babies, but late.
Auckland immunologist Dr Anthony Jordan said throughout the pandemic, the rates of childhood vaccinations dropped across the board.
"We are starting to make gains but it is a really, really risky period for us. If a measles case arrives today, these kids are vulnerable," he told The Hui.
He pointed to cases currently in the Philippines and said: "We are one flight away from an outbreak."
Over 50 percent of those who got measles in the last outbreak ended up in hospital, Dr Jordan said. But community health providers said that for whānau dealing with serious social issues, such as living in emergency housing or with domestic violence, immunisation is not a priority.
"Often immunisations aren't front of mind. We need to understand their priorities, respond to those first and then have the conversations," said Turuki Health Care chief executive Te Puea Winiata.
Teresea Olson, chief executive of Kōkiri Health in Hutt Valley, said more than 4500 children are living in motels or other emergency accommodations, but health workers are unable to reach them there.
"The moteliers won't allow it."
The Hui-Horizon poll also reveals health workers face other battles to get babies properly protected.
The poll asked Māori who were not planning to vaccinate or fully vaccinate their children why they'd made that choice. They were able to give more than one answer.
More than a quarter of those who were hesitant to immunise (28 percent) said they don't trust the vaccines' side effects and roughly the same number (27 percent) said COVID-19 has put them off even thinking about immunisations.
Winiata said clinics were pivoting from focusing on COVID-19 back to other health concerns but were short-staffed. As a result, whānau didn't always get the time to talk and ask questions and find out information.
The director of intelligence for the new National Public Health Service, Juliet Rumball-Smith, acknowledged the importance of Māori community providers to the success of the COVID-19 response and said there was a commitment to replicate it for childhood immunisations at every layer of the health system.
Dr Jordan said if health providers were able to connect really early on with a whanau when the baby was six weeks old, then they were able to set up a long-term relationship with that whanau, including for any subsequent children.
He said the focus now was on turning the COVID-19-vaccinating workforce into a wider immunisation workforce, including pharmacies, which were open at weekends and for longer hours than many health providers.
Asked whether Health NZ Te Whatu Ora would push to have more access to information across other government ministries, Rumball-Smith said "absolutely".
She said immunisation is only one of the health needs for children and whānau and their most pressing issues might be better delivered by another department.
"We want to work as one team."
The Hui-Horizon poll found household income made a significant difference in getting children vaccinated on time.
Fifty-eight percent of households with an income of less than $50,000 vaccinated their children on time. That contrasts with 72 percent of those earning more than $150,000.
Rumball-Smith said the pressures on low-income households were 'huge' and overflowed into every aspect of their lives.
"It's really hard to get time off work and it's really hard to borrow a car or take the bus to get to these places, so we really need a system that responds flexibly," she said.
"And that's why you'll see that we are delivering services in more different ways by more different people and in more different places than we ever have before."
Made with support from Te Māngai Pāho and the Public Interest Journalism Fund.
