New Zealand wants a 90% vaccination rate. The street gangs may hold the key.

AUCKLAND, New Zealand – Rawiri Jansen, a Maori doctor, had an urgent message for the 150 people, mostly patched members of New Zealand’s lavish street gangs and their families, who sat in front of him on a bright Saturday afternoon.

Covid is coming for them, he said. The number of cases in New Zealand hospitals is increasing rapidly. Soon, dozens of new infections per day could be hundreds or even a thousand. People will die. And vaccination is the only defense. “If your doctors are scared, you should be scared,” he said.

At the end of the day, after an extensive question-and-answer session with other health professionals, about a third of those in attendance chose to receive a dose on the spot.

New Zealand has abandoned its highly successful “Covid-zero” elimination strategy in response to an outbreak of the Delta variant, and is now going through a difficult transition to try to keep the number of coronavirus cases as low as possible. On Friday, the country set a goal of fully vaccinating at least 90 percent of the eligible population — a goal, the highest in the developed world, whose success depends on convincing people like those who came together to support Dr. Jansen to hear.

Already 86 percent of the eligible population has received at least one dose. But the last few percent are the hardest to reach, and one group of particular concern is the gang community, many of whose members are Maori or Pacific Islanders, who make up about a quarter of the total population. In the past two months, multiple outbreaks have been reported among gangs, a group that is less likely to comply with official vaccination efforts, forcing officials to work with gang leaders to reach their communities.

New Zealand has one of the highest rates of gang membership in the world. There are about 8,000 gang members in the country, according to the latest police estimates, and many suffer from urban poverty. If we count relatives and acquaintances, the size of the community could be ten times that of a country of five million people, said Jarrod Gilbert, a sociologist at the University of Canterbury and the author of “Patched: The History of Gangs in New Zealand.”

The gangs in New Zealand have a long history, often inspired by similar American groups. In 1961, it became the first country outside the United States to have a Hells Angels chapter. From the 1970s onwards, ethnic-based gangs, including the majority of the Maori Black Power and Mongrel Mob, became more widespread. For Maori who had moved to New Zealand’s urban centers, gangs became a vital means of finding kinship outside of traditional tribal structures.

More recently, said Dr. Gilbert, some are drawn to gangs because of their association with for-profit crime, especially drug sales. New Zealand is a lucrative market for methamphetamine, with gang members among those caught in major police raids.

However, the link between gangs and organized crime is not entirely clear, said Dr. Gilbert. “New Zealanders tend to look at the gangs with a single lens around crime, when the scene is and always has been much more nuanced than that,” he said. Even within a single gang, he added, some chapters can be highly criminalized, while others are more community-oriented.

Since the 1960s, New Zealand politicians have tried to score points by promising to crack down on gangs or by publicly criticizing them. Attempts to contact the gangs typically yielded pearly headlines: A government grant of about $2 million for a drug rehabilitation program linked to members of the Mongrel Mob was heavily criticized, including by police leaders.

But during the current coronavirus outbreak, police and the health ministry have been working with gangs to help achieve vaccinations and contact tracing. Two Mongrel Mob leaders, Harry Tam and Sonny Fatupaito, were granted ‘critical worker’ border exemptions, allowing them to cross from one region to another.

Since then, social organizations with an existing relationship with both the New Zealand government and with gangs and other marginalized groups have acted as emissaries from these hard-to-reach communities. They have been given grants to bring people together to get vaccinated.

“We traditionally have no ways of contacting them,” Gerardine Clifford-Lidstone, the director of Pacific Health in New Zealand, said of the gangs. “And by finding the people who can do that and giving them the information, you’re much more likely to be successful.”

A social change organization called the Cause Collective is one of the groups that helped build the bridges.

“Health officials are now realizing, ‘We don’t really know the communities, the hard-to-reach communities,’ so they need professionals in those areas,” said hip-hop producer Danny Leaosavai’i, aka Brotha D, who works with the organization and is a long-term relationship with gang leaders.

What you need to know about Covid-19 booster shots

The FDA has authorized booster shots for millions of recipients of the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines. Recipients of Pfizer and Moderna who are eligible for a booster include people 65 and older and younger adults who are at high risk for severe Covid-19 due to medical conditions or where they work. Eligible Pfizer and Moderna recipients can receive a booster at least six months after their second dose. All Johnson & Johnson recipients are eligible for a second injection at least two months after the first.

Yes. The FDA has updated its authorizations to allow medical providers to incentivize people with a different vaccine than the one they were initially given, a strategy known as “mix and match.” Whether you received Moderna, Johnson & Johnson, or Pfizer-BioNTech, you can get a booster from any other vaccine. Regulators have not recommended one vaccine over another as a booster. They have also kept quiet about whether it is preferable to stick with the same vaccine if possible.

The CDC has said the conditions that qualify a person for a booster injection are: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney, or liver disease; dementia and certain disabilities. Pregnant women and (ex-)smokers are also eligible.

The FDA approved boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The CDC says that group includes: medical workers; education workers; food and agricultural workers; factory workers; corrections employees; US Postal Service workers; employees in public transport; grocery store workers.

Yes. The CDC says the Covid vaccine can be administered without regard to the timing of other vaccines, and many pharmacies allow people to schedule a flu shot at the same time as a booster dose.

Chris Hipkins, the minister responsible for New Zealand’s response to Covid-19, acknowledged earlier this month that the decision to hire gang leaders was an unusual one.

“Our number 1 priority here is to stop Covid-19, and that means doing what we need to do to prevent the virus,” he said. “Where we’ve been able to engage gang leaders to help with that, and where they’ve been willing to do that, we’ve done that.”

Some gang leaders have acted independently to aid vaccination efforts. They have connected members of their community with health officials, organized events with health professionals such as Dr. Jansen and events streamed on Facebook Live to enable an open forum for questions about rare health risks. In some cases, they have brought vaccines to communities themselves.

“Our community is probably less informed; they’re probably not very healthy,” says Mr. Tam, member of the Mongrel Mob, who is a former government official and who has been granted the Border Exemption. Constant criticism from the media has prevented them from reading traditional news channels, he added.

“They then resort to social media because they have a lot more control,” he said. “It’s also a space that perpetuates conspiracy theories and false information and everything else.” Health advice should come from trusted individuals and community leaders, he said.

In the past week, Mr. Tam has traveled nearly across the country to host pop-up vaccination events for members and their communities, and to coordinate with other chapter leaders to get their members vaccinated, he said.

It was difficult work that put him personally at risk, he said, leading to intense skepticism from people who viewed gangs only as violent or linked to organized crime.

“Why are we worried?” said Mr. Tam. “We worry because we care about those people that others don’t, it’s that simple. They can talk about my gang membership, the rest. But it’s that tape that gives me that penetration, that foot in the door. I can do the things they can’t.”

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