AUCKLAND, New Zealand — Rawiri Jansen, a Maori doctor, had an urgent message for the 150 people, mostly patch-wearing members of New Zealand’s plentiful street gangs and their families, who sat before him on a bright Saturday afternoon.
Covid is coming for them, he said. Cases in New Zealand’s hospitals are rising rapidly. Soon, dozens of new infections a day might be hundreds or even a thousand. People will die. And vaccination is the only defense. “When your doctors are scared, you should be scared,” he said.
By the end of the day, after an exhaustive question-and-answer session with other health professionals, roughly a third of those present chose to receive a dose then and there.
Having abandoned its highly successful “Covid-zero” elimination strategy in response to an outbreak of the Delta variant, New Zealand is now undergoing a difficult transition to trying to keep coronavirus cases as low as possible. On Friday, the country set a target of getting at least 90 percent of the eligible population fully vaccinated — a goal, the highest in the developed world, whose success hinges on persuading people like those who gathered to hear Dr. Jansen.
Already, 86 percent of the eligible population has received at least one dose. But the final few percent are the most difficult 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 overall population. In the past two months, multiple outbreaks have been reported among gangs, a group less likely to comply with official vaccination efforts, forcing officials to cooperate with gang leaders to reach their communities.
New Zealand has one of the highest rates of gang membership in the world. There are around 8,000 gang members in the country, according to the most recent police estimates, and many suffer from urban poverty. Counting family and associates, the size of the community might be 10 times that, in 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.”
New Zealand’s gangs have a long history, often inspired by similar American groups. In 1961, it became the first country outside the United States to have a chapter of the Hells Angels. Beginning in the 1970s, gangs with an ethnic basis, including the majority-Maori Black Power and Mongrel Mob, became more widespread. For Maori who had moved to New Zealand’s urban centers, gangs became a critical way to find kinship away from traditional tribal structures.
More recently, Dr. Gilbert said, some have been drawn to gangs for their association with profit-driven crime, particularly the sale of drugs. New Zealand is a lucrative market for methamphetamine, and gang members have been among those caught in major police stings.
The link between gangs and organized crime, however, is not wholly straightforward, Dr. Gilbert said. “New Zealanders tend to look at the gangs with a single lens around criminality, whereas the scene is and always has been far more nuanced than that,” he said. Even within a single gang, he added, some chapters might be highly criminalized while others are more community focused.
Since the 1960s, New Zealand politicians have sought to score points by promising to crack down on gangs or by publicly criticizing them. Attempts to engage with the gangs have tended to generate pearl-clutching headlines: A government grant of about $2 million to a drug rehabilitation program connected to members of the Mongrel Mob was intensely criticized, including by police leaders.
But during the current coronavirus outbreak, the police and the Ministry of Health have worked with gangs to help with vaccination outreach and contact tracing. Two Mongrel Mob leaders, Harry Tam and Sonny Fatupaito, were given “critical worker” border exemption passes, 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 been deputized as emissaries to these hard-to-reach communities. They have been given grants to help bring people together to get vaccinated.
“We don’t traditionally have ways to connect with them,” Gerardine Clifford-Lidstone, New Zealand’s director of Pacific health, said of the gangs. “And by finding the people that can and giving them the information, you’ve got a much higher chance of being successful.”
A social change organization called the Cause Collective is one of the groups that has helped build the bridges.
“Health officials now realize, ‘We don’t really know the communities, the hard-to-reach communities,’ so they need professionals in those areas,” said the hip-hop producer Danny Leaosavai’i, also known as Brotha D, who works with the organization and has a longstanding connection to gang leaders.
What to Know About Covid-19 Booster Shots
The F.D.A. has authorized booster shots for millions of recipients of the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines. Pfizer and Moderna recipients who are eligible for a booster include people 65 and older, and younger adults at high risk of severe Covid-19 because of medical conditions or where they work. Eligible Pfizer and Moderna recipients can get a booster at least six months after their second dose. All Johnson & Johnson recipients will be eligible for a second shot at least two months after the first.
Yes. The F.D.A. has updated its authorizations to allow medical providers to boost people with a different vaccine than the one they initially received, a strategy known as “mix and match.” Whether you received Moderna, Johnson & Johnson or Pfizer-BioNTech, you may receive a booster of any other vaccine. Regulators have not recommended any one vaccine over another as a booster. They have also remained silent on whether it is preferable to stick with the same vaccine when possible.
The C.D.C. has said the conditions that qualify a person for a booster shot include: 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 current and former smokers are also eligible.
The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.
Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.
Chris Hipkins, the minister responsible for New Zealand’s Covid-19 response, acknowledged earlier this month that the decision to enlist gang leaders was an unusual one.
“Our No. 1 priority here is to stop Covid-19 in its tracks, and that means doing what we need to do to get in front of the virus,” he said. “Where we have been able to enlist gang leaders to help with that, and where they have been willing to do so, we have done that.”
Some gang leaders have acted independently to help the vaccination effort. They have connected members of their community to health officials, organized events with health professionals like Dr. Jansen, and streamed events on Facebook Live to allow an open forum for questions about rare health risks. In some cases, they have taken vaccines to communities themselves.
“Our community is probably less well informed; they’re probably not as health literate,” said Mr. Tam, the Mongrel Mob member, who is a former civil servant and who received the border exemption. Constant media criticism has turned them off from reading traditional news outlets, he added.
“They then resort to social media, because they have much greater control,” he said. “It’s also a space that perpetuates conspiracy theories and false information and all the rest of it.” Health advice has to come from trusted individuals and leaders in the community, he said.
In the past week, Mr. Tam has traveled almost the length of the country organizing pop-up vaccination events for members and their communities, as well as coordinating with other chapter leaders to get their members vaccinated, he said.
It was difficult work that put him at personal risk, he said, and that invited intense skepticism from people who thought of gangs only as violent or connected to organized crime.
“Why do we bother?” Mr. Tam said. “We bother because we care about those people that others don’t care about, as simple as that. They can talk about my gang affiliation, all the rest of it. But it’s that affiliation that allows me to have that penetration, that foot in the door. I can do the stuff that they can’t do.”