Leaders navigate vaccine hesitancy and the impact of COVID-19 on Native Hawaiians


Nicole Pasia


State leaders are having more conversations about reopening Hawaii as residents continue to get vaccinated, but others say more should be done to assess the pandemic’s physical, economic, and social impact on Native Hawaiians. Civil Beat held a virtual conversation with three panelists on Tuesday to foster dialogue around the issue. 


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Dr. Gerard Akaka, vice president of Native Hawaiian Affairs and clinical support at the Queen’s Health Systems Internal Medicine, first outlined the disparate impacts of COVID-19 on the state’s Native Hawaiian and Pacific Islander communities.

He said that Native Hawaiians account for 25% of all COVID-19 cases in the state throughout the pandemic, despite making up 21% of the state population. The case rate rose to nearly 30% during the height of the Delta variant spread in early fall. Disparities for Pacific Islanders were worse — despite making up 4% of the state population, Pacific Islanders made up 14% of all COVID-19 cases to date, and as much as 25% of cases prior to the availability of vaccines. 



Image: Dr. Gerard Akaka


However, as Akaka pointed out, these disease-induced disparities are not new. Hawaii’s indigenous communities have been subject to a myriad of infectious diseases since the arrival of Captain Cook and other settlers in 1778. According to Akaka, after a century, approximately 90% of the Native Hawaiian population died, and as of present day, the population has still not recovered to pre-colonial levels.

With COVID-19 vaccines available since December 2020, Juanita Nalani Benioni, executive to the Kupuna Council and Administrator at the Center for Native Hawaiian Traditional Healing at the Waianae Coast Comprehensive Health Center, encouraged people to continue getting vaccinated. 

“The message for us on the west side is to go out and get vaccinated. We have had an unbelievable resistance to vaccination here … we’re finding there’s a certain age group that have resisted the vaccine. Our goal is to get correct information [about the vaccine] out there.” 

Nāʻālehu Anthony, a filmmaker and director of COVID Pau, an initiative under the House Select Committee on COVID-19, said a culturally-informed approach is a key factor to addressing vaccine hesitancy in Native Hawaiians.

“Part of this has to do with the relationship that Native Hawaiians have to health care in general. I’ve done documentaries on some of the negative health impacts that affect Native Hawaiians … and what that disparity looks like. So, when we talk about COVID,  it’s really talking about how we can have the opportunity to engage this specific community in a way that’s meaningful.”  

He said that many people who are vaccine-hesitant need more information before making a decision, and that they should be able to access it in a non-judgmental space. 

The panelists advocated for framing conversations about vaccination as a way to keep families and communities safe. Benioni said this was crucial for communities like west Oahu, which have been disproportionately impacted by social determinants of health (SDOH) such as food and nutrition. According to Benioni, west Oahu has some of the highest rates of obesity and diabetes in the state, which increases the risk of severe illness from COVID-19.

Beyond that, Benioni underscored that vaccination can not only prevent loss of life, but the potential loss of valuable stories and knowledge Native Hawaiians share with their family and community. 

“Kupuna [grandparents], in our ohana [family], traditionally have a huge responsibility to hold all the stories of their family, of their generation. When they’re taken really quickly [because of] COVID, that’s gone. This is why you need to get vaccinated, kupuna, because look what you have that you need to share, yet, with your mo’opuna [grandchildren] and with others.” 

The full livestream is available on Civil Beats’ Facebook page.