Counties Manukau District Health Board says South Auckland healthcare providers appear to be caught in a "seemingly impossible catch-up phase" as they try to tackle declining child vaccination rates.
The concerns were outlined in a recent paper to the DHB which says immunisation rates fell considerably between March 2020 and March 2021 and have continued to drop since.
The Ministry of Health aims for 95 percent of children to be fully vaccinated at eight months, 24 months and five years of age.
But the rates across the board in South Auckland are much lower and it is something the Counties Manukau DHB is keen to arrest.
Figures show 85 percent of children in Counties Manukau were fully vaccinated at eights months of age in February, but only 67 percent of Māori babies were fully immunised. That compares to 83 percent for Pasifika infants, 89 percent of Europeans and 98 percent of Asian children in the same age group.
Childhood immunisation includes the MMR vaccine for measles, mumps and rubella, as well as vaccinations for pertussis (whooping cough), polio, diphtheria, tetanus, rotavirus, influenza and Covid-19, for those who are eligible.
A Counties Manukau DHB spokesperson said it had already set aside funds to invest in its immunisation programme, but it was not seeking additional support from the Ministry of Health.
But Turuki Healthcare chief executive Te Puea Winiata said it was very difficult for primary healthcare providers in South Auckland to maintain their staff and capacity to carry out vaccinations when they did not have certainty of funding.
"We need certainty of funding so we can target key communities," she said.
Winiata said the fee for service contracts it had with the DHB for Covid-19 vaccinations, which saw it paid per event, meant it was very difficult to plan ahead.
"I think we definitely need more investment and we need a whole shift of thinking," she said. "Instead of just the Covid-19 vaccination programme, we need a whole whānau vaccination programme.
"I think for Māori community it's important that we look at the whole picture."
Dr Nikki Turner is the medical director of the University of Auckland's Immunisation Advisory Centre and said the fall in child immunisation rates was a nationwide problem and began before Covid-19 struck in 2020.
She said the lower vaccination levels for Māori children aged five and under was a sign of the growing equity gaps in the health system, which had only become worse under the pandemic.
Turner said families in lower socio-economic communities like South Auckland were often struggling to find housing, or put food on the table and keeping up with child vaccinations was not seen as a priority.
"And a lot of the children aren't enrolled with a GP, so they aren't embedded in the system and that's a big problem," she said.
Turner said two of the most pressing issues with the drop in child vaccination rates were whooping cough and measles, and the poor immunisation rates in areas like South Auckland needed to be taken seriously.
"If we don't, we will suffer the consequences."
Local Democracy Reporting is Public Interest Journalism funded through NZ On Air