On Monday, 180 health support workers serving rural areas are set to lose their jobs because they are not vaccinated.
Their boss says it is not an "anti-vax issue". Rather, issues such as access to childcare, internet and transport were preventing people from getting jabbed in time for the vaccine mandate deadline.
The vaccination order requires all health practitioners and all workers in close proximity to health practitioners providing services to members of the public to have received their first Covid-19 vaccine by Monday.
Te Puna Ora o Mataatua Charitable Trust chief executive Dr Chris Tooley said he was facing standing down 180 support workers on Monday if they were not vaccinated or if he did not have proof of their vaccination status.
The eastern Bay of Plenty workers provided in-home clinical care for people including kaumatua and those just discharged from hospital, he said.
On Tuesday, those clients would not be receiving care.
If patients were "critical", they would need to be admitted to a hospital or see a GP, Tooley said.
He said his support workers lived in remote areas such as Hicks Bay, Ruatahuna and the back of Kaingaroa forest.
"You can't get further away from townships.
"We've had such a small window to get our support workers vaccinated but they live in areas right around the Eastern Bay that aren't close to townships or vaccination centres.
"Some of them don't even have Wi-Fi or internet to actually receive communications, some of them don't have transport to get to vaccination sites, they don't have childcare ability so they can leave their kids anywhere.
"And we just haven't been able to hit all of them in our window because health providers are also responsible for vaccinating the general community as well.
"It's absolutely nuts on the ground at the moment racing to hit this deadline and we've absolutely had no support from the ministry in giving us any kind of grace period.
"It's not like we can train a workforce overnight to replace people who just happen to live in that part of the area. Some areas only have a population of about a dozen.
"This is a massive problem for us right now. There are a lot of Zoom calls late into the night with a whole bunch of providers just trying to figure out what to do.
"I could have a vaccination site in Kawerau and Murupara, but for people in Waimana that's still a good 30-40km drive.
"It's just not as easy as just rocking up to a clinic 100 metres down the road. This is a rural community ... it's just a completely different story.
"We fully support the vaccination mandate ... but just make it logistically possible for us to do it."
A Ministry of Health spokesperson said the ministry was "aware of this issue" and was supporting the Bay of Plenty District Health Board to work with the trust to ensure any possible impacts on services were mitigated.
This included seeking a temporary health exemption for staff who were yet to get their first vaccination.
The ministry was developing guidelines for a "service disruption exemption" that organisations could seek if there were concerns staff vaccination levels would cause disruption to their service.
Options included a short-term exemption for staff who were yet to get their first vaccine.
The ministry expected to share more details on this exemption in coming days.
"Some organisations have expressed concerns that they may face challenges next week when the vaccination order comes into effect because some of their workers are yet to be vaccinated."
"We are committed to working with the health and disability sector to ensure services remain sustainable under the vaccination order."
The spokesperson said Te Puna Ora o Mataatua was the largest Covid vaccine provider in the Eastern Bay of Plenty.
With partner providers such as Te Puna Ora o Mataatua, the DHB collaborated on initiatives that encouraged communities to get vaccinated.
The DHB and partners delivered in-home vaccinations, were operating mobile vaccinating campervans to reach rural areas, and facilitating pop-up clinics in small rural communities.
"The eastern Bay of Plenty has some of the most remote and rural communities, however, all efforts are being made to vaccinate as many people as possible."
Across the whole Eastern Bay of Plenty the first dose uptake increased from 72.4 per cent to 75.2 per cent in the two weeks to November 10, the spokesperson said.
The number of fully vaccinated people across Eastern Bay of Plenty increased from 56.8 per cent to 62.9 per cent.
The Office of the Prime Minister has been contacted for comment.
The Government announced the healthcare worker vaccination mandate on October 11. Originally the first dose deadline was October 30, but on October 23 this was pushed back to November 15.
According to the Government's Covid-19 website, healthcare is a high-risk sector because workers were more likely to be in contact with someone who has Covid-19.
"A high rate of vaccination in this sector will help to protect staff from getting sick and passing Covid-19 on to others, including those who are at risk from severe illness."
A business can apply for a worker to be exempt from the mandate "to prevent significant disruption to essential health services".