One hundred and twenty-three Bay of Plenty District Health Board staff have been stood down because they were not vaccinated against Covid-19 by Monday.
Remaining staff members would likely have increased workloads, stress and fatigue, Bay of Plenty healthcare unions say.
The Bay of Plenty DHB had the second highest number of staff stood down in New Zealand, followed only by Waikato DHB with 154.
This comes after they did not meet the Government's vaccination mandate, which required all DHB staff to have had their first dose by 11.59pm on Monday.
As at 9am on Wednesday, 42 nurses, six midwives and four senior medical officers were unvaccinated and were stood down.
Seventy-one staff had been defined as "other" which applied to staff of a particular role of which fewer than three staff had been stood down, in an effort to protect their privacy.
This represented 3 per cent of the DHB's workforce.
DHBs spokeswoman Rosemary Clements said DHBs were consulting with unvaccinated staff who had been stood down to answer any questions they might have, discuss other options such as redeployment, support them through the process and encourage them to consider vaccination.
If staff chose to be vaccinated while they were stood down, they would be able to return to work.
"We have engaged and agreed with the health sector unions on the processes we are following."
She said service delivery impacts would vary between DHBs and mitigations were in place where needed to minimise any impact to services.
"Our absolute focus is on ensuring continuity of patient care."
An update on how many staff would be leaving DHBs due to their unvaccinated status would be provided next week.
New Zealand Nurses Organisation organiser Selina Robinson, who looked after Whakatāne Hospital and other sites in the Bay of Plenty, said the impact would be "increased stress".
"It means there will be increased workloads on the staff that are left behind.
"Everybody's feeling very fatigued at the moment anyway with Covid and other things and it's just going to increase those levels of fatigue.
"I think there's going to be less nurses and health workers to deliver the services to the community.
"We're going to lose experience and skill within the area."
Midwifery Employee Representation and Advisory Service co-leader Jill Ovens said there was "a lot of stress" at Tauranga and Whakatāne hospitals.
"They are really under the pump in terms of short-staffing.
"There are a lot more LMCs [private midwives] who have handed over their care of the women to the DHB so there is a lot of stress there."
Tauranga MP Simon Bridges, of National, said he was "absolutely pro-vaccination", but he had some "scepticism" around the no jab, no job mandate.
"I don't think it's sustainable - I think it needs a use-by date."
Bridges said he did not want it to become like MIQ which, in his opinion, had outstayed its welcome.
He said he was not "completely" against the mandate and there was "rationale" in the health system for everyone to be vaccinated.
"But in the end overall I just worry it's not a particularly sustainable position.
"What about we mandate compulsory testing, for example, for the small number of staff that won't vaccinate?
"Is that a realistic possibility that means we keep over a hundred staff that I'm sure otherwise have been doing a terrific job?"
A Ministry of Health spokesperson said regular testing as an alternative to vaccinations for those under the vaccination order was raised by media at the post-Cabinet media conference on Monday.
In response, director-general of health Dr Ashley Bloomfield said: "It's quite clear that vaccination plays two important roles — first of all, reducing the likelihood someone will be infected in the first case, but, secondly, greatly reducing the likelihood they will get very unwell and die. And that's material, and testing can't do either of those things."
The ministry spokesperson said vaccination was the best way to protect ourselves, our whānau and communities which was why the mandate had been put in place.
"We also know the people working in these roles are in positions of care, and it's important they keep our most vulnerable people safe by helping to combat Covid-19 in the community."
Bay of Plenty DHB people and culture executive director Tess Richardson said the board was aware of healthcare unions' concerns and shared those concerns around the pressure on the healthcare system and its employees.
Richardson said the number of staff who had been stood down due to not meeting the mandate requirement was "not the same" as having their employment terminated.
"There is a continued employment conversation that is occurring with these employees.
"The number affected has reduced since figures were initially announced and we're working with these members of our team to identify any possible solutions for ongoing employment as part of our consultation process."
The impact on service was being monitored daily.
"We are of course acutely aware of the significant pressure our staff are currently under and measures are in place to support them wherever possible. Our staff are our most important asset."