The Auditor-General says a "significant" scale-up of the vaccination effort is required to achieve the Government's goals.
A report published on Tuesday sought to assess how ready the sector is to meet the Government goal of vaccinating as many people aged 16 and over as possible by the end of 2021.
Auditor-General John Ryan says it's clear the health sector, led by the Ministry of Health, is working hard to achieve this - but it's not enough.
There has been good early progress, Ryan noted, but the procedures in place now would not be enough to handle when the number of people getting vaccinated ramps up in the second half of the year.
"I am not yet confident that all the pieces will fall into place quickly enough for the programme to ramp up to the level required over the second half of 2021. There is a real risk that it will take more time than currently anticipated to get there."
He says the rollout is complex and hopes a review so early in the process will provide the Ministry of Health an opportunity to identify and adapt its program.
So far, almost 400,000 vaccine doses have been administered.
Given the scale of the rollout, Ryan says he didn't expect a perfect plan - but he did expect to see a level of planning that "matched the public commitments the Government has made".
"Some aspects of the plan are still not fully developed. Information systems are still being worked on. If everything goes to plan these will be ready, but only just in time."
At the time of the audit, there were "significant risks" around the number of vaccinators; the distribution model used to ensure doses were sent to the right places; and ensuring Māori, Pasifika people, people with disabilities and those in hard to reach communities were vaccinated.
The report made six recommendations to improve the rollout in the coming weeks and months.
The recommendations are:
- The Ministry of Health continues to be transparent around supply risks and the possible impact on the rollout schedule
- Create contingency plans for major risks - for example, if a vaccine dose fails to be delivered to the country at the right time, or not enough vaccinators can be secured
- Improve the guidance to DHBs about when it's acceptable to deviate from the sequencing framework and communicate this to the public
- Continue working with DHBs, and Māori, Pasifika and disability health providers to ensure equity is embedded in all plans
- To continue to raise public awareness of the rollout in a way that encourages uptake, ensures communications are coordinated with key vaccination events and is tailored to different audiences - in particular Māori, Pasifika, people with disabilities, and harder-to-reach communities.
The Director-General of Health Dr Ashley Bloomfield says the report is "timely and useful".
"The Ministry of Health welcomes the recommendations in the report and is well-positioned to respond to the findings, including implementing the recommendations at pace."
But he says given that the report was being undertaken in the very early stages of the rollout, some of the findings or conclusions have already been addressed.
"In all areas identified as needing to be strengthened, the programme has made a number of initial changes and improvements. Some recommendations have been fully implemented or are largely complete."
Examples of this are expanding the amount of rollout data published by the Ministry and engaging with DHBs and health providers.
The Ministry of Health's vaccination campaign is on track so far.
Bloomfield says by June, the Ministry is "confident" most people in group 1 (border workers and their families) and 2 (high-risk frontline workers and people in high-risk places) will have been offered a vaccine and "real progress" will have been made towards vaccinating those in group 3 (people who are at risk of getting very sick from COVID-19).
From July onwards, the general population should be able to get their vaccines.