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In a letter to Minister of Health Andrew Little and then-Minister for Covid-19 Response Chris Hipkins, dated May 11, 2022 and obtained under the Official Information Act, College of Midwives chief executive Alison Eddy urged the government "to ensure a robust evidence review is undertaken as soon as possible".
She wanted the review to inform decisions about the future of the Covid-19 vaccine mandate for health care workers, "given the critical nature of the midwifery workforce shortages".
"This review needs to quantify the threat posed by unvaccinated health care workers who have access to daily pre-work RATs (rapid antigen tests) and PPE (personal protective equipment), against the risks posed by a lack of qualified health practitioners available to provide essential maternity care."
"We didn't lose a huge number of midwives proportionally, but we couldn't afford to lose any."
The college was not asking for the mandate to be lifted but for a justification of its continuance, Eddy said.
She highlighted the pandemic's landscape had changed since the mandate was introduced, including RATs being widely available and Omicron being the dominant Covid-19 variant as opposed to Delta, which was more likely to cause severe illness.
A change to the mandate "would make absolutely no difference" in some regions but there were others left without any registered midwives where even having one midwife return could make a "significant difference", Eddy said.
Midwifery union Midwifery Employee Representation & Advisory Service (MERAS) co-leader Caroline Conroy said it was a "complex" issue to navigate.
But she did echo concerns around staff shortages.
"I think they would be very happy to have their colleagues back," she said whilst noting Covid-19 cases were still high, among other illnesses, and workplaces needed to be safe.
University of Auckland vaccinologist Helen Petousis-Harris said "the conversation has definitely changed" and it was "very reasonable" to review evidence for having mandates.
There were "a few" arguments on both sides of the fence but there were nuances to it, she said.
Petousis-Harris wanted to ensure pregnant people were vaccinated "because this virus can be pretty nasty and pregnancy is a big deal".
"I would actually have some reservations if somebody wasn't prepared to vaccinate themselves that they might not be so prepared to support their clients getting vaccinated."
Covid-19 Response Minister Ayesha Verrall responded to Eddy's letter on behalf of Hipkins on June 2, 2022, stating she recognised the pressure the midwifery workforce faced and thanked the college for its work to ensure high vaccination rates among midwives.
"As we have with all of our Covid-19 response settings, we are keeping the scope of the order (Covid-19 Public Health Response (Vaccinations) Order 2021) under regular review, using the latest data and evidence as it comes available to us."
Verrall did not have any information to share in relation to timeframes for changes to the order.