New figures reveal a growing burden of respiratory disease on New Zealand families, hospitals and the economy, with children and older people particularly affected. The scale of the increase demands more than additional funding: it demands a transparent examination of what is driving the illness, which interventions are working and whether important explanations have been overlooked.
Report by eLocal
New Zealand recorded 97,151 respiratory disease hospitalisations in 2025, compared with 80,230 in 2022, according to new figures reported by RNZ.
That represents an increase of 16,921 hospitalisations, or 21.1%, over three years.
The financial burden is equally concerning. Respiratory disease is now estimated to cost New Zealand approximately $11.5 billion annually, an increase of around $3 billion compared with the earlier estimate.
These figures describe more than pressure on hospital budgets. They represent children missing school, older New Zealanders experiencing serious illness, families losing income, and healthcare workers struggling to meet growing demand.
They also raise a fundamental question: why, after years of substantial public health expenditure and unprecedented medical intervention during the Covid-19 pandemic, is the country's respiratory disease burden still so high?
Will this in fact make New Zealand stronger? That is the test any new health spending or intervention must meet. More expenditure without understanding the causes of illness may expand the healthcare system without improving the health of the population it serves.
The Scale of the Problem
The figures reported by RNZ, drawing on the Cardiac and Respiratory Foundation's latest data, reveal several concerning patterns.
Children under 14 and adults over 65 accounted for approximately 70% of respiratory hospitalisations. Pacific peoples experienced hospitalisation rates 2.4 times those of other ethnicities, while Māori experienced rates approaching twice those of other groups.
Lung cancer accounted for 3,477 hospitalisations in 2025. The report also cited 1,912 lung cancer deaths in 2022, a different reporting year that should not be confused with the 2025 admission figures.
The burden extends beyond hospitals. Approximately 466,000 school days are estimated to be lost annually because of asthma, compared with 360,000 in the earlier figures cited by the foundation.
The increase in respiratory hospitalisations is significant, but it requires careful interpretation. Hospital admissions are not necessarily a count of unique patients, because an individual may be admitted more than once. Nor does the percentage increase automatically establish a comparable increase in the underlying risk of disease.
Population growth, population ageing, changing disease patterns, hospital admission practices and the availability of community treatment can all influence the figures.
Nevertheless, a sustained increase of this magnitude warrants detailed investigation.
A Crisis That Predates Covid, but Has Changed Since
New Zealand's respiratory health problems did not begin in 2020.
The Foundation's historical respiratory impact reports document a longstanding burden from asthma, chronic obstructive pulmonary disease, bronchiectasis, respiratory infections and lung cancer.
The foundation's earlier reporting identified respiratory disease as a major contributor to hospital admissions and mortality, with particularly severe consequences for Māori, Pacific communities and people living in deprivation.
This history matters because it challenges any attempt to attribute the entire respiratory crisis to one recent event.
At the same time, the Covid-19 period introduced major changes to New Zealand's disease environment.
Border restrictions, lockdowns, altered social contact, disrupted schooling, changes in healthcare access, widespread SARS-CoV-2 infection and mass vaccination all occurred within a relatively short period.
Respiratory viruses that normally circulated seasonally were affected by public health restrictions. Subsequent reopening changed patterns of exposure and transmission.
Pharmac acknowledged in its 2022 assessment of RSV prevention that the pandemic may have changed the timing and impact of RSV seasons.
These are plausible contributing factors to changing hospitalisation patterns.
The essential task is to determine their relative importance rather than assuming that any single explanation is sufficient.
The Questions Raised by Dr Guy Hatchard
In his recent opinion article, The Pretence of Certainty, Dr Guy Hatchard challenged the assumption that New Zealand's wider health crisis can be explained entirely by management failures and inadequate resources.
Hatchard argues that health authorities should undertake more comprehensive analyses of health outcomes by vaccination status, age, disease category and other relevant variables.
He has also drawn attention to published research examining changes in immunoglobulin G4, or IgG4, responses following repeated Covid-19 mRNA vaccination.
One study, published in 2023 and indexed by PubMed, examined how prior SARS-CoV-2 infection influenced the development of spike-specific IgG4 antibodies following vaccination.
Another 2023 publication explored possible implications of vaccine-associated IgG4 responses.
These publications raise legitimate scientific questions about immune responses, but they do not establish that Covid-19 vaccination caused New Zealand's increase in respiratory hospitalisations.
An altered antibody profile is not equivalent to demonstrated population-wide immune deficiency. Establishing a causal relationship would require appropriately designed studies measuring clinical outcomes, accounting for prior infection, age, underlying illness, exposure patterns and other confounding factors.
Hatchard's central demand for better investigation can therefore be assessed independently of whether his proposed explanation proves correct.
If the data can help distinguish competing explanations, it should be analysed rigorously and the methods made available for scrutiny.
The Whistleblower Allegations Require Evidence
Material supplied to eLocal includes a transcript described as a whistleblower account concerning Pfizer Covid-19 vaccines.
The recording makes sweeping allegations about vaccine ingredients, reductions in white blood cell production and deliberate immune suppression.
Those claims are serious, but the transcript does not identify a verifiable laboratory analysis, authenticated manufacturing records, an independently established chain of custody or clinical evidence sufficient to substantiate them.
In particular, the claims that vaccination eliminates most white blood cell production or that boosters contain HIV material capable of causing HIV infection are not established by the evidence supplied.
For an investigation concerned with scientific accountability, the same evidentiary standard must apply to pharmaceutical manufacturers, regulators, critics and whistleblowers.
A dramatic allegation is not proof merely because it challenges an institution. Equally, an institution's assurance should not be treated as a substitute for accessible data and independent examination.
The appropriate response to testable claims is to identify the documents, samples, methods and results that would allow those claims to be verified or rejected.
Following the Money and the Decisions
Respiratory disease is now estimated to impose an annual economic burden of $11.5 billion.
That figure deserves careful examination because an economic cost estimate can include direct healthcare expenditure, lost productivity, premature mortality and other indirect costs. It is not equivalent to an annual government cash payment of $11.5 billion.
Nevertheless, the burden is substantial.
The financial consequences fall on several groups: taxpayers financing public healthcare, employers losing productive working time, households meeting additional costs and patients experiencing reduced quality of life.
Meanwhile, the public health system must make decisions about preventive medicines, clinical services, staffing, diagnostics and access to treatment.
The foundation has called for funding of nirsevimab, a medicine designed to protect infants against severe respiratory syncytial virus infection.
Nirsevimab is a long-acting monoclonal antibody, rather than a conventional vaccine. That distinction matters when assessing its mechanism, evidence and cost-effectiveness.
Medsafe approval was announced in July 2026, while Pharmac's advisory process has considered the evidence and potential funding.
The question is not simply whether a pharmaceutical product should be funded. It is whether its expected benefits, risks, cost and accessibility compare favourably with alternative uses of limited health resources.
Preventing severe illness in infants could reduce suffering and hospital admissions. Equally, policymakers must consider housing conditions, tobacco exposure, access to primary care, chronic disease management and the underlying determinants of respiratory illness.
The strongest public health strategy may require several interventions rather than one nationally uniform solution.
Why Māori and Pacific Communities Carry a Greater Burden
The disproportionate respiratory hospitalisation rates experienced by Māori and Pacific peoples are among the most important findings.
They cannot be understood adequately through national averages alone.
Housing quality, household crowding, income, environmental exposure, access to timely healthcare and the prevalence of underlying conditions may all contribute to unequal outcomes.
The evidence must distinguish between these factors rather than treating ethnicity itself as a biological explanation.
A national health strategy that overlooks the conditions in which people live risks directing money towards repeated treatment while leaving preventable causes untouched.
For New Zealanders, the relevant measure of success is not the number of programmes announced, but whether fewer people become seriously ill, fewer children miss school and fewer families experience avoidable hardship.
What Health NZ Should Make Public
A credible national investigation would begin with a detailed breakdown of respiratory admissions and outcomes.
That should include age-standardised rates, diagnostic categories, repeat admissions, regional variation, ethnicity, deprivation, prior respiratory disease and the severity of illness.
Where lawful and methodologically appropriate, linked health data could also examine previous SARS-CoV-2 infection, vaccination history and other clinical exposures.
Such analyses would need robust privacy safeguards and independent statistical oversight.
Importantly, observational comparisons must account for confounding. Vaccination status, for example, is associated with age, health vulnerability and access to care, making crude comparisons potentially misleading.
Researchers should also distinguish the immediate effects of infection from longer-term complications and from respiratory conditions unrelated to Covid-19.
The objective should be to test competing explanations, including those that challenge existing policies, rather than design an investigation around a predetermined conclusion.
Public confidence depends on transparent methods, reproducible results and a willingness to acknowledge uncertainty.
Follow the Money: Who Profits From New Zealand's Respiratory Crisis?
New Zealand's respiratory disease burden is now estimated to cost the economy $11.5 billion annually. Yet one important financial question remains unanswered: how much of the money spent responding to this crisis has flowed to pharmaceutical manufacturers?
The public deserves a transparent accounting of the medicines, vaccines, antiviral treatments, monoclonal antibodies and other pharmaceutical products purchased to prevent or treat respiratory disease. That accounting should identify the manufacturers, quantities purchased, government expenditure, contract arrangements where disclosure is lawful, and the clinical outcomes achieved.
It should also distinguish pharmaceutical companies' sales revenue from their actual profits, and the cost of medicines from the wider economic burden of respiratory illness.
This is not evidence that pharmaceutical companies caused the crisis. It is a question of financial accountability. Companies can profit from supplying effective treatments, but commercial success alone does not establish whether public expenditure has delivered value for patients and taxpayers.
Pharmac, Health New Zealand and the government should be able to demonstrate how purchasing decisions are made, what evidence supports them, and whether prevention and treatment programmes are reducing hospitalisations and improving health outcomes.
The question is not simply how much New Zealand is spending on respiratory illness. It is who receives that money, what results New Zealanders obtain in return, and whether the incentives of suppliers and public health authorities are aligned with the goal of reducing disease.
And the final question New Zealanders deserve answered is this: How much money have pharmaceutical companies earned from the drugs, vaccines and treatments purchased and used throughout this health crisis, and how much of that expenditure has demonstrably improved the health of New Zealanders?
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