Parts of the Hunter will have full adult vaccination rates 15 percentage points lower than the recommended 70 per cent when the state starts reopening next week.
Federal government figures issued on Monday show first-dose COVID-19 vaccination rates in three Hunter local government areas, Lake Macquarie, Port Stephens and Upper Hunter, have surpassed 90 per cent after a rapid uptake in recent weeks.
The other Hunter LGAs have single-dose rates above 80 per cent, but none has a double-dose rate higher than 70 per cent.
Only Upper Hunter, which had a double-rose rate of 66.9 per cent on Sunday, is likely to reach the milestone by Monday next week.
Muswellbrook (47.7 per cent), Cessnock (49.2) and Singleton (49.9) will have vaccination rates in the mid-50s when pubs, cafes and shops start opening to the fully vaccinated.
Health authorities held a walk-in vaccination clinic in Muswellbrook on Monday to boost the town's coverage.
Maitland (55.1 per cent) is lagging two weeks behind the NSW average, and Newcastle (58.9), Dungog (58.7), Lake Macquarie (61) and Port Stephens (62.1) are also off the pace.
The NSW first-dose rate stood at 88.5 on Sunday and the second-dose rate at 67.5.
The Hunter's large indigenous population remains woefully short of vaccine targets.
Just 37 per cent of indigenous adults aged 15 and over in the Hunter were fully vaccinated at September 28.
Lake Macquarie MP Greg Piper said the region's vaccine figures were troubling, especially given a recent spike in COVID-19 cases in his electorate.
The government last month reversed its decision to allow regional travel in and out of Sydney given the uneven vaccine coverage.
Mr Piper was unsure how successful longer lockdowns would be in areas with low vaccination rates given many people were already ignoring health orders.
"We have to continue to consider that COVID is out there and it's highly contagious," he said.
Hunter New England Health reported 59 new cases in the 24 hours to 8pm on Sunday, including 21 in Cessnock, 19 in Lake Macquarie, eight in Maitland, seven in Newcastle, three in Port Stephens and one in Muswellbrook.
NSW recorded 623 new cases.
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