The number of children failing to attend school regularly reached a seven-year high last year and the education ministry is blaming a spike in winter colds and the flu.
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The ministry's annual attendance report said 63 percent of children attended more than 90 percent of school in term two last year, down from 67 percent in 2016.
"The biggest contributing factor to this change was an increase in absences due to illness and medical reasons," the report said.
"Absences for medical reasons accounted for almost 5 percent of all class time in Term 2 of 2017, compared to 4 percent in each of the three previous years," it said.
In decile one schools, regular attendance dropped below 50 percent for the first time in the seven years on record, to 47 percent.
Only 50 percent of Māori students and 52 percent of Pasifika students attended school regularly last year, while the rate for Pakeha children was 66.5 percent and for Asian students it was 73 percent.
The figures also showed a trend of increasing truancy continued last year, with unjustified absence accounting for one-fifth of all absences.
"The percentage of class time missed due to truancy increased from 1.8 percent in 2016 to 2.0 percent in 2017," the report said.
It said 40,700 students missed some class time in term two last year because their family took them on holiday and the average length of such absences was 4.8 days.
The report showed the South Island had above-average levels of attendance with Canterbury and Chatham Islands recording the highest figure for regular attendance at 69 percent.
Tai Tokerau had the lowest percentage of regular attenders, 51 percent, followed by Hawke's Bay and Tairāwhiti with 58 percent, and Waikato on 58 percent.
The report was based on returns provided by 80 percent of state and state integrated schools.