Measles overseas and in New Zealand

This fact sheet is being revised to reflect the latest Ministry of Health priority groups (17 September)

 Quick answers to frequently asked MMR questions during the 2019 measles outbreaks

UPDATE 17 September 2019 (7 PM)

Vaccination priorities In view of significant limitations in MMR supply, general practices and PHOs are asked to reserve vaccine for the priority groups described below. Priority groups In Auckland: Ensure all children receive their MMR vaccinations on time at 12 months and 4 years Targeted community outreach managed by the three Auckland DHBs, namely groups who are most affected by the outbreak including 15–29 year olds and particularly Pacific peoples within those groups. Rest of New Zealand: Ensure all children receive their Schedule vaccines on time at 15 months and 4 years. Susceptible close contacts of a confirmed case within 72 hours of first exposure to measles when possible.   Vaccinators can help to ensure the MMR vaccine is used to protect the most vulnerable populations by only vaccinating people from the groups listed above.

 

Managment of non-priority groups

• For patients booked in for MMR vaccination or who are eligible, but do not meet the above priorities, we recommend that general practice offer to put them on a recall for when vaccine stock become available again.
• When stocks are secure, practices should be offering MMR vaccine to all those who need it, to bring them up to two documented doses as per the Schedule.

MMR stock

52,000 vaccines of Priorix arrived in the country on 16 September and are being distributed this week. These will be used to restock each region to support vaccination for the above priority groups. The Ministry will maintain some stocks centrally both to continue to ensure vaccination availability for the childhood schedule visits over coming weeks and to respond to any emerging issues.

Each DHB will have a single point of contact to oversee the management of vaccine stock for providers to offer childhood immunisations.

• The DHB-nominated stock manager will advise PHOs and practices of the DHB-process for ordering Priorix vaccine. Orders of Priorix placed before the DHB-process is operational will not be filled. 
• The nominated stock manager will also work closely with the DHB's public health unit to allocate any vaccine when needed for immunisation of susceptible close contacts. However, maintenance of the Childhood Immunisation Schedule is the priority.

PHARMAC is continuing to actively source more vaccine supplies.

MMR vaccination advice

♦ Children aged 12 months to under 5 years [PRIORITY GROUP]

Maintenance of the Childhood Immunisation Schedule is the priority.

• Recommended to receive their MMR vaccinations at 15 months (12 months in Auckland, refer below) and 4 years as per the Immunisation Schedule.
• All vaccines due at 15 months can be given from 12 months of age.
  • The second MMR vaccine dose is recommended to be given on-time at 4 years of age.
  • After one MMR vaccination 90–95% of people are fully protected from measles, hence the first dose is the priority for all.
• Recall children from 16 months to under 5 years of age who are overdue immunisations (in Auckland), with a focus on Pacific peoples within this group.

♦ Young people aged 15–29 years who live in Auckland [PRIORITY GROUP]

• Recall young people in this age group who do not have one documented dose of MMR vaccine, with a priority focus on Pacific peoples within those groups.

Note: Young people aged 18–29 years who are living in the Auckland region who are not eligible to receive publicly funded healthcare (i.e. non-residents)

There is no MMR vaccine available for purchase as all MMR vaccine stock is supplied by ProPharma and cannot be sold. During the current measles outbreaks administer the MMR vaccine to these adults when it is prescribed in their medical notes by their doctor. 

PMS entry and claiming for catch-up doses of MMR vaccine

In the PMS immunisation section, go to 'Schedule selection tab 3' and select 'MMR schedule – Adult eligible', then go to 'Immunisation tab 1' and select MMR1 to enter the first catch-up dose of MMR vaccine. Ensure 'Autobill' is selected as an Immunisation Subsidy can be claimed.

♦ Adults aged 30–50 years

• MMR vaccination is not currently prioritised for these age groups.
• Please offer to add a recall due in 3-6 months to contact those who request MMR vaccination but are not able to receive it at this time.

♦ Adults aged 50 years or older (born in New Zealand or overseas before 1969)

• Not recommended to receive MMR vaccination. They are considered to be immune to measles.
• No measles vaccine was available in New Zealand until 1969 and measles is so infectious that people born before this were highly likely to be exposed.
• For those born overseas, it is fairly similar as most countries introduced a measles vaccine in the late 1960s, 1970s or later.

Auckland primary care resource

• Please download the  Measles whānau pack for GPs and EDs from the Auckland Regional Public Health Service measles webpage and print copies of the fact sheets to use if your practice sees a person suspected of having measles or a person with confirmed measles.

Travel overseas to a country with a measles outbreak

MMR vaccination is not currently prioritised on the basis of travel to a country with a measles outbreak.

Advice for front line health care staff born on/after 1 January 1969

• PLEASE check your measles immunisation status.
• If you do not have two documented MMR vaccine doses it is important to obtain catch-up MMR vaccinations.
• When two catch-up doses of MMR vaccine are required, the second MMR vaccination can be given a minimum of 4 weeks after the first MMR dose.
• If you come in contact with a measles case and do not have any documented measles-containing vaccine doses and your measles immunity is unknown, you will need to be stood down from work during the possible incubation period or until you are confirmed as being immune to measles.

Latest updates

  Ministry of Health – 2019 measles outbreak information

  Ministry of Health – Immunisation Update for primary care teams and health professionals, 11 June 2019

 IMAC – Quick update on measles and vaccination priorities, March 2019

Measles within New Zealand

Since 2012, all measles outbreaks in New Zealand started with travellers bringing the disease from overseas. Individuals who have not been immunised against measles or had the disease, and individuals who are immune compromised due to an illness or treatment, may catch the disease next time an overseas traveller who has measles arrives in New Zealand. 

In 2019, a total of 1,324 measles cases were confirmed in New Zealand between 1 January and 17 September. As of 13 September, 441 people with measles had been hospitalised. 

Location by District Health Board	Cumulative number of confirmed measles cases in 2019
Northland	43 cases
Auckland region	1108 cases
Waikato	32 cases
Lakes	12 cases
Bay of Plenty	31 cases
Taranaki	6 cases
Hawkes Bay	3 cases
MidCentral	3 cases
Wellington region	21 cases
Wairarapa	1 case
Canterbury	42 cases
South Canterbury	1 case
Southern	21 cases

 

Other resources

IMAC

 Quick answers to frequent MMR questions fact sheet

 Measles fact sheet

 Diseases and medications when live vaccines may be contraindicated fact sheet

 Measles – Why immunise video

 Quick update on measles and vaccination priorities, March 2019 video

 Protecting children with cancer video

Websites

  2019 measles outbreak information, Ministry of Health

 Measles weekly report, ESR (Institute of Environmental Science & Research Limited)

 SafeTravel, a New Zealand website with advice for New Zealanders living and travelling overseas

 Centers for Disease Control and Prevention – Destinations, travel updates about non-USA countries with measles outbreaks. On the CDC Destinations webpage, choose the country for intended travel from the list of destinations.