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Quick answers to frequent MMR questions during the 2019 measles outbreaks (25 October 2019)
Quick answers to frequent MMR for infants aged 6–11 months questions (18 October 2019)
UPDATED 4 DECEMBER 2019 (3PM)
What changed?
- Advice regarding MMR vaccination eligibility added.
MMR prior to travel to an area with an active measles outbreak
Age group | MMR vaccination recommendation | Exceptions for the Auckland region |
---|---|---|
50 years or older |
|
No exceptions. |
18–49 yearsæ |
Prior to travel to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak** (not Auckland).
|
Except in the Auckland region where
|
15–17 years |
Prior to travel to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak** (not Auckland).
|
Except in the Auckland region where
|
5–14 years |
Prior to travel to Auckland, Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.**
|
Except in the Auckland region where
|
16 months to under 5 years (13 months to under 5 years in Auckland) |
Prior to travel to Auckland, Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.**
|
Except in the Auckland region where
|
12–15 months |
Prior to travel to Auckland, Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.**
|
Except in the Auckland region where
|
6–11 months |
Prior to travel to Auckland, Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.**
|
Except in the Auckland region
|
Under 6 months |
|
No exceptions. |
Footnotes
æAdults aged 18–49 years are only eligible to receive MMR vaccination if their immigration/residency status entitles them to receive publicly funded healthcare, e.g. born in NZ, have permanent residency, holds a work visa for a period of 2 years or longer.
ß MMR vaccine is not available for purchase by ineligible adults.
** Travel to
- Fiji, Philippines, Samoa, Tonga
- Albania, Austria, Belarus, Bulgaria, Czech Republic, France, Finland, Georgia, Germany, Greece, Hungary, Ireland, Italy, Japan, Lebanon, Poland, Portugal, Romania, Russia, Serbia, Syria, Taiwan, Thailand, Tunisia, Turkey, Ukraine, the United Kingdom and the USA. (Source: Fit for travel – Measles risk for international travellers).
Vaccination priority groupsIn view of significant limitations in MMR supply, general practices and PHOs are asked to reserve vaccine for the priority groups described below. MMR vaccination eligibility
ß MMR vaccine is not available for purchase by ineligible adults. Please click on this link to read the All of New Zealand except Northland, Auckland, Waikato and Southern DHBs
Northland DHB
Auckland DHBs
Waikato DHB
Southern DHB
Please click on this link to the
Clinicians are still able to vaccinate outside of the priority groups. This decision would depend on whether the practice has sufficient vaccine without impacting on the stock needed for their priority groups. |
Additional information regarding priority groups
♦ Infants aged 6–11 months
Can receive their first MMR vaccination (MMR0):
- If they are travelling to an area with a serious measles outbreak (overseas or Auckland).
- If they are a contact of a confirmed case within 72 hours of first exposure to measles, or
- On parental request if there are concerns about a high-risk of exposure to measles and their GP advises administration of MMR.
MMR Vaccines
-
Priorix®: The administration of Priorix to infants aged 6–11 months is off-label. There are no safety concerns. Every dose needs to be individually prescribed. Priorix cannot be administered to infants aged 6–11 months under a standing order.
-
M-M-R® II: Authorised vaccinators in primary care will be able to administer the M-M-R II vaccine to infants aged 6–11 months without an individual prescription when stock has been distributed to primary care. M-M-R II can be administered to infants aged 6–11 months under a standing order in any community based targeted immunisation programmes.
The infant will still require the 15-months (12-months or a minum of 4 weeks after MMR0, whichever is later, in Auckland) and 4-years MMR vaccinations as per the Schedule.
PMS entry and claiming for MMR0
- Enter the dose on the NIR using your PMS ‘MMR at-risk’, ‘MMR misc’ or ‘MMR primary’ vaccine option.
- Leave the Schedule 15-months and 4-years MMR vaccinations as to be given in the future.
- Ensure ‘Autobill’ is selected as an Immunisation Subsidy can be claimed.
- If the MMR ‘at-risk’, ‘misc’ or ‘primary’ vaccine option has not been activated in your PMS, contact the PMS provider for advice.
Children aged 12 months to under 5 years
Maintenance of the Childhood Immunisation Schedule is the priority.
- Recommended to receive their MMR vaccinations at 15 months (12 months in Auckland) 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.
- All children aged under 5 years who are not up-to-date with their Schedule vaccines should be actively recalled to receive age-appropriate catch-up vaccination, including MMR vaccine.
Children aged 5 years to under 15 years (except Waikato and Southern DHBs)
- Opportunistic vaccination of any child under 15 years (but we do not expect you to actively recall this group at this stage).
- We recommend you contact any under the age of 15 years on your MMR waiting list.
Children aged 5 years to under 15 years in Waikato DHB
- Actively recall children aged 5 years to under 15 years who do not have one documented MMR vaccination.
Children aged 5 years to under 18 years in Southern DHB
- Actively recall children aged 5 years to under 18 years who do not have one documented MMR vaccination.
Young people aged 15–29 years who live in Auckland
-
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 or Northland who are not eligible to receive publicly funded healthcare (i.e. non-residents)
There is no MMR vaccine available for private purchase. Administer the MMR vaccine to these adults. It should be 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 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.
MMR stock
Each DHB has a single point of contact to oversee the management of MMR vaccine stock for providers to offer childhood immunisations.
- If your practice does not know who your DHB-nominated MMR stock manager is, please ask the National Health Coordination Centre Operations team by sending an email to NHCC_Operations@health.govt.nz.
- The DHB-nominated MMR stock manager will advise PHOs and practices of the DHB-process for ordering Priorix vaccine.
- The nominated MMR 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.
- The DHB-nominated MMR stock manager will be the sole point of contact for ordering the MMR vaccine. For all other schedule vaccines, please continue to order them in the normal way from ProPharma.
Other resources
IMAC
Measles fact sheet
Diseases and medications when live vaccines may be contraindicated fact sheet
Measles – Why immunise video
Protecting children with cancer video
Websites
Auckland Regional Public Health Service measles webpage
Northland DHB measles webpage.
Ministry of Health – 2019 measles outbreak information
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.