Measles in New Zealand

Click on the links to download and print our fact sheets for quick reference

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	Not eligible to receive MMR vaccination, even if they are travelling to Auckland, Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.**^,ß	No exceptions.
18–49 years^æ	Prior to travel to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak** (not Auckland). One MMR vaccination.^ß	Except in the Auckland region where Individuals can/should receive a second MMR vaccination prior to travel if MMR1 was given at least 28 days earlier.
15–17 years	Prior to travel to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak** (not Auckland). One MMR vaccination.	Except in the Auckland region where Individuals can/should receive a second MMR vaccination prior to travel if MMR1 was given at least 28 days earlier.
5–14 years	Prior to travel to Auckland, Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.** One MMR vaccination.	Except in the Auckland region where Individuals can/should receive a second MMR vaccination prior to travel to another country with an active measles outbreak if MMR1 was given at least 28 days earlier.
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.** Age-appropriate catch-up vaccinations, including MMR vaccination.	Except in the Auckland region where Children can/should receive their second MMR vaccination, due at 4 years of age, prior to travel l to Samoa, Tonga, Fiji, Philippines or another country with an active measles outbreak if MMR1 was given at least 28 days earlier.
12–15 months	Prior to travel to Auckland, Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.** One MMR vaccination plus the three other vaccinations (Hib, PCV10 and VV) due at 15 months (12 months in Auckland). The second MMR vaccination remains due when the child is aged 4 years as per the Immunisation Schedule.	Except in the Auckland region where Active recall of chidlren aged 12 months irrescpetive of travel. Children can/should receive their second MMR vaccination, due at 4 years of age, prior to travel l to Samoa, Tonga, Fiji, Philippines or another country with an active measles outbreak** if MMR1 was given at least 28 days earlier.
6–11 months	Prior to travel to Auckland, Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.** One MMR vaccination. The 15-months and 4-years MMR vaccinations remain due to be administered at the relevant ages as per the Immunisation Schedule.	Except in the Auckland region Active recall of infants aged 6–11 months for MMR0 irrespective of travel. Administer 15-months vaccinations at 12 months of age or a minimum of 28 days after MMR0, whichever is later, irrespective of travel.
Under 6 months	Not eligible to receive MMR vaccination even if they are travelling to Auckland, Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.**	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.

^ßMMR 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 groups

In 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

All children and adolescents aged under 18 years are eligible to receive MMR vaccination as per the New Zealand Immunisation Schedule and vaccination priority group recommendations regardless of their immigration/residency status.
Adults aged 18 years to under 50 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.
- Adults who are not eligible to receive publicly funded healthcare are not eligible to receive MMR vaccination even if they are meet the criteria for one of the vaccination priority groups.^ß
Adults aged 50 years or older are not eligible to receive MMR vaccination even if they are travelling to a country with a measles outbreak.^ß

^ßMMR vaccine is not available for purchase by ineligible adults.

Please click on this link to read the Ministry of Health email update on vaccination eligibility 4 December 2019.

All of New Zealand except Northland, Auckland, Waikato and Southern DHBs

Infants aged 6–11 months can receive one dose of MMR if they are travelling to an area with a serious measles outbreak (overseas or Auckland).
Ensure all children receive their Schedule vaccines on time at 15 months and 4 years.
Actively recall children aged under 5 years who need catch-up vaccination.
Opportunistically offer one catch-up dose of MMR for children aged 5 years to under 15 years who do not have one documented MMR vaccination.
People under the age of 50 years travelling from New Zealand to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.
Vaccinate susceptible close contacts of a confirmed case within 72 hours of first exposure to measles when possible.

Northland DHB

Infants aged 6–11 months can receive one dose of MMR if they are travelling to an area with a serious measles outbreak (overseas or Auckland).
Ensure all children receive their MMR vaccinations on time at 15 months and 4 years.
Actively recall children aged under 5 years who need catch-up vaccination.
Opportunistically offer one catch-up dose of MMR for people aged 5–29 years who do not have one documented MMR vaccination.
Based on clinical judgement, one catch-up dose of MMR can be administered to people aged 30–50 years who do not have one documented MMR vaccination, e.g. they live with someone who is unable to be immunised, are frontline healthcare staff, teacher or early childhood educator.
People under the age of 50 years travelling from New Zealand to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.
Vaccinate susceptible close contacts of a confirmed case within 72 hours of first exposure to measles when possible.

Auckland DHBs

Actively recall infants aged 6–11 months for MMR0.
Ensure all children receive MMR1 and MMR2 vaccinations on time at 12 months and 4 years:
- Infants who received an MMR0 dose need to receive MMR1, and the other vaccines due at 15 months of age, when aged 12 months or a minimum of 4 weeks after the MMR0 dose, whichever is later.
Actively recall children aged under 5 years who need catch-up vaccination.
Opportunistically offer one catch-up dose of MMR for people aged under 30 years who do not have one documented MMR vaccination with particular focus on the priority groups below.*
Based on clinical judgement, one catch-up dose of MMR can be administered to people aged 30–49 years who do not have one documented MMR vaccination, e.g. they work in higher risk environments, for example institutions such as prisons, or are in one of priority groups below.*
*Auckland region 15–50 years priority groups
- Pacific and Māori people.
- Students at school and tertiary institutions.
- Postpartum women and family members of babies aged 0–6 months.
- Teachers and early childhood educators.
People under the age of 50 years travelling from New Zealand to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.

Waikato DHB

Infants aged 6–11 months can receive one dose of MMR if they are travelling to an area with a serious measles outbreak (overseas or Auckland).
Ensure all children receive their Schedule vaccines on time at 15 months and 4 years.
Actively recall children aged under 5 years who need catch-up vaccination.
Actively recall children aged 5 years to under 15 years who do not have one documented MMR vaccination.
People under the age of 50 years travelling from New Zealand to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.
Vaccinate susceptible close contacts of a confirmed case within 72 hours of first exposure to measles when possible.

Southern DHB

Infants aged 6–11 months can receive one dose of MMR if they are travelling to an area with a serious measles outbreak (overseas or Auckland).
Ensure all children receive their Schedule vaccines on time at 15 months and 4 years.
Actively recall children aged under 5 years who need catch-up vaccination.
Actively recall children aged 5 years to under 18 years who do not have one documented MMR vaccination.
People under the age of 50 years travelling from New Zealand to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak.
Vaccinate susceptible close contacts of a confirmed case within 72 hours of first exposure to measles when possible.

Please click on this link to the Ministry of Health Immunisation Update 20 November 2019 that includes updates on:

MMR priority groups and MMR related travel advice,
the extension of Menactra eligibility from 1 December 2019, and
the 2020 National Immunisation Schedule.

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.