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Measles in New Zealand
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Measles in New Zealand

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UPDATED 20 DECEMBER 2019 (2 PM)

What changed?

  • Criteria for MMR vaccination for adults aged 50 years or older

  • Pacific temporary migrant workers including those enrolled in the Recognised Seasonal Employee (RSE) Scheme can receive MMR vaccination

  • Addition of the  Ministry of Health Measles Update 20 December 2019 that includes updates on:

    • Public health measures being implemented by some Pacific Island Countries.
    • MMR vaccination for some adults aged 50 years or older.
    • Measles, mumps and rubella (MMR) vaccination of Pacific temporary migrant workers including those enrolled in the Recognised Seasonal Employee (RSE) Scheme.

MMR prior to travel to an area with an active measles outbreak, and
for Pacific people in the Auckland region

Age group

MMR vaccination recommendation
outside the Auckland region

 MMR vaccination recommendation
within the Auckland region
50 years or older

If proof of MMR vaccination is required prior to travel to American Samoa, Republic of Marshall Islands, Tokelau or Solomon Islands,
OR 

If the person is in an age group where MMR vaccination is necessary in a country currently experiencing a measles outbreak, e.g. a person aged 50 years to under 60 years is travelling to Samoa.

  • One MMR vaccination.ß
  • Adults must be eligible to receive publicly funded healthcare to receive funded MMR vaccination.
  • Proof of vaccination may include medical records, laboratory tests, immunisation record summary, or letters from GPs or vaccinators.

If proof of MMR vaccination is required prior to travel to American Samoa, Republic of Marshall Islands, Tokelau or Solomon Islands,
OR 

If the person is in an age group where MMR vaccination is necessary in a country currently experiencing a measles outbreak, e.g. a person aged 50 years to under 60 years is travelling to Samoa.

  • One MMR vaccination.ß
  • Adults must be eligible to receive publicly funded healthcare to receive funded MMR vaccination.
  • Proof of vaccination may include medical records, laboratory tests, immunisation record summary, or letters from GPs or vaccinators.
30–49 yearsæ

Prior to travel to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak** (not Auckland).

  • One MMR vaccination.ß
  • Adults must be eligible to receive publicly funded healthcare to receive funded MMR vaccination.

Except in the Auckland region where

  • One MMR vaccination may be given to people, irrespective of eligibility to receive publicly funded healthcare, who are planning travel to Samoa, Tonga or Fiji.
  • One MMR vaccination may be given to Pacific people, irrespective of eligibility to receive publicly funded healthcare or planned travel.
  • One MMR vaccination may be given to people who are eligible to receive publicly funded healthcare, who are planning travel to the Philippines or another non-Pacific country with an active measles outbreak**
18–29 yearsæ

Prior to travel to Samoa, Tonga, Philippines, Fiji or another country with an active measles outbreak** (not Auckland).

  • One MMR vaccination.ß
  • Adults must be eligible to receive publicly funded healthcare to receive funded MMR vaccination.

Except in the Auckland region where

  • One MMR vaccination may be given to people, irrespective of eligibility to receive publicly funded healthcare, who are planning travel to Samoa, Tonga or Fiji.
  • One MMR vaccination may be given to Pacific people, irrespective of eligibility to receive publicly funded healthcare or planned travel.
  • One MMR vaccination may be given to people who are eligible to receive publicly funded healthcare, who are planning travel to the Philippines or a non-Pacific country with an active measles outbreak.**
  • A second MMR can/should be given 
    to people who are eligible to receive publicly funded healthcare prior to travel Samoa, Tonga, Fiji, Philippines or another country with an active measles outbreak** 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

  • A second MMR can/should be given prior to travel to Samoa, Tonga, Fiji, Philippines or another country with an active measles outbreak** 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

  • A second MMR can/should be given prior to travel to Samoa, Tonga, Fiji, Philippines or 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 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 children aged 12 months irrespective 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.

ß MMR vaccine is not available for purchase by ineligible adults.

** Travel to

  • Fiji, Philippines, Samoa, Tonga
  • Papua New Guinea
  • 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).

Pacific temporary migrant workers including those enrolled in the Recognised Seasonal Employee (RSE) Scheme can receive MMR vaccination

  • Providers can provide one MMR vaccination for unimmunised Pacific temporary migrant workers, including those on the RSE scheme.
  • Providers will not be able to claim the Immunisation Benefit for any vaccine given to Pacific temporary migrant workers. The Ministry of Business, Innovation and Employment (MBIE) will notify employers that they will be expected to pay for any administration fee. The vaccine itself can be provided free of charge to the workers.
  • Providers and employers are required to keep records of any vaccine administered to Pacific temporary migrant workers and share this with District Health Boards (DHBs). The Ministry of Health ask that DHBs send the number of completed Pacific temporary migrant worker vaccinations to [email protected] by 31 March 2020.
  • Providers need to supply a signed record of vaccination for the person to keep and, where possible, should record the vaccination on the National Immunisation Register. We also encourage employers to know and keep a record of the immunity of measles for their workforce.
  • Vaccinators in the following areas may be requested to provide Pacific temporary migrant worker MMR vaccinations:
    • Bay of Plenty
    • Hawkes Bay
    • Horowhenua-Manawatu Districts (MidCentral and Whanganui DHBs)
    • Nelson
    • Marlborough
    • Otago (Southern DHB)
  • Please click on this link to the  Ministry of Health Measles Update 20 December 2019 that includes more information on providing MMR vaccination for Pacific temporary migrant workers.

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 outside the Auckland region 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 18 years to under 50 years in the Auckland region can receive one MMR vaccination, irrespective of eligibility to receive publicly funded healthcare, who are planning travel to Samoa, Tonga or Fiji or who are Pacific people, irrespective of planned travel.
  • Adults aged 50 years or older can receive one MMR vaccination ONLY IF one of the following situations apply:
    • They require proof of MMR vaccination prior to travel to American Samoa, Republic of Marshall Islands, Tokelau or Solomon Islands, OR 
    • They are in an age group where MMR vaccination is necessary in a country currently experiencing a measles outbreak, e.g. a person aged 50 years to under 60 years is travelling to Samoa.
    • Adults also must be eligible to receive publicly funded healthcare to receive the MMR vaccination.
  • Proof of vaccination may include medical records, laboratory tests, immunisation record summary, or letters from GPs or vaccinators.
  • MMR vaccination is not available for adults aged 50 years or older who do not meet the travel criteria described above.ß

ß MMR vaccine is not available for purchase by ineligible adults.

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, irrespective of eligibility to receive publicly funded healthcare, and who are travelling from New Zealand to Samoa, Tonga or Fiji.
  • Pacific people under the age of 50 years, irrespective of eligibility to receive publicly funded healthcare or planned travel.
  • People under the age of 50 years who are eligible to receive publicly funded healthcare, and who are travelling from New Zealand to the Philippines or another non-Pacific country with an active measles outbreak.
  • Based on clinical judgement, people aged 50 years or older who are eligible to receive publicly funded healthcare, and who are travelling to Samoa, Tonga or Fiji, and do not have proof of immunity.

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.

 

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

      Outside of the Auckland region, ordering MMR vaccine has reverted to the normal ordering process from ProPharma along with other Schedule vaccines. Distribution levels of MMR will continue to be monitored daily by the Ministry of Health.

      Within the Auckland, Counties Manukau and Waitemata DHBs, each DHB continues to have a single point of contact to oversee the management of MMR vaccine stock for providers to offer childhood immunisations. 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.

       

         

         

         

        Last updated: Jan 2020