MR: To avoid a measles epidemic, Aotearoa must close the ‘immunity gap’

The number of children in Aotearoa New Zealand who are not immunised against measles is still growing and we are now close to the tipping point that set off measles epidemics in previous years warn public health experts.

While there have been moves to improve immunisation coverage, the number of measles-susceptible children is still increasing by around 1000 every month. The latest Briefing from the Public Health Communication Centre (PHCC) lays out three actions that are needed urgently to prevent another measles epidemic. 

Dr Oz Mansoor and co-authors say most important is a catch-up immunisation for those aged 15 months to 9 years who didn’t get the MMR (measles-mumps-rubella) vaccine. “We can use existing immunisation requirements for primary schools and pre-schools to reach 95% coverage required to stop spread,” says Dr Mansoor. But he says this will need staff to identify the unvaccinated and then engage with parents who may be vaccine hesitant. “It can take time to build a relationship, and to explain the benefits and potential risks of the MMR vaccine with vaccine misinformation so prevalent.”

The measles component of the MMR vaccine will protect for life, with a single dose working for about 90% of children. The second dose protects those whose first dose failed, leading to about 99% protected after two doses.

“In addition to preventing a serious disease that can kill and have other serious consequences, being immunised means that there is no need for quarantine if the child becomes a close contact of a measles cases,” says Dr Mansor

While we address our immunity gaps, the Briefing also urges immediate action to reduce the risk of measles entering the country. “This can be as simple as making sure all travellers are aware of the risk and encouraged to check that they are protected against measles. They should also be urged to take documentation of immunity with them to avoid the need for quarantine if they become a measles contact during their travels,” says Dr Mansor.

The third point of action advised by the Briefing is to have a stronger immunisation component in our response to measles cases. “This could include targeted vaccination of susceptible individuals in communities where cases occur. Basically, looking at a wider ring of immunisations around an outbreak, using the Aotearoa Immunisation Register.”

“The number of susceptible children is now close to that before the 1980, 1985, 1991 and 1997 measles epidemics. Compared to those years, we now have more susceptible young adults, and may be already primed for a large epidemic,” says Dr Mansoor.