The Northland DHB has asked schools to consider sending children home for at least two weeks if they have not been vaccinated against measles. Given that the region's immunisation rate is put by the DHB at "the low to mid 80 per cents," that could involve around one child in six.
Chief executive Dr Nick Chamberlain wrote to all Northland principals last week, saying the region's first two cases of measles had been reported, and there was a 95 per cent chance that any infected child would spread it to other children within one metre of them.
"Once measles has spread, it has a mortality rate of one in 1000. That is why school children who come into contact with a child with measles must stay home for 14 days after contact," he wrote.
Dr Chamberlain asked schools to check whether their pupils had been immunised, and ensure that all children and staff who had not been receive a measles, mumps and rubella (MMR) vaccination.
"Please consider excluding unimmunised children during this period of high risk, i.e. at least the next two weeks," he added.
"If we have more cases it could be longer, and we will keep you informed.
"I understand if exclusion seems too harsh, or has too many unintended consequences, or you simply don't want to go there. So, if this is not possible, unimmunised children who are unwell with fever, a cough or cold, must be kept away from school as it could be the early (pre-rash) stage of measles."
Te Tai Tokerau Principals' Association president Pat Newman said about 250 of the 400 pupils at his school, Hora Hora, had not provided their immunisation records, although they were repeatedly asked for them at enrolment.
"Generally someone says we've lost them, and I can understand that, to be honest," he said.
He had asked the DHB to check its immunisation records for all the children who had not provided certificates, and would then ask parents whose children had not been immunised to have them vaccinated.
Some parents were reluctant to go to a doctor because of unpaid debts for other family members, in which case he would ask the DHB to vaccinate their children at school. Some children could not be vaccinated because of health conditions.
"I'm reluctant to send them home, but at the end of the day I've got to look at what's best for the whole school," he said.
According to Environmental Science and Research, 111 cases of measles were reported nationally between January 1 and May 3. Eight of those affected had been fully vaccinated.
Meanwhile Education Minister Chris Hipkins last week accused parents who did not have their children vaccinated of being "pro-plague." He also said the DHB needed to "step up in its responsibility on immunisations in the region."
"Clearly there is an issue there that the DHB needs to address," he said. "I don't believe that kids should be denied their right to an education, particularly if it's a conscious choice by their parents not to immunise ... Those kids actually are the ones who most deserve to learn about science.
"Children shouldn't be excluded from their education because their parents are pro-plague."