New Zealand’s childhood immunisation rates are at some of the lowest ever levels, sparking fears of an outbreak of measles as 1000 students and teachers isolate after a case of the highly infectious disease was detected at an Auckland high school.
Alarm from experts over a drop in New Zealand’s childhood measles vaccination rates since 2020, comes as last night a second person was confirmed to be infected with the disease in Auckland.
Dr Owen Sinclair, an Auckland-based Māori paediatrician, told the Herald measles is “much more infectious than Covid and much more lethal”.
“[Measles] kills children which Covid [largely] didn’t,” he said. “If you’re not immune and you come into contact with a person who has measles you’re almost certain to get it,” said Auckland-based Māori paediatrician Dr Owen Sinclair.
Sinclair’s warning comes after Auckland Regional Public Health Service (ARPHS) on Wednesday night ordered Albany Senior High School to close for two days because a student who has measles had attended school while infectious last week.
All 900 students and 100 staff are being considered close contacts because the student was in all five of the school’s open-plan modern learning environments while infections.
ARPHS is contacting those who are not considered immune and advising them they have to isolate at home for seven days from Thursday.
In an update by ARPH via Te Whata Ora on Thursday night, a spokesperson said those students and staff at Albany Senior High School “need to stay at home in quarantine”.
Contact tracing for the school was “progressing well”, they said, while the source of infection was now believed to be someone who had recently travelled abroad.
“This contact has now been identified as a confirmed case. This person is a household member of the first case and is also staying at home currently. This provides a link back to the border.
There is one “lower risk exposure event” related to this confirmed case at Chemist Warehouse Albany on April 20 from 2.45pm to 4.30pm. People who were present a the store during this time were advised to check their measles immunity.
Despite authorities describing early indications of the immunisation rate at the school being “close to 80 per cent” as “a high percentage of students are considered immune” it was still slightly less than the national MMR vaccination rate for two-year-olds of 82 per cent at the end of last year.
“We are matching the national immunisation records of everyone who was at school on the days the student was infectious,” the spokesperson said.
“This is taking some time to verify but early indications are that close to 80 per cent of students have either one or two doses of MMR vaccine, so the majority have some protection against measles.”
Authorities were also “moving fast” to check staff immunity, with blood tests taking place where necessary.
“Having enough staff who are immune and not in quarantine will be key to a decision to reopen the school on Monday.”
ARPHS is expected to provide a further update on Friday.
“In light of these cases, we are continuing to strongly encourage everyone who is eligible for two doses of the MMR vaccine to get themselves and any eligible children immunised,” the spokesperson said.
Sinclair said current vaccination rates were “as low as has ever been recorded” but he was hopeful the North Shore case would not spark a wider outbreak given Albany was a relatively high socio-economic area where more people were likely to be vaccinated.
The MMR vaccine is included in the national childhood immunisations schedule so most children should receive it at 12 months and 15 months.
But, at the end of last year, only 82 per cent of New Zealand’s two-year-olds were fully vaccinated. This was a drop from 91 per cent before the Covid pandemic and down from 92 per cent at the end of 2017.
Sinclair said there were also very large groups in the community, including 124,000 Maori, who had never been vaccinated. For Māori children, the vaccination rate is down to 66 per cent.
“It’s a huge concern. It’s an incredibly infectious, lethal disease. Between one and three children per thousand who get measles will die,” Sinclair said.
“The last outbreak we had was 2019 and there were 2000 cases. It was just by luck really that we didn’t have anyone die.”
To reach herd immunity 95 per cent of the country needs to be immune, Sinclair said.
Sinclair said New Zealand society has never been great at vaccinating children but rates had fallen further in the last few years because resources were diverted toward the Covid-19 vaccination campaign. Lockdowns also meant access to primary health care was difficult and many children did not get their vaccinations on time, he suggested.
Health Minister Ayesha Verrall told the Herald childhood immunisation rates have been falling across the world – in part due to pressures brought on by the Covid-19 pandemic.
“New Zealand is part of this global trend,” she said.
Immunisation, she explained, remained one of the best ways to protect New Zealand’s children from a range of diseases. Te Whatu Ora and community providers are collaborating to administer 3000 MMR doses each week across the country.
“We know that childhood immunisation rates for Māori and Pacific tamariki are too low and that is why improving their rates of vaccination is a priority.
“There is a strong programme to improve child immunisation rates, following the recent release of the Immunisation Taskforce report, with 26 of the 54 recommendations already underway.”
In February, Verrall said she was “very concerned” about a measles outbreak “in part because of the reduced vaccination rates around the time of the pandemic in New Zealand”.
Positively, there has been a strengthening of our public health systems to respond to outbreaks through contact tracing, thanks to the Covid response, Verrall said.
“It’s a horrible illness. I have sadly seen some people with measles. It’s not just a rash - you are very uncomfortable. We had about a third of the young adults, who were otherwise healthy when they got measles, in the last Auckland outbreak came to hospital. If you are unsure if you were vaccinated and you’re a young adult, now would be the time to get vaccinated.”
Sinclair said measles was usually less severe in teenagers and young adults but it could still be lethal. The bigger concern was those people passing it on to unvaccinated children - the group most at risk.
But, a measles outbreak was entirely preventable if enough people were vaccinated, he said.
People are considered immune if they have evidence of two MMR doses after 12 months of age, have had measles or were born before 1969.
National Public Health Service interim clinical lead Dr William Rainger said the Albany Senior High student who had measles had not recently been overseas so they were working to trace the chain of infection.
The student and their family were in quarantine.
Albany Senior High School board of trustees chairman Philip Voss said it was a concern for the school.
“It’s been a disrupted year with all sorts of other factors going on in schools too in terms of PPTA strike action and all sorts of other things too. Our thoughts are always, first and foremost, with our young folk and their learning.
“I guess at the moment it’s about them being safe and healthy and, in the same way we have done for all the Covid things over the last few years, that’s at the forefront of our thinking.”
Rainger said many people under the age of 30 missed out on their MMR vaccination as a child.
“If you’re in this age group and you’ve not had the vaccine, or you’re not sure, go and get it. It will protect you and those you love against serious illness and you won’t need to stay at home in quarantine if you are exposed to measles.”
Launching the Government’s winter health plan yesterday, Verrall said she was confident the plan would help people get the care they needed over winter.
“The system [last winter] did well, but people did have to wait for care too long. And we want to improve that. That’s what these measures are designed to do. Let people get care in the community, so they don’t need to be in hospital.”
It comes amid huge pressures on the health system driven by an aging and growing population with increasingly complicated health problems, exacerbated by the pandemic.
The plan also sought to increase vaccination for Covid-19 and winter illnesses such as flu but also childhood immunisation, which have dropped to record lows.
