New Zealand is on the brink of a measles epidemic because of falling immunisation rates, immunity gaps, and an increasing risk of imported cases, according to public health experts.

In the latest Briefing from the Public Health Communication Centre, Professor Michael Baker and co-authors lay out the evidence showing New Zealand is highly vulnerable to a measles epidemic which could result in thousands of cases, hospitalisations, chronic illness, and potentially deaths.

Professor Baker says urgent steps are needed to catch up those who have missed out on vaccination.

“This is alongside work to increase routine childhood coverage, particularly for Māori, Pacific Peoples, and deprived communities.

“Our immunisation rates are at their lowest since 2009 with overall coverage at two years now at 83 per cent. Even more concerning is the much lower coverage for Māori children at 69 per cent, Pacific children at 81 per cent, and 75 per cent for children living in the most deprived neighbourhoods. These levels are far below the 95 per cent target level needed to maintain measles elimination.” .

Professor Baker says measles is not endemic in NZ so an outbreak will only be caused when infected travellers arrive from overseas.

He says the risk is increasing with rates of the disease rising across parts of the world and inbound traveller numbers up to near pre-pandemic levels.

“While we commend the government announcement for investment in measures to raise vaccination rates with a priority focus on Māori, multiple additional strategies are needed immediately to avoid an epidemic.”

Professor Baker and his co-authors propose these strategies include: Reducing the risk of imported measles by asking all those travelling to NZ, and all New Zealanders travelling overseas, to check their individual and family measles immunity, and get vaccinated if susceptible or uncertain.

Rapidly addressing immunity gaps, with the priority in early childhood education centres, schools, and other institutions where many people mix.

For disease control and equity, we need to prioritise immunisation strategies to reach Māori, Pacific, and the most deprived children.

Using the Aotearoa Immunisation Register (AIR) more widely to track and offer vaccination to all born since 2005 without documentation of two MMR doses.

Preparing for measles outbreaks across the country, including procedures to ensure safe management of cases presenting in healthcare and educational settings, and comprehensive documentation and follow up of the measles immunity status of children attending ECE centres and schools.

Dr Mamaeroa David, a co-author of the paper and general practitioner based in West Auckland says: “Our immunisation rates were higher in 2019 when we had our last national outbreak which hospitalised nearly 800 people with measles. If we have another epidemic, we are also putting our Pacific neighbours in danger. In 2019 our outbreak spread to Samoa resulting in 83 measles-related deaths largely in children younger than five years.”

“We need to use all the tools available to support a rapid catch-up in MMR vaccine coverage. These measures include supporting Māori-led vaccination programmes that engage effectively with communities, responding to misinformation and disinformation relating to vaccination, and supporting vaccine delivery in schools and other environments where young people can be reached.”