Measles health sector update outlining priority groups, regional plans, and MMR0 in Auckland

21 Oct 2019

In this update, we outline priority groups, regional plans, and MMR0 in Auckland

We thank you again for your ongoing work to respond to the measles outbreak, while continuing to deliver the National Childhood Immunisation Schedule.  We acknowledge this has put pressure on many of you and your resources.

Reported cases of measles in Auckland are trending downwards but it is still too early to say the outbreak is over, and we need to remain vigilant.  In addition, there are outbreaks in several other DHBs with active public health case management and contact tracing underway. We are working with those DHBs to agree and support locally specific vaccination plans.

The Ministry of Health, PHARMAC and DHBs will continue to manage MMR vaccine distribution to ensure vaccine is supplied across the country to meet priorities and target outbreak areas. This process is critical to ensure our most vulnerable communities are protected.  

However, with the recent arrival of 107,520 vaccines and a further 85,000 doses arriving next month, we anticipate you will now have sufficient vaccine to be able to provide vaccinations to people outside the specified priority groups.  We do not recommend actively recalling patients outside of the priority groups at this point, but GPs will be able to order additional vaccine to meet their local demand.

Groups that may have additional concerns such as women of child bearing age, people working with small children, and family members with newborns are being advised to talk their GP about their vaccine status.

Please note a number of these topics will also be covered in announcement by Associate Minister of Health Julie Anne Genter today.

Nationwide Priority groups

The nationwide priorities for MMR vaccination are:

  •        ensure all children receive their vaccinations on time at 15 months (12 months in Auckland) and 4 years to maintain the national Childhood Immunisation Schedule. Please note that this also includes active recall of children under 5 years who have not received either dose of MMR vaccine
  •        susceptible close contacts within 72 hours of first exposure to measles when possible
  •        opportunistic vaccination of any child under 15 years (but we do not expect you to actively recall this group at this stage).

Regional responses

There are five DHBs, in addition to the Auckland DHBs, that have or are developing regional outbreak responses. These are: Lakes DHB, Bay of Plenty DHB, Southern DHB, Waikato DHB, and Northland DHB.

These DHBs will communicate directly with GPs and health providers in their regions if there are any specific activities or priority groups, they need to be aware of.

Only the DHBs in the areas mentioned above have regional plans that are being approved by the Ministry of Health.

Auckland MMR0

The Ministry of Health has approved a regional plan for Auckland DHBs to vaccinate babies six months and over starting on 21 October 2019.  This is part of the response to the outbreak and will be reviewed in mid-December to decide whether this policy will continue.

The DHBs will be managing the vaccine allocation to primary care providers for this.

Babies vaccinated between six and 11 months of age will still need to receive two more MMR vaccinations, with the first dose at 12 months.

Please remember this is for Auckland only.

Vaccine deliveries

On 4 October 107,520 vaccines arrived in New Zealand.  These have been through a quality assurance process and are now being distributed to regions.

Additionally, 85,000 doses will arrive before Christmas and 70,000 doses will arrive in January.

Please discuss vaccine stock orders with your local DHB.

Your DHB’s nominated vaccine stock manager will continue to be the sole point of contact for ordering the MMR vaccine.  Please continue to order other schedule vaccines in the normal way through your regional distribution centre.

Travelling to areas with serious measles outbreaks (international and Auckland) for infants under 15 months

Many GPs are receiving a number of queries from people with children under the age of 12 months who either live in an outbreak area or who are travelling to an outbreak area. There is no active recall of children under the age of 12 months.

However, infants aged 6–15 months who are travelling to Auckland are able to get the MMR vaccine, if the primary health care provider believes this to be appropriate.

If MMR vaccine is given to infants aged 6-11 months, the infant will still need two more doses of the MMR vaccine between the ages of 1 and 4 years old.

Pregnant women

Following the release of the Auckland Metropolitan DHBs Hospitalisation report, a number of health providers have received calls about whether pregnant women can be vaccinated for measles.

Pregnant women are unable to be vaccinated with MMR. If they are a close contact of a known measles case, they will be contacted by the public health unit. If you are contacted for advice, please see section 11.8.2 of the Immunisation Handbook for further information.

Auckland Regional Public Health have published information on their website for pregnant women and you may find this helpful. https://www.arphs.health.nz/assets/Uploads/Resources/Disease-and-illness/Measles-Mumps-Rubella/Measles-and-Pregnancy-Q-and-A.pdf

Pharmacist Vaccinators

The Ministry has been working on ways to unlock the potential for pharmacist vaccinators to administer the MMR vaccine.

Amendments have been made to the listing in the pharmaceutical schedule which will enable pharmacists to be reimbursed for administration of the MMR vaccine to specified eligible people within the community pharmacy setting.  

However there remain a number of other logistical and other matters to work through before pharmacists can commence this activity.  The Ministry and DHBs will continue to work through these issues and will keep you updated on progress.