National Health Advisory - Measles Update and Travel Advice to the Pacific 20 Nov 2019

Thank you for the work you have been doing to combat the measles outbreak in New Zealand, all the while continuing to deliver high quality health services. Your work has certainly made a significant difference.

ADVISORY SUMMARY:

Thank you for the work you have been doing to combat the measles outbreak in New Zealand, all the while continuing to deliver high quality health services. Your work has certainly made a significant difference.

Measles update

The current national priorities for MMR vaccination are:

•    ensure all children receive their vaccinations on time at 15 months (12 months in Auckland) and four years to maintain the national Childhood Immunisation Schedule
•    susceptible close contacts within 72 hours of first exposure to measles when possible
•    babies aged six months to 11 months who live in Auckland or who are travelling to Auckland or overseas to a country that has an active outbreak of measles
•    children and adolescents aged 15 and under who have not had a single dose of MMR
•    in accordance with the National Immunisation Schedule, all children under five who have not received either dose of MMR should be actively recalled. We consider active recall of this group to be in line with the priority groups.
•    people under the age of 50 travelling from New Zealand to Samoa, Tonga, Philippines and Fiji
•    People travelling to a region where there is an active outbreak of measles – regions with measles outbreaks can be found at https://wwwnc.cdc.gov/travel/notices/watch/measles-global

There is no active recall for people outside of the priority groups at this time.

Travel advice

Given the outbreaks of measles in Samoa, Tonga, Philippines and Fiji, the Ministry of Health is asking primary care providers to ensure vaccinations are up-to-date for any individual (aged 50 and under) who indicates they will be travelling to one of these areas, or any country that has an active outbreak of measles. Outbreak regions can be found at https://wwwnc.cdc.gov/travel/notices/watch/measles-global.

We also recommend infants aged six to 11 months travelling to an outbreak area have one dose of MMR. Please remember that any child vaccinated before 12 months of age will still need two further doses of MMR. All people need to be vaccinated at least two weeks before travel. The Ministry will issue a public travel advisory on encouraging vaccination for people travelling to outbreak areas.

Addressing the immunity gap among 15 to 29 year-olds

New Zealand has a known immunisation gap for measles in the 15 to 29 age group. Planning is underway address this immunisation gap.

The Ministry of Health will begin contacting all DHBs about their plans for this 15 to 29 age group.

Please note: because planning is underway to improve immunity in this age group you do not need to actively recall people in this age group at the present time (unless your DHB has a regional plan, as part of its outbreak response).

Update on the meningococcal vaccine

From 1 December 2019, PHARMAC will be funding a meningococcal ACWY vaccine - Menactra) -for individuals aged 13 to 25 years in close-living situations.

This means that one dose of meningococcal ACWY vaccine is funded for those aged 13 years to 24 years (under 25 years) who:

•    are entering within the next three months, or are in their first year of living in boarding school hostels, tertiary education halls of residents, military barracks or prisons;

In addition, from 1 December 2019 to 30 November 2020 people already living in boarding school hostels, tertiary education halls of residents, military barracks or prisons will also have access to the vaccine.

Providers will be able to enter the vaccinations given on the NIR via their PMS and claim for the vaccine administration in the same way they currently do for other special groups (high risk) vaccinations.

It is important to note that the ACWY vaccine does not provide protection against meningococcal B disease.  As a result, it is important to consider meningococcal disease even in people who have been vaccinated if they present with symptoms consistent with meningococcal disease.  

Changes to the National Immunisation Schedule

The Ministry of Health is currently working to finalise changes to the National Immunisation Schedule. We expect to be able to communicate finalised changes to the health sector early in the New Year.

If you have any queries about anything in this update, please email immunisation@health.govt.nz