One of the world's most contagious diseases is surging overseas, just as vaccination rates in New Zealand drop and the international border opens further.
Measles vaccination rates have slumped significantly over the past two years during the Covid-19 pandemic, with tens of thousands of children at risk.
"In Auckland we know that 68% of Mа̄ori children at two years are fully immunised, 80% for Pacific, 82% for European; we should be sitting at 95%," Dr Bryan Betty of the Royal New Zealand College of General Practitioners said.
The MMR vaccine is highly effective, with two doses providing 99% protection against measles.
Two experts 1News spoke to agree that New Zealand is in a worse position now than it was before the 2019 outbreak, which saw more than 2000 people infected and more than 700 hospitalised.
"The immunisation rates have fallen considerably and this is a huge concern going forward into winter, especially with what's happening around the world with measles," Betty said.
The World Health Organization is warning of a "perfect storm", with low measles vaccination rates combining with a relaxation of Covid-19 restrictions.
The UN body has observed a 79% increase in measles cases in the first two months of 2022, compared to the same time in 2021, and centred in Africa.
“Now is the moment to get essential immunisation back on track and launch catch-up campaigns so that everybody can have access to these life-saving vaccines,” Director-General of the World Health Organization. Dr Tedros Adhanom Ghebreyesus. said.
New Zealand has not been immune from Covid disruption to other vaccination campaigns.
"There's some parts of the community where you might have less than half the children who've received the vaccines that they needed," vaccinologist and associate professor at the University of Auckland, Helen Petousis-Harris, told 1News.
She's concerned the disease will take off if it gets a hold in the community.
"It's going to be like throwing a match on dry tinder and it'll probably go off like a firecracker."
Betty said: "We know that it is transported by planes, the borders open, measles will come into the country at some point, it's probably going to be within the next three to six months."
Mа̄ori and Pacific children were four and 14 times more likely (respectively) to catch the illness than New Zealand Europeans during the 2019 outbreak.
Its spread to Samoa lead to the deaths of 83 people, mostly children under 5 years old.
"There were a lot of children that needed a lot of really high-level care so it's going to impact our health system which we know is quite stressed already," Petousis-Harris said.
The Ministry of Health says it's increasing its focus on MMR vaccinations "in parallel with that of other vaccines like Covid-19 and flu" and has plans in place to manage the threat of an outbreak.
"We are working closely with DHBs and the wider health sector to ensure Kiwis are better protected from measles through vaccination," acting group manager Rob Humphrys told 1News in a statement.
"This includes providing information to parents and caregivers, using data to identify parts of the country where additional focus is required, and supporting GPs and Māori and Pacific providers to have conversations with the whānau in their care about the importance of MMR vaccinations as part of the childhood immunisation programme schedule."
People who have not had their children vaccinated are encouraged to do so, with a recent change meaning tamariki can receive their second dose at 15 months.
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