The global measles threat is growing, according to the World Health Organization – and New Zealand is not immune to that danger, writes Anna Murray.
It’s been four years since Samoa’s devastating measles outbreak, but the memories of what the small island nation endured in 2019 still bring health professionals to tears.
More than 80 people died of the illness in Samoa over the course of two months, most of them young children.
The outbreak is believed to have begun with an infected traveller from New Zealand and quickly ripped through a country that had low vaccination rates at the time.
It was one of the topics discussed at the Aotearoa New Zealand Immunisation Conference on Friday and there were few dry eyes left in the room, according to GP and Medical Director of the Immunisation Advisory Centre (IMAC), Dr Nikki Turner.
“People were crying, remembering the children who did not need to die,” she said.
Global measles threat still growing
Measles cases around the world increased by 18% year-on-year in 2022, according to a new report released by the World Health Organization.
The number of deaths from the disease also increased by 43% globally.
“The increase in measles outbreaks and deaths is staggering, but unfortunately not unexpected given the declining vaccination rates we’ve seen in the past few years,” it said.
It added that measles cases anywhere pose a risk to all countries and communities where people are under-vaccinated.
The dangers of measles
Turner said New Zealanders need to care about our own vaccination rates because it’s a terrible – but preventable – disease.
“[Measles] kills, and if it doesn’t kill, it can certainly make people, particularly children, very sick,” she said.
Measles is a highly infectious airborne virus, much more contagious than Covid-19. It is estimated that one person with measles can infect approximately 16 other unvaccinated people.
Approximately one in 10 people with measles will need hospital treatment and the consequences can be ongoing. It can lead to ear infections that can cause permanent hearing loss, pneumonia, seizures and swelling of the brain.
“It affects your immune system,” Turner said. “So, even if you get over the measles, you then tend to be sick from a whole lot of other infectious diseases.”
Measles can also have complications for pregnancy. Two unborn babies died in Auckland during New Zealand’s own measles outbreak in 2019, which infected more than 2000 people and hospitalised around 700.
Health officials said while they couldn’t be certain the unborn babies died due to measles, their mothers were being treated for the disease at the time.
A preventable illness
Turner said measles is completely preventable through vaccination.
One dose of the MMR vaccine offers about 95% protection. That climbs to 99% after two doses.
“With some diseases, vaccination just modifies it or reduces it, but with measles, if you have high enough vaccination coverage in your country, you do not have the disease at all,” she said.
“We can eliminate measles and we’ve done that in many parts of the world.”
Herd immunity against measles requires 95% of the population to be immune.
Immunisation coverage for New Zealand children aged two years was at 83.1% for the quarter ending June 30, 2023.
Turner said New Zealand had been tracking quite well in its child immunisation targets up until around 2017 when there was a bit of a drop-off.
She said that drop became more significant with the arrival of Covid-19.
“A lot of routine health services got distracted by Covid ... so that was a big part of it,” she said.
“I think in New Zealand, our healthcare resources were stretched to start with ... and then Covid came along and we’re just short of staff and resources and [the vaccination programme] really got squeezed.”
Turner said the international and local kickback over Covid has not helped either.
“I think a lack of trust and people's concerns about the mandates with Covid, and a lack of trust in government has spilled over into a lack of trust in the childhood [immunisation] programme,” she said.
“I think the problem we always have is until you see disease, it's always hard to sell it. So, when measles comes back, it propels people into action, but to try and say to people, we're trying to stop measles coming back is actually the hard call when people are tired of vaccines and infectious diseases.”
An ounce of prevention worth a pound of cure
But, Turner said, the health sector is still working hard to stop a measles outbreak taking hold in Aotearoa again.
The Immunisation Taskforce was established in 2022 to address the falling rates of childhood immunisations. It released a report in April this year, which highlighted 10 key priorities.
A national action plan and four regional action plans have been developed to reach an initial target of 90% immunisation for tamariki aged two years old.
Te Whatu Ora said it is working with Te Aka Whai Ora and community providers to reach this target by June 30 next year.
“While our public health services are well prepared and practiced in managing measles outbreaks, including recent cases in Northland and Taranaki, it requires all New Zealanders to play their part,” it said.
“The most recent case in Taranaki highlights the vital importance of people being up to date with their measles immunisations, particularly if they are travelling outside New Zealand.”
Turner is also urging those who are yet to immunise themselves or their families against measles to do so.
“We’re not just protecting ourselves but we’re protecting particularly the frail members of our community, so we’re there for each other, and New Zealand is good at that,” she said.
The MMR vaccine is available for free for children as part of the National Immunisation Schedule. It’s also free for anyone born since 1969 who does not have two recorded doses of the MMR vaccine. If anyone isn’t sure they have had two doses of the vaccine, there is no additional risk in getting another jab.
“It's like being prepared, which is really hard when there's so many other issues going on, but ... we do not have [measles] in New Zealand and we want to keep it out for all of us,” Turner said.
“If we don't vaccinate, it will come back.”
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