Experts ‘petrified’ about record low child immunisation

“It’s a recipe for disaster” is how “petrified” health experts have described record low childhood immunisation rates — including for measles — which they fear will fuel deadly new epidemics.

For Ma¯ ori, just 47 per cent of those aged 18 months had full immunisation coverage over the past year — a drop of 26 points since the start of the pandemic, and 22 points below the national rate.

To achieve herd immunity experts say at least 90 per cent must be achieved.

With vaccination coverage lower than at any point on record, the health sector, especially in Auckland, is on tenterhooks as international travel ramps up and so too the risk of imported cases, including from Fiji which is experiencing a measles outbreak.

“I think worried is an understatement,” said Dr Owen Sinclair (Te Rarawa), a Ma¯ori paediatrician at Waita¯kere Hospital.

“We are petrified. An outbreak would be catastrophic, with many deaths.”

Sinclair and other health experts spoken to say the immunisation programme is “broken” and needs to be rebuilt from the ground up, with a focus on equity, for the risks in any outbreak will be far from evenly shared.

According to the Ministry of Health’s latest data in the 12 months to June, for Ma¯ori at 18 months, a key marker for vaccinations such as MMR — measles, mumps and rubella — nationally rates have dropped below 50 per cent for the first time in over a decade, for the past year, to 47.4 per cent.

In Counties Manukau, the centre of many severe and deadly Covid outbreaks and the measles outbreak several years ago, the rate at 18 months for Ma¯ori is just 37 per cent (for Pa¯keha¯ it is 72 per cent).

Nationally the rate is 69.4 per cent, 76.5 per cent for Pa¯keha¯ and 59.6 per cent for Pacific.

While all groups have dropped significantly since the start of the pandemic, it has been most significant for Ma¯ori and Pacific.

For Ma¯ ori, the rate has plummeted 26 points from 73.1 per cent in June 2020, and Pacific 25 points from 84.5 per cent.

In New Zealand, children are immunised for a range of diseases, including pertussis (whooping cough), pneumococcal disease and measles, between 6 weeks and 4 years old, with further immunisations at 11 or 12 years.

MMR vaccinations are given at 12 and 15 months (it was previously 15 months and 4 years but changed in October 2020 after the measles outbreak here), meaning 18 months gives an indication of measles coverage.

The Ministry data records only those fully vaccinated, so it is unclear how many have had MMR vaccines, but experts say from experience it is the most-commonly missed vaccine.

Sinclair said there had been problems with vaccination levels but never like this.

University of Auckland immunisation researcher Dr Anna Howe said everybody in the health sector was “extremely concerned” at the record low rates.

“We know MMR coverage is not great around the world and measles is starting to circulate globally and it is far more infectious that Covid.”

She said Auckland, with its extremely low rates and proximity to travel, was like a tinderbox.

Howe said of most concern was the inequity, which had only grown since the pandemic. Many of the lessons learned in the latter stages of the Covid-19 vaccine rollout in working with Ma¯ori and Pacific providers, and extra trained vaccinators, should be employed here.