IF YOU THINK YOU HAVE MEASLES OR HAVE BEEN IN CONTACT WITH A CONFIRMED CASE OF MEASLES, PLEASE CALL US FIRST BEFORE COMING IN. WHEN YOU ARRIVE FOR A CONSULTATION, PLEASE STAY IN YOUR CAR AND COMMUNICATE WITH US BY PHONE UNTIL A DOCTOR OR NURSE CALLS YOU IN. IF YOU ARE COUGHING WE WILL ASK YOU TO WEAR A MASK WHEN YOU COME INSIDE.

This is our plan for managing this outbreak:

We are recalling all our patients who have declined or delayed MMR vaccines.
Next we are immunising all adults born after 1969 who have never had one dose of MMR in their lives, or who are unsure.
After we have made sure everyone had had one dose, then we can tackle booster doses for everyone. We do not have the capacity for booster doses in adults at this time. If you are worried about your immunity after one dose, please go to Labtests for a blood test. Unfortunately, this is not funded, see FAQs below.

PLEASE DO NOT WALK IN FOR AN MMR WITHOUT AN APPOINTMENT, WE ARE EXPERIENCING VERY HIGH DEMAND AND YOU WILL MOST LIKELY BE ASKED TO MAKE AN APPOINTMENT AT A LATER DATE.

We are able to immunize only our enrolled patients. We are aware that the Newspapers are saying you can go to any GP for free jabs, but we do not have the capacity to immunize nonenrolled patients. Those who are not our enrolled patients need to go to their own registered doctors. If you are not enrolled in any general practice, you can enrol here today

The Ministry has advised us to give MMR vaccines to the following:

Children on the current immunisation schedule – we can bring forward the 15-month immunisation to 12 months. This is given again at 4 years.
Children aged 6-12 months who have been in contact with a known case.
Children 6-12months they are traveling overseas soon to countries with an active measles outbreak. Here is another link to information about countries with active measles outbreaks
Youths and adults under 50 years who have had no doses of measles vaccine.

Please note that those who are over 50 years old are considered immune, as they have most likely developed natural immunity during their childhoods when the vaccine was not yet developed.

For those under 50, they have usually been immunised depending on which country they grew up in. There was an earlier vaccine available from 1963. It was improved and the current measles vaccine was developed in 1968.

Measles vaccines were introduced in NZ in 1969, in the UK in 1968, in South Africa in 1975, USA in 1968, Canada in 1970, in Australia in 1969, Ireland in 1985, China in 1963. Korea in 1965, Hong Kong in 1967, Singapore 1976, Fiji 1982, India 1985.

One dose of the vaccine protects 95 people out of a 100 i.e. 95%. A second dose gives protection to another 3-4 people out of 100.

FAQs:

Why is there an outbreak?

There are a few reasons:

Measles is a highly infectious disease, one of the most infectious known. It is estimated that each person with measles will infect 15 others who are not immunised.
If someone gets measles, they are infectious 5 days before they even realise it is measles. The first 5 days it looks like an ordinary bad case of flu. The rash only comes out after day 5. So they can infect many people during this period
Those they infect only get sick 10 to 14 days later, so there is a lag where many cases develop unseen and in turn each person will infect others before they develop a rash.
A country needs 95% coverage to stop measles from spreading. This is called “herd immunity”. In some areas of New Zealand only 60% of people are immunised.
There are several reasons why the immunisation rate is so low in some areas such as access issues (time off work, transport), poverty, inequities, health literacy, and fear of side effects of vaccines
There is a prominent internet presence of those who believe vaccines are dangerous, fueled by information that is just plain wrong.

Immunisation rates have dropped in many other countries, primarily because of the antivaccine movement, and visitors from overseas can arrive by plane carrying the virus.
Those under 40 or 50 years old mostly grew up in a world where measles was very rare (post vaccinations) and have had no experience of the devastating effects of infection.

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My baby is less than a year old. What can I do to protect her/him?

Keep your baby away from un-vaccinated people and those who are coughing or sniffy as much as possible. Immunise her/him promptly at 12 months, and call us to discuss options if baby is 6-12 months and at day-care and might be exposed. Consider keeping baby home from daycare if possible. The immunisations do not work in babies less than 6 months old, and are only about
60-70% effective in babies 6-12 months.If your baby has been in contact with a known case of measles during their infectious period (5 days before and 5 days after the rash came out) please call us for advice.

Can my baby have their MMR at 6 months?

Ministry is not recommending routine measles vaccines at 6-12 months unless your baby has been exposed to an active case of measles during the infectious period (5 days before the rash came out and 5 days afterward) or will be traveling to a country with an active outbreak. This is because the MMR is only about 60-75% effective at 6 months of age, and we will need to give atotal of three jabs if the first one is given at less than 12 months. However, if your baby is at day-care and likely to be exposed to measles, please call us to discuss, we will certainly recommend immunising your baby from 6-12 months if they are at risk.

Currently countries with known outbreaks

Africa: DRC, Madagascar, Nigeria
South America: Argentina, Brazil, Chile, Columbia Peru, Uruguay, and Venezuela
USA: all states
Europe: France, Poland, Ukraine
Israel, Syria
Pacific: Japan, Hong Kong, Philippines
European countries – Austria, Bulgaria, Czech Republic, France, Finland, Germany,
Greece, Hungary, Ireland, Italy, Poland, Portugal, Romania, and the United Kingdom
Neighboring countries in the European region have also been affected: Albania, Belarus, Georgia, Russia, Serbia, Turkey, and Ukraine

Is the measles vaccine (MMR) free?

Measles vaccine (MMR) immunisations are funded for NZ residents and those eligible for funded medical treatments. Unfortunately it is not free for those who do not qualify. see bottom of page for details.

I am an adult and I don’t know if I had a measles vaccine as a child. What do I do?

50 years or older i.e. born before 1969: If you were born before 1969 (over 50 years old) you are considered immune as there was lots of measles in the population until then. Because measles is highly infectious, it is very unlikely that anyone over 50 years old would have escaped infection and consequent lifelong immunity.

Younger than 50 years i.e. born after 1969: The measles vaccine was introduced into most first world countries in 1968-1969 – this includes NZ, Australia, UK, USA. So if you had any jabs as a child and were born after 1969, you would have definitely got the measles vaccine with all your immunisations. One dose of the vaccine protects 95 people out of a 100 ie 95%. A second dose adds another 3-4 people out of 100.

Details of some countries: The current measles vaccine was developed in 1968 and introduced in NZ in 1969, in the UK in 1968, in South Africa in 1975, USA in 1968, Canada in 1970, in Australia in 1969, Ireland in 1985, China 1965, Korea 1965, Hong Kong 1967,Singapore 1976, Fiji 1982, India 1985

If this information hasn’t helped and you are under 50 years old, we will assume you were not immunised – please book in for an MMR

I am an adult under 50 years old and I really can’t remember if I had my jabs, and my mum/whanau can’t remember either

If you are a health care worker in contact with patients, a teacher working with children, or otherwise at risk, you might want to consider having a blood test to check if you are immune, see below. Otherwise please book in for an immunisation.

I want a blood test to check if I am immune to measles

We are only allowed to order a funded blood test to check immunity if you have been closely exposed to a notified case of measles during their infectious period (5 days before the rash came out, and 5 days afterwards) and the result will impact on school or work attendance. If you haven’t had a close exposure to an infectious case during their infectious period, we are not allowed to order a funded blood test for you. However you can access this test by paying at Medlab to have a measles immunity blood test (about $50-55). You don’t need a lab form from the doctor, you can just go and request it and pay for it. Please ask for a copy of the results to be sent to us.

How long does measles immunity (natural or from a vaccine) last?

Immunity is lifelong regardless if it is naturally acquired in those older than 50, or by immunization in those younger than 50

I am an adult/child less than 50 years old and I know definitely I didn’t have any measles vaccines

You are eligible for a free measles vaccine at the GP. We are currently overwhelmed by the demand and are only able to immunize our registered patients. We are also experiencing heavy demand and you may not be able to get an appointment at a time that suits you for a jab for a week or more. Please do not walk in for a jab without an appointment, our nurses need to prioritize our vulnerable children first and you will be asked to make an appointment at a later date. We are holding special MMR clinics some evenings during the week: please phone to book in for one of these clinics.

My child/I am sniffly and have a cough and want to be checked in case this is early measles

Please call us before you arrive if you think you have any signs or symptoms of measles and let us know. When you arrive, please call us from your car and let us know you are here. A doctor or nurse will come to fetch you from your car or see you in your car. We need to keep our waiting room and consulting rooms safe for small babies and others at risk.

My child/I have a rash and are very worried this is measles

I/my child have been told I have been in contact with an active case of measles during their infectious period (5 days before the rash came out, and 5 days afterwards)

• If you are NOT immunized: You need to enter into quarantine from 7 days after the first day you were in contact with the case and stay in quarantine for 14 days after your last contact with the infected person ie a full two weeks. Here is the quarantine calculator, and here is more information for contacts. We are happy to give you a doctors note for work/school, but please do not come into the practice during this period. We will email you the note. After your quarantine period is over and you remain well, please book in for an immunisation.

• IF YOUR CHILD THAT HAS HAD A MEASLES CONTACT DURING THE INFECTIOUS PERIOD IS LESS THAN ONE YEAR OLD OR ISIMMUNOCOMPROMISED (have a weak immune system eg have cancer, on immunosupressant treatment such as chemotherapy, oral steroids or ome arthritis medications etc.) PLEASE CALL US FOR ADVICE.

If you ARE immunized: you are safe, you cannot spread the illness to others, and do not need to enter into quarantine.

I/my child have been told I have been in contact with an active case of measles, but this was NOT during their infectious period (5 days before the rash came out, and 5 days afterwards)

You will not be infected by that case, but you are still generally vulnerable. Please call us to book an appointment for the immunization.

My doctor has said I may have measles. What do I do?

Here is the information about quarantine and keeping others safe. If you have a health concern whilst you are unwell, please call the practice before arriving. Unfortunately, there is no specific treatment for measles. Here is some more information about this illness. Things that can help are bed rest in a quiet dark room, paracetamol or ibuprofen for pain/fever, drinking lots of fluids, wiping the eyes gently with wet cotton wool or a soft facecloth. If you have concerns about these symptoms please call us, do not break quarantine:

trouble breathing
stiff neck
feeling drowsy or you cannot wake them up
coughing up green or yellow thick mucus
back pain
sore ears
having a fit (seizure)
not passing urine for 10 hours.

How dangerous is measles? Has anyone died in New Zealand?

Thankfully nobody has died yet during this outbreak. Measles has a mortality rate of 1-2/1000 people infected. About one-third of people infected during this outbreak are needing hospital admission for complications such as pneumonia and encephalitis. Babies, small children with lowered immunity, and adults who are immunosupressed (eg organ transplants} have a 50% mortality from measles. In the 1991 outbreak of measles in NZ, there were around 7000 cases of measles and 7 deaths.

I have been in contact with a family member of a confirmed case of measles. I am not immunized against measles.

What do I do?

If the family member has followed full quarantine instructions, you do not have to go into quarantine, but you are still vulnerable to other cases in the community who might be infectious.. Please book in to have your measles jabs with us if you are not immunisedagainst measles. (enrolled patients only)

If they have not followed quarantine instructions, and you have been exposed to them during the quarantine period, need to go into quarantine from 7 days after you first saw them and 7 days after ie a full two weeks. After this period, if you have not contractedmeasles, you can book in for an immunization. Please do not come into the practice for an immunization during your quarantine period. If you become unwell in your quarantine period, please phone us and we will advise what to do. Please do not come into the practice without a doctor or nurse fetching you from your car.

I have heard that the MMR contains egg and I am allergic to egg:

The modern MMR vaccine does not contain egg albumin

I am allergic to antibiotics and I have heard that the MMR contains antibiotics

The MMR contains a tiny amount of neomycin in order to keep it sterile. If you are allergic to neomycin please discuss with us.

I have heard that the MMR causes seizures in children

Children commonly get febrile seizures during childhood, these are commonly not dangerous and there is an extra 1/1000 of these seizures after MMR. Measles disease is particularly dangerous to the brain. 1 in 1000 people with measles develop inflammation of the brain
(encephalitis) – 15 in 100 of these people die and approximately 30 in 100 are left with permanent brain damage. 1 in 100,000 people who have had measles will, years later, develop a serious brain inflammation called subacute sclerosing panencephalitis (SSPE). This serious
complication always results in death.

I have heard that the MMR can cause my baby to get a cough

The MMR vaccine can cause your child to have a bit of a runny nose and cough as it teaches your child’s immune system to learn to recognise and kill the measles virus. This does not turn to pneumonia. As many as 1 out of every 20 children with measles gets pneumonia, the most
common cause of death from measles in young children.

I have heard that the MMR vaccine can cause my baby to get measles

The vaccine is a very weak virus and cannot give your baby measles. Also, those who have received the vaccine cannot give measles to anyone else.

My nanna is on chemotherapy and I am worried I will give her measles if I have the MMR

You cannot give measles to anyone when you have your MMR vaccine.

I have heard that the measles vaccine (MMR) causes autism

There was a paper published in claiming the MMR caused autism, which has since been found to be untrue and withdrawn, and the author Dr. Wakefield was found guilty of ethical, medical, and scientific misconduct and his medical license was cancelled. Additional studies showed that
the data presented were fraudulent. There is no evidence that this vaccine causes autism

I have heard that the measles vaccine (MMR) contains mercury

The MMR does not contain mercury.

I am pregnant/trying to get pregnant. Can I have the measles vaccine (MMR)?

Unfortunately it is not safe to have this vaccine whilst you are pregnant, or if you are not using contraception and may be pregnant. This is because the vaccine is a weakened live virus and will pass to the fetus and may cause harm. We recommend that you use contraception for a month and have a negative pregnancy test before we give you this vaccine. In addition, we recommend that you do not fall pregnant for one month after this vaccine is given.

I am on immunosupressant medication. Can I have the vaccine?

No this virus is a weakened live virus and may harm you if you are on any of these medications.

I would like more information about vaccines

Immunisation Advisory Centre of New Zealand

Links to full resources from ARPHS

• Fact sheet – Information for people with suspected measles
• Fact sheet – Information for close contacts exposed to measles
• Immunisation Advisory Centre phone 0800466863
• Pack – Whānau Pack for GPs and EDs
• Calculate your quarantine period
• Translated key messaging
• Poster – Stop! Do you think you have measles?
• Latest measles advisories
• Information Sheet for MMR Vaccine
• Data Sheet for MMR Vaccine

Doctors Resources

• Guide – Managing measles in primary care
• Clinical pathway
• Form – Notifications

This information is not copyrighted – please feel free to share, link or use this information to help our communities.

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