Measles outbreak status and response

Outbreak overview and spread
The current measles situation involves two separate outbreaks, one originating from overseas travel to countries currently experiencing outbreaks and subsequent domestic travel, resulting in clusters such as the Bluebridge ferry cluster, and another outbreak in Auckland also linked to international travel. Concerns remain re undetected community transmission.

Case management and containment
There has been an extensive public health response, including managing over 200 exposure events and 3,348 close contacts, which involved identifying, checking immune status, quarantining non-immune individuals, and daily monitoring. Despite three days without new cases, the risk of ongoing community transmission remains, and containment is considered feasible but resource-intensive.

Laboratory and hospital capacity
Laboratory capacity for PCR testing and serology is stable, with no delays in case confirmation and same-day test results. Hospital services have remained fully functional, with no measles-related admissions in the current week, although some cases have required hospitalisation.

Immunisation uptake and awareness
There has been a significant increase in daily MMR doses administered during Measles Immunisation Week, with nearly 3,000 doses given in one day compared to the usual 600. The campaign has focused on raising awareness rather than mass vaccination events, with notable uptake among 19–55 year olds and older children.

Age-based immunity guidance
Updated guidance on determining immunity based on birth year and country of origin is in final stages of preparation and will be released soon. The guidance clarifies that those born before 1969 in New Zealand are considered immune due to prior wild-type measles circulation, while those from certain other countries may require clinical discretion for vaccination. Formalised guidance will be distributed to address pressure in primary care regarding older age groups.

Eligibility for non-residents
There is some confusion regarding MMR eligibility for individuals not eligible for New Zealand health services, explaining that vaccination for these groups is not universally available and must be coordinated through local public health teams and service specifications, with administration fees only covered for those eligible for health services.

MMR zero dose review and clinical discretion
A rapid evidence review for the potential introduction of an MMR zero dose for infants under 12 months is ongoing, considering risks, benefits, and operational impacts.

Asking overseas visitors to immunise
Some clinics have reported families requesting early immunisation (MMR0) due to family coming from overseas for Christmas. The better approach is to ensure those around young babies are fully immunised. People are encouraged in conversations such as these to ask their family members to check their status and ensure visitors to New Zealand are immunised before travelling to NZ.

Data reconciliation and targeted communication
There is a challenge in reconciling immunisation records for adults aged 21–36, noting large gaps in documented immunity. The importance of leveraging PMS and NIR data to identify immune individuals and prioritise outreach was emphasised, with a staggered approach planned for those lacking records.

Equity and maternal antibody considerations
Concerns were raised over assumptions regarding maternal antibodies in infants, particularly among Māori, and the need to consider equity implications in the MMR zero review, ensuring the approach benefits those most at risk.

Current vaccine stock and distribution
There is no shortage of MMR vaccine nationally, but some providers experienced delays in order fulfilment due to high demand. Stock was reallocated from national to regional stores based on administration rates, and most unfilled orders have since been addressed. Ongoing efforts are focused on improving delivery rates and ensuring providers can meet local demand.

Feedback on communication gaps
Communications from the centre to PHOs have been noted to be less comprehensive than in previous outbreaks, with some important updates, such as Immunisation Week, being learned from media rather than official channels. NPHS acknowledged the challenge of balancing information overload with insufficient updates and committed to refining the communication cascade to ensure timely, relevant, and non-duplicative messaging through appropriate regional channels.