.svg) Map of confirmed measles cases in New Zealand during the 2019–2020 outbreak by district health board (DHB) | |||||||||||||||||||||
| Date | 1 August 2019 – 21 February 2020[1]
16 February – 16 May 2019[2]
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| Casualties | |||||||||||||||||||||
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The2019–2020New Zealand measles outbreak was anepidemic that primarily affected theAuckland region.[8] It was the largestmeasles outbreak in the country since the introduction of the second dose of MMR vaccine to the New Zealand National Immunisation Schedule in 1992. An outbreak in 1991 caused an estimated tens of thousands of cases, followed by another outbreak in 1997 with 2,169 reported cases.[9]
The D8 strain was confirmed to be the main strain of the epidemic,[10][11] although the B3 strain was also detected,[12] and the epidemic has spread to several other countries. InSamoa more than 72 people have died.[13] Cases inTonga andFiji have also been recorded, and an outbreak inPerth began in October 2019 after a New Zealander visited while infectious.[14] In New Zealand, two unborn fetuses in second trimester died as a result of the outbreak.[15]
The New Zealand Government was criticised for its response to the epidemic, particularly due to shortages in the supply of vaccines.[16][17] Scientists also criticised theMinistry of Health for not acting on previous recommendations to conduct national 'catch-up' campaigns with theMMR vaccine prior to the outbreak.[18]
In 2017, the New ZealandHealth Ministry produced documents highlighting the urgent need to increase measles immunisation among young people, stating that a "systematic, programmatic approach" was needed to address an immunity gap.[19] In 2018, DrNikki Turner, Chair of the National Measles Verification Committee, met to discuss the immunisation gap. It was noted damage was historical and immunisation rates had improved but by 2019 the gap had not been fully addressed. Many young people were unaware of their vaccination status, indicating that poor record keeping contributed to ineffective delivery.[20] David Haymen and Turner concluded that the best way to close the immunity gap was to undertake a formal catch-up programme.[21]
Research into the 2019 measles epidemic traced its history and showed it was young infants who were most at risk, followed by teenagers and adults under the age of 30.[20] Analysis by theImmunisation Advisory Centre found that individuals born between 1982 and 2007 had low immunization rates, and vaccination records are incomplete for that period as the National Immunisation Register was introduced in 2005.[22] The research also suggested management strategies such as a national campaign targeting at-risk age groups; establishment of systems to ensure adequate supplies of vaccines; provision of support for their delivery at the practice level; and creative use of community facilities to improve accessibility.[20]
During theCOVID-19 pandemic in New Zealand, it became apparent that in the drive to obtain a vaccine for that outbreak, there was a stall in getting measles vaccination programmes rolled out effectively. Dr. Nikki Turner warned that because of this disruption, it was possible that there would be "bigger problems with children dying from measles, and the damage from measles, than Covid."[23]
Although New Zealand has had a high demand for the MMR vaccine, resulting in a shortage, there has also been an increase in the number of people who have declined the vaccine since 2017.[24]
As of 24 February 2020, there had been 2,194 cases of measles reported throughout New Zealand since 1 January 2019.[1] Auckland had been the worst-hit region, with 1,736 cases alone.[1] The New Zealand government activated the National Health Coordination Center in August 2019 to respond to the outbreak.[25]
| Region | Cases | Hospitalised |
|---|---|---|
| Northland | 133 | 23 |
| Waitematā | 306 | 129 |
| Auckland | 274 | 108 |
| Counties Manukau | 1,157 | 435 |
| Waikato | 51 | 12 |
| Lakes | 30 | 6 |
| Bay of Plenty | 45 | 19 |
| Tairāwhiti | 0 | 0 |
| Taranaki | 8 | 3 |
| Hawke's Bay | 26 | 8 |
| Whanganui | 0 | 0 |
| MidCentral | 10 | 0 |
| Hutt Valley | 9 | 1 |
| Capital and Coast | 24 | 7 |
| Wairarapa | 1 | 0 |
| Nelson Marlborough | 1 | 0 |
| West Coast | 0 | 0 |
| Canterbury | 44 | 17 |
| South Canterbury | 2 | 0 |
| Southern | 73 | 6 |
| Total (nationwide) | 2,194 | 774 |
