New Zealand Infant Immunisation Coverage Declining - Data

Health experts are warning new data showing a decline in immunisation coverage could mean thousands of New Zealand infants are unprotected from serious, but vaccine-preventable illnesses[1],[2].

New Ministry of Health statistics show a drop in the vaccination rates of infants over the last quarter, when compared to the previous year 1,2.

According to the Ministry's figures, the decline in the infant immunisation rate which includes the period of the first COVID-19 lockdown, is more pronounced amongst those who live in the areas of greatest socioeconomic deprivation with a decrease of 4.4%, compared to a 2.4% fall over the rest of the country. The proportion of Māori infants inoculated with all Government funded vaccines in the National Immunisation Schedule has also fallen by 5.6%1, 2.

The data also shows a number geographical variations, with babies under the age of six months who live in the Northland, Tairawhiti and Lakes DHBs the least likely to be vaccinated with rates up to 16% lower than the national average of 76.2% for the latest quarter1, 2.

Auckland University Professor and director of the Immunisation Advisory Centre (IMAC) Dr Nikki Turner says the figures are particularly concerning given the decline in rates of immunisation is greatest among the most vulnerable groups in our community.

Dr Turner says one of the most important diseases to be vaccinated against in the first six weeks of an infant's life is whooping cough.

Whooping cough (pertussis) is a common and potentially deadly childhood illness caused by the bacterium Bordetella pertussis, one of the most contagious diseases affecting the human population[3].

“We do not want to delay the start of the immunisation programme for young infants and the major risk is whooping cough. So it’s important to start at six weeks and make sure they get the first three doses on time; six weeks, three months and five months.

“There’s a lot of whooping cough around so we don’t want anyone to delay, it’s been a disrupted year so people can get a bit confused about when to go in. It’s also important for pregnant women to remember to be immunised for it as well,” she says[4].

Dr Turner says along with infants, adolescents have been affected by disrupted access to healthcare providers and school-based immunisation programmes during the pandemic.

“Anyone with children aged 11 and 12 need to make sure they are accessing the funded vaccines for whooping cough, diphtheria and tetanus as well as HPV through their general practice.

Dr Turner says while it’s encouraging to see no measles outbreaks have occurred so far this year, she says it’s vital that the 15 month and four year old vaccinations to help protect against this disease are maintained.

“I do urge parents to check in with their nurse or doctor to see if their children have had their essential vaccinations, and if not, make a plan to bring them up to date.”

While these vaccines are on the publicly funded schedule Dr Turner says there are others that parents should speak to their doctor about to help protect their children against common diseases which are always circulating in the community such as meningococcal disease.

Meningococcal disease is an uncommon but life-threatening bacterial infection causing two serious illnesses: meningitis (an infection of the membranes that cover the brain) and septicaemia (blood poisoning)[5].

There are several different types or serogroups of meningococcal bacteria including groups A, B, C, W and Y, the most common in New Zealand being meningococcal group B with over 50 percent of cases caused by this strain in 2019*,[6],[7].

In New Zealand meningococcal B is rare but can strike at any age, most frequently in babies and children under five, followed by teenagers 5,6 . Māori and Pasifika infants under one year of age have higher meningococcal B rates compared to other populations in New Zealand 6.

There are effective meningococcal vaccines available for purchase from general practice, particularly for those most at risk which include infants, toddlers, adolescents and young adults 3.

Director of The Meningitis Foundation NZ Andrea Brady says vaccines play an important role in preventing the spread of bacteria that cause meningococcal disease and reducing disease rates.

“Vaccines are available to help protect against the most common forms of meningococcal disease. However, awareness and understanding of the available vaccines for meningococcal disease is relatively low,” she says.

Brady says there is no one vaccine that covers all the common types of the disease. Two separate vaccines are required; one for meningococcal B and another which covers types A, C, W and Y.

The ACWY vaccine is free for people aged 13-25 years living in boarding school hostels, tertiary education halls of residence, military barracks, or prisons. For everyone else, the ACWY vaccine and the B vaccine need to be purchased by private prescription[8].

“Although there is a cost involved, we believe the investment in the health and wellbeing of your child is absolutely worth it. Vaccines are the best form of disease prevention,” says Brady.

Brady advises Kiwis to talk to their GP or practice nurse about the different meningococcal vaccines, and parents to make sure their child gets the best possible protection by ensuring the vaccine course is completed on time.

Brett Marett, medical director for GSK NZ, one of the country’s largest providers of vaccines says while it is a challenging time for the healthcare sector it is important to maintain vaccination timeframes according to the National Schedule.

“There can be a number of reasons why parents can’t easily access their healthcare provider, especially during a pandemic however it is important to follow the Ministry of Health’s immunisation guidelines to help protect children from a wide range of diseases that are prevalent in our community,” he says.

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[1] Ministry of Health. Immunisation coverage data – three-month reporting period 1 April 2020 – 30 June 2020. Available here. Accessed 29 August 2020

[2] Ministry of Health. Immunisation coverage data – three-month reporting period 1 April 2019 – 30 June 2019. Available here. Accessed 29 August 2020

[3] Ministry of Health. Immunisation Handbook 2017. Wellington, Ministry of Health 2017

[4] The Institute of Environmental Science and Research. Pertussis Report May 2019. Available at https://surv.esr.cri.nz/PDF_surveillance/PertussisRpt/2019/PertussisReportMay2019.pdf. Accessed 16 September 2020.

[5] Ministry of Health website. Meningococcal disease (including meningitis.) Summary Tab. Available at: https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/meningococcal-disease-including-meningitis Accessed 29 August 2020

[6] The Institute of Environmental Science and Research. Invasive Meningococcal Disease Report 2019. Accessible here.

[7] Ministry of Health website. Meningococcal disease (including meningitis.) Summary Tab. Available here: Accessed 29 August 2020

*of those cases that could be typed

[8] Decision to widen access to meningococcal ACWY vaccine for people in close-living situations. Available here. Accessed August 29 2020

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