PHARMAC announces extension to Menactra eligibilityFrom 1 December 2019, PHARMAC is widening access to meningococcal ACWY vaccine (Menactra®) for people aged 13–25 years in a close-living situation. 
The proposal was approved as consulted on except, as a result of consultation feedback, some changes to the eligibility criteria to clarify that people entering board school hostels, tertiary education halls of residence, military barracks or prisons within the next 3 months would be eligible for vaccination before they enter these institutions.

For more information, click on the links below:

https://www.immune.org.nz/hot-topic/pharmac-announces-extension-menactra-eligibility

https://pharmac.cwp.govt.nz/news/notification-2019-11-13-acwy-vaccine/​

Please view this link for a brief summary which should answer most questions about Measles: https://www.arphs.health.nz/assets/Uploads/Resources/Disease-and-illness/Measles-Mumps-Rubella/Quick-guide-to-measles-20190619.pdf

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.

PLEASE DO NOT WALK IN FOR MEASLES IMMUNISATION (MMR) WITHOUT AN APPOINTMENT. YOU WILL BE ASKED TO MAKE AN APPOINTMENT AT A LATER DATE AS WE NEED TO PRIORITISE OUR VULNERABLE CHILDREN. WE ARE EXPERIENCING HIGH DEMAND AND THE WAIT TO HAVE IMMUNISATIONS AT OUR PRACTICE IS ONE TO TWO WEEKS.
There are more than 800 cases in Auckland as of 2 September 2019. There are about an extra 20 cases a day. The majority of cases are occurring in South Auckland, particularly Mangere, Manurewa and Papakura. However the number of cases in the Auckland DHB area is growing. Current detailed information here.
We are able to immunise 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 immunise non-enrolled patients. Those who are not our enrolled patients need to go to their own registered doctors or go to one of the following drop in clinics:

• Monday to Friday 9am to 4pm:Clendon Public Nursing Office, Clendon Shopping Center
• Saturday and Sunday 9am to 4pm: Manukau SuperClinic, 901 Great South Road
  
  

Ministry have advised us to give MMR vaccines to the following:

• Children on the current immunisation schedule – we have brought forward the 15 month immunisation to 12 months. This is given again at 4 years.
• Children aged 6-12 months if in contact with a known case.
• Children 6-12months they are travelling 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, Canadain 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 ie 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 anti-vaccine 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.
  
  

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 sniffly as much as possible. Immunise her/him promptly at 12 months. Consider keeping baby home from daycare if possible. If your baby has been in contact with a known case of measles during their infectious period (5 days before and 5 days after came out) please call us for advice. 
Can my baby have their MMR at 6 months?
The Ministry of Health 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 afterwards)or will be traveling to a country with an active outbreak. This is because the MMR is only about 75% effective at 6 months of age, and we will need to give a total of three jabs if the first one is given at less than 12 months.
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, Phillipines
• European countries – Austria, Bulgaria, Czech Republic, France, Finland, Germany, Greece, Hungary, Ireland, Italy, Poland, Portugal, Romania, and the United Kingdom
• Neighbouring countries in the European region have also been affected: Albania, Belarus, Georgia, Russia, Serbia, Turkey and Ukraine
  
  

I can't get an appointment with your clinic for a measles vaccine (MMR) this week
We are trying our best but are absolutely swamped, and have to continue with our regular work whilst we are coping with this outbreak. We are very sorry that we cannot immunise everyone immediately but it is not possible. While you are waiting for your jabs, please stay away from coughing/sniffly people, stay away from big gatherings e.g. sports events/shopping centers etc. You may consider working from home or keeping your baby at home. 
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 ie 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 ie 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 theUK 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 atLabtests 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 immunise our registered patients. We are also experiencing a heavy demand and you may have to wait a day or two. Please do not walk in for a vaccine without an appointment, our nurses need to prioritise children first and you will be asked to make an appointment at a later date.
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
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.
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 IS IMMUNOCOMPROMISED (have a weak immune system eg have cancer, on immunosupressant treatment such as chemotherapy, oral steroids 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 immunisation.
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 mucous
• back pain 
• sore ears
• having a fit (seizure)
• not passing urine for 10 hours.
  
  

How dangerous is measles? Has anyone died in Auckland?
Thankfully nobody has died yet during this outbreak. Measles has a mortality rate of 1-2/1000 people infected. 1/10 people infected will need hospital admission for complications such as pneumonia and encephalitis. Babies and small children with lowered immunity 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 immunised 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 immunised against 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 contracted measles, 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 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 would like more information about vaccines
Immunisation Advisory Centre of New Zealand
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.

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

Just a brief update:
 - 15 month MMR Vaccines are currently being brought forward to 12 months with the spread of Measles continuing in Auckland. You can read more here:
https://www.arphs.health.nz/public-health-topics/disease-and-illness/measles/

- Flu Vaccines are now almost out of stock nationwide, and any remaining stock has been prioritised to those most at risk. Read more here:
http://www.immune.org.nz/hot-topic/influenza-vaccine-supply-issue

Auckland Medical officer of health is not concerned that there is a measles outbreak in Auckland as there is in Christchurch.  Isolated cases will be inevitable but an outbreak is unlikely.  Below is some useful information regarding measles and the MMR vaccine and who should be vaccinated.

One dose of measles or MMR vaccine will protect 95% of vaccinated people from measles. 

If you think you have measles or have been in contact with measles - Please DO NOT COME INTO THE CLINIC. 

This is very important, call us on 416 8541 and speak with a nurse.  We will arrange to come an meet you in your car in the carpark.  This is to prevent the spread of measles as it is a highly contagious airborne disease.

We have face masks and sterilising hand gel outside the front door of our clinic.

Vaccinations:
Children 15 months and older who have not had a MMR vaccine.  We are able to vaccinate these children from 12 months of age to provide protection, but we are not actively recalling children between 12-15 months early due to supply constraints. Please call 416 8541 to book a nurse appointment to vaccinate.

Children under 4 who have had their 15 month MMR vaccine, are not required to have the second MMR vaccine early.  Normal recalls will be issued at 4 years.

Adults - born between 1969 - 1984 who are not sure whether they have had any doses of MMR are eligible for a funded MMR booster in clinic.  Please call 416 8541 to book a nurse appointment to vaccinate. (the vaccine is free, a $23 nurse fee applies per vaccine).

Adults born before 1969 - are considered immune to measles as the disease was prevalent and circulating widely prior to the introduction of the measles vaccine in 1969.  No action needed for these patients.

We are currently receiving a lot of requests about the Northland Meningitis cases and vaccination programme. 

​There has been 29 cases of Meningococcal W strain so far in 2018 (twice as many as 2018), 7 of those in Northland.  (source)

You can read the following links to make an informed decision to vaccinate your children. Although meningococcal disease is rare, it can be deadly. 

There are two vaccines available:
 - Bexsero was only recently launched in early November 2018, and only covers the B strain which is the main circulating strain in NZ, and needs two doses at $140 each)
 - Nimenrix (covers the A,C,Y and W strains, which includes the current outbreak strain, and only needs one dose at $140). Nimenrix is currently out of stock with no ETA, but may be back in stock next week (week of 3rd December 2018). 
 - Menactra is currently out of stock (all stock going to the Northland vaccination programme)

To book a vaccine, you can call our nurses to make an appointment with them. You don't necessarily have to see a Doctor to have this vaccine (but a Doctor has to prescribe it in the background). 

Main link for reading:
http://www.immune.org.nz/diseases/meningococcal-disease 

PDF version: 
www.immune.org.nz/sites/default/files/resources/Written%20Resources/DiseaseMeningococcalImac20180912V01Final_0.pdf

Bexsero vaccine information:
www.immune.org.nz/sites/default/files/resources/Written%20Resources/NonprogrammeVaccineBexseroImac20181109V01Final.pdf

Nimenrix vaccine information:
www.immune.org.nz/vaccines/available-vaccines/nimenrix

 Our Easter weekend 2018 hours -

Thursday 29 March                    OPEN -  Normal hours 8am - 7pm
GOOD FRIDAY 30 March           CLOSED  
Saturday 31 March                     OPEN -  Normal hours 9am - 12
Sunday 01 April                           CLOSED   
EASTER MONDAY 02 April       CLOSED
Tuesday 03 April                         OPEN -  Normal hours 8am - 7pm
​

​

​Friday               22 Dec 2017                8.30am until 6.30pm
Saturday          23 Dec 2017                9am to 12pm
SUNDAY          24 Dec 2017                CLOSED
 
MONDAY         25 Dec 2017                CLOSED - Christmas Day
TUESDAY        26 Dec 2017                CLOSED - Boxing Day
Wednesday    27 Dec 2017                8.30am until 4.30 pm
Thursday         28 Dec 2017                8.30am until 4.30 pm
Friday               29 Dec 2017                8.30am until 4.30 pm
SATURDAY      30 Dec 2071               CLOSED
SUNDAY          31 Dec 2017                CLOSED
 
MONDAY          01 Jan 2018                CLOSED - New Year's Day
TUESDAY         02 Jan 2018                CLOSED - New Year's Day Holiday
Wednesday     03 Jan 2018                8.30am until 4.30 pm
Thursday          04 Jan 2018                8.30am until 4.30 pm
Friday                05 Jan 2018                8.30am until 4.30 pm
Saturday           06 Jan 2018                9am to 12pm
SUNDAY           07 Jan 2018                CLOSED
 
Monday            08 Jan 2018                8am to 7pm - NORMAL HOURS RESUME