Last year saw the highest number of measles cases in Australia in more than a decade. Photo: Sergey KhamidulinNearly half Australia’s suburbs do not have enough people immunised against measles to protect them against outbreaks of the potentially deadly disease, a conference has heard.
Measles has been officially eliminated within Australia, but NSW health says international travel means the condition is being imported into the state at least once a month, putting children who are not fully immunised at risk.
It considers the threat so serious it is rolling out a state-wide booster program to children in their senior years of high school.
Australia’s relatively high overall rate of immunisation for measles masks the dangers at a local level, where analysis from the National Centre of Immunisation Research and Surveillance for Vaccine Preventable Diseases has found immunisation rates are well below the minimum requirement that 95 per cent of 6 year-old children should have at least one measles vaccination.
In some Australian postcodes such as Mullumbimby rates are as low as 57 per cent, sparking questions about whether schools need to begin more strictly enforcing school-entry vaccination requirements.
In NSW after Mullumbimby, Brunswick Heads is at 67 per cent, and Bellingen, Bangalow, Byron Bay are about 76, 80 and 82 per cent respectively. Sydney City is at 72 per cent, although difficulties collecting data in that area may mean this is an underestimate.
In Victoria, the Yarra Valley is at 77 per cent, while Melbourne City is 55 per cent and Southbank is 67 per cent, although difficulties collecting data in the last two areas may mean this is an underestimate.
The Victorian health department could not say how many neighbourhoods across the state were not meeting minimum measles vaccination requirements.
But a spokesman was keen to point out Victoria’s childhood immunisation coverage was “among the highest in the country” – 93 per cent for children aged 5.
“No Jab, No Play” legislation is set to be introduced in Victoria next year. It would see children who are not fully immunised banned from enrolling in childcare, unless they have an approved exemption for a medical reason or their parents have a conscientious objection.
The director of the National Centre of Immunisation Research and Surveillance, Peter McIntyre, said measles was dangerous not just for unvaccinated children, but adults as well.
“You do get a substantial number of people who get quite ill from it,” he said. “With measles a proportion will end up in hospital, and you don’t get many ‘mild’ cases where you are just feeling a little bit off.”
His presentation to an NHMRC Centre of Research Excellence in Immunisation advocacy workshop revealed analysis of nearly 1500 post codes in the Australian Childhood Immunisation Register had found 44 per cent had immunisation rates below 95 per cent, the national target agreed to by the country’s health ministers.
“We have got a long way to go,” he said. “Because we have got these pockets of people who aren’t immunised, we get these bushfires”.
“They are related to travel, things like there was a singing or dancing group visiting from the Philippines, or people travelling to Thailand, which also has measles, and about three years ago there was quite a lot of measles in France”.
Last year saw the highest number of measles cases in more than a decade in Australia, while NSW in particular has been struggling with a number of outbreaks, with the biggest in 2012.
Professor McIntyre said recent scares over measles outbreaks in the US were about far lower rates of the disease than occurred in Australia, in part because the US had extremely strict rules around checking that people were vaccinated before each level of school and university.
“You can’t get into any of these places unless you have got your bit of paper saying you have got your two doses of measles vaccine,” he said. “Here the schools legislation doesn’t necessarily get enforced.”
So far the US CDC has identified 125 cases of measlesinfamously linked to an outbreak at Disneyland theme parks in California, where the population is nearly 70 per cent larger than Australia. In 2014 Australia recorded 340 cases of measles.
Professor McIntyre said the government’s recently announced plans to develop a school vaccination register could improve this, although it needed to be easy to use as schools already had a lot of responsibilities and may not be equipped to check and enforce the rules.
Vicky Sheppeard, the director of the communicable diseases branch of NSW Health, said the ministry was so concerned about the low rates in some suburbs that it has developed a targeted program in high schools, which was rolled out at 145 schools in areas with low coverage in term four last year.
That program had been so successful it would now be rolled out across the state this year and next.
She said parents had been so keen to get their kids vaccinated they had managed to reach 11,000 children. All up 20,000 had been given parental permission, but checks revealed the remainder were already up-to-date and so did not need the vaccine.
“Really it’s often that parents are busy, and life circumstances have for one reason or another got in the way, whether it’s moving, the number of children they have had, or illness, it’s really just been a missed opportunity,” she said.
The department is also developing targeted programs, including a pilot program in Western Sydney that offered vaccines through Pacific Islander churches.
“There are simple ways to reach people, you just need to develop programs that meet their needs,” she said.