Experts disagree on the reasons for a marked downturn in child immunisation rates for mumps, measles, whooping cough and more, or whether official figures are even reliable
New data shows more parents are choosing not to vaccinate their children in accordance with the national immunisation schedule – a series of free vaccines offered to babies and children and includes protection against measles, chickenpox and polio to name a few.
Ministry of Health data for the second quarter shows for the year to June the proportion of those declining vaccines across all age groups up to 5 years old had increased on the year to March.
University of Auckland vaccinologist Helen Petousis-Harris said she would be very surprised if there was not a link to Covid-19 vaccine disinformation.
“Websites and social media platforms that are opposed to vaccines and promote myths about vaccines are growing and they are growing in terms of the number of people that they’re recruiting into those networks.
“So I would be very surprised if there wasn’t links to Covid-19 disinformation.”
Immunisation coverage for New Zealand children by aged two is 83.7 percent for 12 months to June.
That’s down slightly on the year to March when it was 84.4 percent.
But it is not just total coverage figures that are moving in the wrong direction.
The proportion of parents or caregivers declining to get the vaccine for their children is higher.
For the year to March, 6 percent of 18-month olds were not fully immunised and marked as “decline” compared with June when that proportion rose to 6.2 percent.
Likewise for 2-year olds in March 5.7 percent were not fully vaccinated for this reason, but this had lifted to 6 percent.
The data translates to 300 less children being vaccinated across that age range in a three month period.
Immunisation Advisory Centre medical director Nikki Turner said it was hard to know exactly what the figures meant or what was behind them.
“The Covid vaccination programme has had some gains for us and some losses.
“The mandates did help us get a higher Covid vaccine uptake but there is a small group that feels quite isolated by it.”
She said “vaccine fatigue” may have also set in.
“Some people have found the last two years very hard and whether that group is growing is hard to know.”
Dodgy data
But Waitakere Hospital paediatrician Owen Sinclair said the way the data was collected was unreliable and it was rare to come across families who were anti-immunisation.
He said a “decline” data point may be collected simply because it meant the health provider no longer had to follow up on late or missed immunisation appointments.
“If someone cancels their appointment for the third time they sometimes just mark it as declined so it’s referred to another service [such as] an outpatient service… it just makes it someone elses problem.”
He said many outpatient services were thoroughly short-staffed and so it was unlikely the parent was then followed up with.
“It’s a system failure… the problem with low immunisation rates is the system – the anti vax are an extremely small amount of people.”
Outbreak fears
Sinclair said immunisation rates were now the lowest since records began and he was fearful more children would die of preventable disease.
“The 2019 measles outbreak in Samoa, the vaccine rate was 31 percent. In South Auckland the 6-month-old vaccine rate for Māori is also 31 percent.
“We’re looking down the barrel of an outbreak where children are completely undefended and we’re going to have an epidemic that kills lots of them.”
Auckland University paediatric researcher Anna Howe said immunisation rates were falling before the Covid-19 pandemic but were now worse for a multitude of reasons including the lockdowns.
“Rates for whooping cough cover are as low as 45 percent for Māori. We normally get a whooping cough outbreak every three to four years so we are due for one.
“Measles is the main concern and we are terrified that we’ll export it to the Pacific like in 2019.
She also said maternal vaccine coverage was “sub-optimal”.
Pregnant women are recommended to get an influenza vaccine as well as a vaccine to protect against tetanus, diphtheria and whooping cough.
“The rate is about 47 percent at the moment and that whooping cough cover the mother gets protects baby for the first six weeks of its life, when they’re most at risk,” she said.
No judgement
Dr Nikki Turner said the best use of resources was engagement and education.
“This is not a time to be judging people.
“We need to be engaged alongside communities and for those services to be well-funded. It’s harder work but in the long-term you gain a community that’s more cohesive and trusting.
She said the most effort needed to go to the group that were not actively declining but those who were not getting the vaccine on time.
“The first effort should be to those who have barriers.”
She said not all decliners were cut from the same cloth
“There are those who will disagree with the science and will not change their mind and in a democracy that is their right.
“But there are also people with bad experiences and low trust in the system and it’s worth putting time into and engaging and re-establishing trust with them.
“Things have gone wrong for some people in the past and we should put effort into supporting them and understanding when and why they’ve lost trust.
“Having some empathy in people’s lives… it’s not a time to be judgemental, it’s a time to understand.”
