Flow chart and FAQ measles (Sept 2019)

MMR Vaccination Flow Chart Guide for PHO Receptionists & Practice Managers This Guide has been developed to assist Receptionists and Practice Managers to respond to queries from patients and parents about the MMR vaccine and advise accordingly during the current Measles outbreak. Read in conjunction with the MMR Vaccination Frequently Asked Questions on next page.

MMR VACCINATION FLOW CHART Was the patient born before 1969?

Are they > 50 years of age?

Yes

No

The patient is immune to measles as there was enough measles in the population prior to 1969. They do not require serology or vaccination

Is the patient over 12 months of age?

No

Yes

Is the patient over 6 months of age?

Are they pregnant?

Yes

No Yes

They cannot receive the MMR vaccine

Does the patient have a documented dose of MMR in your PMS?

Yes Do they have 2 doses documented?

Yesis immune The patient to measles and does not require additional vaccination or serology

If only oneNo dose documented book them an appointment to get another dose

No

They can receive one dose of MMR after consultation with the GP. Book them an appointment with the GP and nurse.

Book them an appointment with the nurse to get vaccinated with MMR

Created by L Goodall – Auckland PHO Child Health Coordinator September 2019

No

They cannot receive the MMR vaccine

September 2019

Measles Vaccination (MMR) Frequently Asked Questions A Guide for PHO Receptionists & Practice Managers This Guide has been developed to assist Receptionists and Practice Managers to respond to queries from patients and parents about the MMR vaccine and advise accordingly during the current Measles outbreak. Read in conjunction with the MMR Vaccination Flow Chart.

I was born before 1969/older than 50 years. Do I need to be immunised with the MMR vaccine?

No. People born prior to 1969 (who are 50+ years) are immune to measles because there was no measles containing vaccine and there was enough infectious measles in the population meaning most people are immune to measles.

I was born overseas prior to 1969.

Do I need the MMR vaccine?

No. Most counties had enough measles circulating in the population that you are believed to be immune to measles.

Refer to practice nurse for further advice.

I’m pregnant, can I get the MMR vaccine?

No. You are unable to receive the MMR vaccine while you are pregnant. It is a live vaccine and there is a risk that it can be harmful to your baby. You can get the MMR vaccine as soon as baby is born.

Can I receive the MMR vaccine if I am immunocompromised/have immunity problems?

No. If you are on treatment or have a medical condition that affects your immune system you are unable to have live vaccines.

Can I get the MMR vaccine if I’m breastfeeding?

Yes. You can safely have the MMR vaccine.

My baby is under 6 months. Can s/he have the MMR vaccine.

No. We cannot give your child the MMR vaccine if under 6 months.

There is no effective immune response to the MMR vaccine if your baby is under 6 months. It is expected that they will have some protection with antibodies from the mother.

Refer to Practice Nurse for further advice.

To protect your baby, make sure those around you and your baby are immunised. If the baby is in childcare and there are other children with coughs and are unwell, the MoH advises you to keep your baby home.

My baby is 6 - 12months. Can s/he have the MMR vaccine?

Yes. If you suspect your baby is at high risk of getting measles, we can give a dose of the MMR vaccination from 6-11 months of age.

If travelling overseas, the vaccination needs to be given two weeks before travel. Your child will still need two more doses of MMR at 12 months and 4 years of age.

Book a time to talk to the doctor or practice nurse.

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September 2019

My workplace told me I need a blood test (serology) to see if I am immune to measles. Can I have a serology test?

No. Free blood tests to check for measles immunity are not available. Vaccination is the best options.

I don’t know if I have ever had the MMR vaccination – is it safe to have further MMR vaccines?

Yes. There are no safety concerns if you get more than two MMR vaccines in your lifetime. If we do not have two documented doses of MMR in your patient record, we recommend you having the MMR vaccine so that you are protected against measles.

Is the MMR vaccine free?

Yes. All patients entitled to subsidised healthcare and born after 1969 can get a free MMR vaccination.

If we do not have two documented doses in your patient record, we can give you the MMR vaccine if you were born after 1969. We can give you your vaccination history for your employer and for your own records.

The Ministry of Health (MOH) funds the injection subsidy for all patients including casuals who are vaccinated in general practice clinics.

While there is no subsidy for people not eligible for Primary Care services, such as international students and those on work visas, do not turn people away. Record their name and if possible, their NHI number as there may be a funding wash up.

How long does it take for the vaccine to work?

The vaccine takes 10-14 days to become establish immunity. One dose of the MMR vaccine gives 95% protection and two MMRs gives 99% protection from measles.

Due to stock demand we are not recalling for an additional dose at this stage.

If I’m vaccinated can I get the measles?

Vaccines do not always provide 100% immunity and people can still catch measles even if vaccinated. However, immunisation is the best protection and protects you from getting a severe case of measles.

My baby is due their immunisations. Can I get the MMR vaccine at the same time?

Yes. We will vaccinate everyone where there is no record of the MMR vaccination. The higher number of people who are immunised in the community the more chance we have protecting those who cannot have immunisations, for example pregnant women, those immunocompromised (low immunity) or those too young to receive the immunisation.

Can my child have their 4-year-old MMR vaccine early?

Yes. We can give the 4-year old the MMR vaccine early if the parent requests it. They are still due for another vaccination at 4 years.

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September 2019

I’ve had one dose of the MMR vaccine can I get another one?

Yes. If you have not received a live vaccine (e.g. Varicella, Zostavax or MMR) within the last four weeks.

REFERENCES Immunisation Advisory Centre www.immune.org.nz Toi Te Ora Public Health: Measles https://www.toiteora.govt.nz/measles Immunisation Handbook 2017 https://www.health.govt.nz/publication/immunisation-handbook-2017 Ministry of Health Measles https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/measles

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