The New Zealand Ministry of Health expresses its condolences to the families of children who recently died in Samoa shortly after the administration of MMR vaccine. Samoan health authorities have launched an investigation into the deaths – until this is complete, it is too early to determine their underlying cause. The Ministry is working with health authorities in Samoa and other Pacific countries to provide assistance to the investigation, and support the delivery of safe and effective vaccination programmes throughout the Pacific.
The Ministry would like to reassure parents of the safety and effectiveness of immunisation. The MMR (measles, mumps and rubella) vaccine has an excellent safety profile and has been used without any significant problem for several decades. Hundreds of thousands of children have had the vaccine in the Pacific without issue, and millions more in New Zealand and worldwide. Deaths following MMR vaccination are exceptionally rare, and similar events overseas have been a result of administration errors rather than a problem with the vaccine itself.
In New Zealand and Niue a brand of MMR vaccine called Priorix is used in our vaccine programmes. The vaccine is manufactured by GSK in Europe, and tested there before being sent to New Zealand. It is distributed through a quality distribution system that keeps it in a cold chain from factory to the patient. Mild side effects such as fever and rash are reported with this vaccine from time to time. There are no reports of death following use of the Priorix vaccine.
In other Pacific Island nations, different brands of vaccine are used. Three countries administer an MMR vaccine (Samoa, Cook Islands, Tokelau) and six other countries including Tonga use a different vaccine that contains only Measles and Rubella (MR vaccine). All of these vaccines are manufactured by a different manufacturer in India and are assessed and approved by the World Health Organization and distributed by UNICEF.
These vaccines have been used in the Pacific for many years without any evidence of harm or serious adverse effects. They are also distributed in a number of South American countries and in the Caribbean island nations. The World Health Organization has advised that there are no concerns about the safety of these vaccines in these other countries, and they continue to be used there.
The MMR vaccine used in Samoa is delivered in bottles (or vials) containing five doses. The batch of vaccine used in Samoa has been used for several months without any problems in Samoa and vaccines from the same batch continues to be used around the globe. As a precautionary step Samoa has stopped its vaccination program using these multidose vials until their investigation is complete. At present the safety concern is limited to these five-dose vials of vaccine.
Cook Islands and Tokelau
The MMR vaccine used in the Cook Islands and Tokelau, while made by the same company, is provided in single dose bottles. Local health authorities have reviewed the vaccine and the vaccine programme, and have decided to continue vaccination with the single dose MMR vaccine product they currently use.
Other Pacific Island nations
The MR vaccine used by Tonga and five other Pacific Island nations is not implicated by the unfortunate events in Samoa, and the Ministry of Health supports the continued use of this vaccine in those countries.
The investigation in Samoa
Officials and experts from the World Health Organization and Australia are supporting Samoan Health authorities in their investigation of these tragic deaths. The investigation will cover a wide range of topics including testing the vaccine administered to these infants to determine what it contained, as well as testing other bottles of the vaccine currently in Samoa. It will also explore the distribution path for the vaccine and seek assurance on its transport and storage as well as examine the vaccine program. It will also seek information from the family about what happened and whether there is a family history of health problems.
It is far too early in the investigation to determine the underlying cause of why these two infants died. New Zealand will work with health authorities in Samoa and across the Pacific Island nations to support them to ensure their vaccination programmes are as safe as possible.