The measles outbreak sweeping through Auckland comes at no surprise to the Immunisation Advisory Centre, with a range of factors at play turning people away from immunisation.
Director of the Immunisation Advisory Centre Dr Nikki Turner told TVNZ 1's Q+A they expected "something like this to happen because we've known there are gaps in immunity across the New Zealand population".
Yesterday, Prime Minister Jacinda Ardern said there have been 963 confirmed cases of measles since March , 804 of them in Auckland.
Northland has the lowest immunisation rate in the country, along with the West Coast. There are also micro-areas of low immunisation in the Coromandel.
"We find there are communities of people who do not trust health care authority advise or have had bad experiences and they tend to group together. We often find pockets of communities who are less confident about receiving vaccine," Dr Turner said.
"What we're seeing in New Zealand at the moment is severe poverty (that) has got worse in the last few years and we have seen a drop off in people being able to obtain immunisation in a timely manner, for their children."
"It's very hard for these families."
During New Zealand's last measles outbreak 22-years-ago, only 60 per cent of children were immunised.
"Alongside that, in the early 90s came along the scare with MMR (vaccine), that one doctor in England had proposed it could be linked to autism. The science has completely debunked that theory but it's got stuck in the national psyche," Dr Turner said.
While the extreme-end of the anti-vax movement is thought to make up 25 per cent of the resistance to immunisation, Dr Turner said the worry was the group they call "vaccination hesitancy".
"This is about people who have had a lot of fears and concerns, they've heard stories, they're worried. Social media and the internet ramp up people's fears. The key is the loss of a relationship with the healthcare provider."
However, she said making the measles immunisation mandatory was not the answer.
"I think making an environment where you have to make a choice with support and understanding is the way New Zealand should go."
Health Minister David Clark agreed.
Dr Clark talks to Jack Tame about measles outbreak, immunisations and vaping, on September 2.
"We know it’s a simple, scientifically-proven cure to deadly diseases, so we need to encourage people as strongly as we can," he said.
On moves to prevent unvaccinated children from attending school, Dr Clark said district health boards put the decision into the hands of schools.
"DHBs can send the message out that then schools can refuse to take people, and we’ve seen schools doing that in some instances.
"It’s really tricky, because we don’t want to punish the kids for the choices that their parents have made in these instances, and actually, those kids probably need good education as much as anyone else."
Q+A is on TVNZ1 on Mondays at 9.30pm, and the episode is then available on TVNZ OnDemand and as a podcast in all the usual places.
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