Rural Kids & MMR2: New Taranaki Study
Liam Ballard, Hannah Lawn, Thomas Dawson, Kyle Eggleton. (2025) Evaluating rural–urban MMR vaccine inequity in the Taranaki region: a retrospective cohort study. Journal of Primary Health Care doi:10.1071/HC25093
2025-11-27
The recent outbreak of measles in Aotearoa New Zealand highlights the low coverage of MMR vaccination and the potential for another epidemic to occur. Within this study the authors examined MMR coverage within Taranaki. Participants were born within 2019-2021. The second dose of the MMR vaccination was lower in R2/3 areas compared to R1 or U2 areas. There is the potential, therefore, for any measles epidemic to have more impact in more rural and remote areas of Aotearoa New Zealand.
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Abstract
Introduction: In New Zealand, lower immunisation coverage is seen among those of Māori and Pacific ethnicity, as well as in communities with higher levels of socioeconomic deprivation. However, the impact of rurality on routine childhood immunisations has been incompletely investigated.
Aim: This study aims to measure the effect of rurality on second-dose measles–mumps–rubella vaccination (MMR2) within the Taranaki region. Methods. This was a retrospective observational study using routinely collected health data. Participants were born in 2019, 2020, or 2021 and lived in the Taranaki region at age 24 months. Rurality was determined using the Geographic Classification for Health (GCH). The percentage of MMR2 coverage was calculated for each rurality grouping, and logistic regression was used to adjust for confounders.
Results: A total of 4596 participants were enrolled across three GCH levels. MMR2 coverage rates were 56.2% in the most rural group (R2 + 3), compared to 63.0% in R1 (Rural 1) and 62.3% in U2 (Urban 2). Adjusting for ethnicity and socioeconomic deprivation produced odds ratios (ORs) of 1.33 for R1 participants and 1.18 for U2 participants, compared to R2 + 3. It was also shown that Māori had lower immunisation coverage than non-Māori at every GCH classification.
Discussion: Children living in more rural areas had lower rates of MMR2 coverage at age 24 months. This may reflect inequitable impacts of the COVID-19 pandemic or uneven rollout of the 2020 changes to the National Immunisation Schedule.