Kia ora e te whānau.
Welcome to the first session in our new series of HealthCast.
This is a space where we can talk about health matters and get some really great insight and advice from our health care professionals at Health New Zealand Te Whatu Ora.
First, we’re going to be looking at the role of immunisations in living a longer and healthier life, and I'm joined by the wonderful Dr. Lily Fraser. Nau mai haere mai to the HealthCast.
Lily, can you tell us a little bit about your role and what you do in health care?
Kia ora Beth and kia ora koutou. My name is Lily Fraser. I'm a GP. I’m from Ngāi Tahu down in Te Waipounamu. I currently work in two Māori providers—one up in Auckland, Turuki Health Care, and the other one down here in Oamaru, te haumaru te whare koi ora Oamaru.
Ah kia ora, welcome, thanks for being with us today.
So, we’re going to put immunisations in a lens today, and I guess for parents and caregivers, there are a number of actions we take every day to protect our youngest tamariki. If you think about it, we put seatbelts on our kids, we practice safe sleeping, we safety-proof our homes, and another tool we should have in our toolkit to keep our tamariki safe is immunisations.
Can you tell us what role immunisations play in protecting our youngest tamariki and helping them live a longer and healthier life?
Yeah. The immune system is this really incredible thing. When it's exposed to different illnesses or vaccinations, it has a memory of that.
When a baby or pēpē is inside our puku and growing, it shares the blood from the mother, and in that blood, we also get immune system exposure. When a baby is born, it has some immunity and protection to all the illnesses the mum has been exposed to or vaccinated against over her life. That will be in pēpē when they are born, which is pretty amazing.
Unfortunately, that immunity from mum wears off over time. That's one of the reasons we start vaccinating at a younger age—because we’re trying to line it up with the time that immunity starts to wear off. Different immunity wears off at different times.
Our first immunisation sessions happen at six weeks, with ongoing immunisations over the early period of our tamariki’s lives. This is the time when their immune system is learning about the different illnesses in the community.
The immunisations we choose are mostly for diseases that can be really serious for our tamariki. We still have colds and gastro infections, but the ones on the vaccination schedule are more likely to have serious impacts on our kids.
There’s a lot going on in the immunisation schedule—so many different diseases are covered—and we often don’t take the time to think about or understand what those are. It’s important to have an idea of why we’ve chosen these particular illnesses to protect our tamariki against.
Let me go through some of them and share what my experience has been as a GP.
One of them is Rotavirus. It’s a tummy bug that can cause very severe diarrhoea, vomiting, and fever in little kids. When I was a junior doctor working in pediatric wards, we would have entire wards full of rotavirus cases. These kids were very sick, and the illness was highly contagious. Handwashing alone couldn’t always protect you from it.
This vaccine is a more recent addition to our programme. I remember dehydrated little babies in hospital looking so miserable—so it’s great that now, with immunisation, kids aren’t getting as sick. It might not prevent 100% of cases, but it definitely makes it much less severe.
Another one is Diphtheria. It’s a bacterial infection that was common in the first half of the last century and had a high death rate. The bacteria forms a membrane across the back of the throat, making it hard to breathe. I’ve never seen a case in my 20 years as a doctor, which is a big win for immunisations.
Tetanus is another one. The bacteria lives in soil—we can’t avoid it. When exposed, it paralyzes your muscles, including the ones in your lungs, making it impossible to breathe. People with severe tetanus often need life support. The vaccine is very effective, and tetanus is now rare. You might still get a tetanus booster if you have a bad cut and haven’t had one in the last ten years.
Whooping cough is something we still see. In babies under one year old, it’s particularly scary—they cough repeatedly and struggle to catch their breath. I’ve seen people black out from it. It comes around every few years and spreads easily, which is why we need high vaccination rates to stop outbreaks.
Polio is another. Older generations often knew someone with polio, as it could cause muscle paralysis or smaller limbs. It sometimes affected the lungs and could be fatal. Thanks to vaccination, polio has been eliminated from Aotearoa, but it’s still present globally, so we continue vaccinating to protect against reintroduction.
Hepatitis B was also very common, especially among Māori and Pacific peoples. It’s spread through body fluids and can stay in the body for life if caught young. It mainly damages the liver and can lead to liver cancer. Many adults in New Zealand still live with chronic hepatitis B and need regular monitoring and specialist care.
If a mum has hepatitis B during pregnancy, the baby receives immunisation at birth to prevent infection. Hepatitis B still significantly affects whānau today.
Interviewer: An important one here.
Dr. Lily Fraser: Yeah, and so that’s been on the vaccination schedule since the 80s. We’re definitely seeing a big reduction in hepatitis B in our younger ones. But sometimes, if mum hasn’t had all the tests during pregnancy, it’s not picked up, and baby can still get hepatitis B.
A couple of other really important ones are pneumococcal and meningococcal vaccines. These bacteria can cause illnesses like meningitis. In my lifetime, we’ve seen big outbreaks of meningococcal disease where whānau have sadly passed away or been left with severe disabilities—loss of limbs and ongoing health problems.
The difficult thing with these infections is that tamariki can get very sick, very quickly. A child might seem like they just have a cold in the morning, but by nighttime they’re seriously unwell. If that happens overnight while they’re sleeping, hours really matter.
In general practice, if we think a child may have one of these illnesses, and there might be a delay getting to hospital, we’ll start antibiotics immediately through a drip because early treatment is critical.
From six months of age, babies can get the flu vaccine. Like COVID vaccines, flu protection wears off and the virus changes, so it’s something we need annually. We all know how severe the flu can be—even for adults—so for tamariki, who can get dehydrated and have high fevers and muscle pain, it’s especially important.
The next combined vaccine is measles, mumps, and rubella (MMR). Measles still causes outbreaks in Aotearoa, and Samoa had a devastating epidemic. People can underestimate measles—it’s not just a rash and fever; it can affect the brain, cause pneumonia, and make children critically unwell. Since it’s a virus, there’s no specific treatment other than fluids and pain relief, which sometimes isn’t enough.
I haven’t personally seen mumps since having it as a child, but it can have serious complications—especially for adult males where it can sometimes cause infertility. Rubella is usually mild for tamariki but very dangerous for pregnant māmā. If caught early in pregnancy, often before you even know you’re pregnant, rubella can cause serious birth defects. We don’t see much of it now because of immunisations.
Another one is Haemophilus influenzae type b (Hib), a bacteria that used to be more common. It can cause meningitis, severe throat infections where children can’t swallow, pneumonia, and other serious bacterial infections. It’s rare now thanks to vaccination.
So, there’s quite a wide range of illnesses covered. They’re not “just a cold.” These are serious diseases, which is why these vaccines have been chosen.
Interviewer: Thanks for explaining that. We often hear the names of these diseases but don’t fully understand their impact. It’s really valuable insight into why immunising our tamariki sets them up for a healthy future. Most people still take their kids to get immunised, but some don’t. What are the common reasons you see for that?
Dr. Lily Fraser: The most common reason is simply being busy. Especially when it’s not your first child—you’re juggling work and multiple tamariki, and sometimes it just slips through the cracks. You might get a text reminder but move on and forget.
Our community nurses and Plunket teams do a great job reaching out and offering options, but sometimes whānau change phone numbers, lose phones, or can’t reply due to no credit, so they miss the reminders.
For some whānau, there’s hesitancy or questions about vaccines. They may be worried about side effects or have heard myths. In those cases, it’s really important to talk with someone you trust in the hauora system—your nurse, GP, or a Māori provider—someone who can answer questions openly and transparently.
Interviewer: You’ve shared a lot of insight already, but could you give an example of what can happen if a child isn’t immunised?
Dr. Lily Fraser: One whānau really sticks with me. This was before the hepatitis B vaccine was available. A large whānau where all the kids caught hepatitis B from their mum, which was common back then.
By the time I met them, only one brother remained. He was in his 50s; all his siblings had passed away from liver cancer caused by hepatitis B. He was the last one, and they had become strong advocates for hepatitis B vaccination. He even participated in vaccine trials to help others avoid what his whānau went through.
Here’s the full transcript you provided, cleaned up with all timecodes removed and lightly polished for clarity while keeping the original meaning and tone:
An important one here.
And so that's been on the vaccination schedule since the 80s. So we're definitely seeing our younger ones having a big reduction in the number of people. But, you know, sometimes mum hasn't had the tests during pregnancy, it's not picked up, and then baby can still get Hepatitis B.
A couple of really important ones because they cause really severe illnesses are Pneumococcal and Meningococcal. They can cause things like Meningitis. I know in my lifetime there have been some really big outbreaks of Meningococcal disease where whānau have died from meningococcal meningitis, but also where people have been left with severe disabilities and ongoing problems—like loss of limbs or other serious effects.
The hard thing with those two bacteria is our tamariki get sick really quickly. They might seem like they’ve just got a cold in the morning, and by night they’re really, really sick. That can happen overnight while they’re sleeping. In those cases, hours are really important.
If a child comes to us at the GP and we're not close to a hospital, and we think there might be a delay, we will give antibiotics immediately through a drip if we think they might have one of those illnesses, because our kids can get very sick, very fast.
From six months of age, our babies can get the flu vaccine. That’s one of those vaccines, like the Covid vaccine, that wears off over time. The viruses also change quickly, so it’s something we need to get annually for ongoing protection.
Most of us know how severe the flu can be—it really knocks even adults into bed. For our tamariki, dehydration and high fevers can be very serious. And as adults, we know how bad that muscle pain feels—imagine that for a little one.
The next three are given together as one vaccination: measles, mumps, and rubella. Measles is something we still frequently have outbreaks of—we’ve had them in Aotearoa, and our whānau in Samoa have had a devastating measles epidemic.
Sometimes people think measles is just a fever and a rash, but it can actually affect the brain, cause pneumonia, and make children very unwell. Because it’s a virus, we can’t give antibiotics—there’s no treatment except fluids and pain relief, which sometimes isn’t enough when tamariki haven’t been exposed before.
Mumps—I haven’t seen mumps since I had it as a kid. It’s not always a severe illness, but it can have serious side effects. For example, in adult males, it can sometimes cause infertility.
Rubella is another rash illness that’s often mild in children, but it’s very important to protect māmā when they’re pregnant. If rubella is caught early in pregnancy—often before you even know you’re pregnant—it can cause serious deformities in the developing baby. This used to be quite common, but now we rarely see it thanks to immunisations.
Another one on the schedule is Haemophilus Influenzae type B (Hib). That’s another bacteria that we don’t see as often anymore, but it can also cause meningitis, severe throat infections where swallowing is difficult, pneumonia, and other bacterial infections in the body. Like Pneumococcal, it causes a wide range of illnesses, which is why it’s on the schedule.
So you can see why these vaccines have been chosen—they’re not just for mild illnesses like a cold. They protect against serious, potentially life-threatening conditions.
Thanks for explaining that because we hear about these diseases, but many of us don’t fully understand the implications. It’s great insight into why we should immunise our tamariki. It really is one of the best ways to set them up for a healthy future.
I know most people still take their kids to be immunised because they know it’s the right thing to do. But some don’t—what are the common reasons, Lily, for people not immunising?
I think probably the most common reason is simply being busy. Especially if it’s not your first child—often we do better with our first, but when you’ve got more than one tamaiti at home, or you’re working, it can just slip by.
You might get a reminder text but move on to the next thing and forget. Nurses and Plunket teams do an awesome job reaching out to whānau and offering options, but sometimes your phone number has changed, or you’ve lost your phone, or you don’t have credit to reply. There are many reasons messages don’t get through or aren’t acted on.
For some whānau, there’s also hesitancy or questions about why a child should be vaccinated. Some worry about side effects, and there are many myths out there about vaccines. That’s why it’s important—if you’re unsure or worried about what a vaccine might do—to have a kōrero with someone you trust in the health system.
That could be your nurse or a Māori provider—someone who can answer your questions clearly and transparently.
From your experience, Lily, could you share a story of what could happen if we don’t immunise—perhaps a child you’ve seen who became unwell and could have been protected?
One whānau really sticks with me. This was before Hepatitis B immunisations were available. A large whānau—all the kids caught Hepatitis B from their mum, which was common at the time.
When I was working with this whānau, there was just one brother left in his 50s. All his siblings had passed away from liver cancer caused by Hepatitis B, and he was the last one.
They became strong advocates for Hepatitis B vaccination. He was involved in trials and really wanted to prevent others from going through what his whānau had. I often think about the impact that had on a whole generation—and not just one whānau. Hepatitis B affected multiple people in many whānau. I’m so grateful we now have the vaccine, and we no longer see entire families wiped out like that.
Another memory is from when I was working an evening urgent care shift. A four-week-old baby—too young to be vaccinated—had caught whooping cough. She had just come out of hospital, and her parents were still so worried.
It was heartbreaking to see how fast she was breathing, struggling with long coughing fits. At that time, vaccination rates in the community had dropped, and we were seeing outbreaks.
I think about that little baby when I talk to māmā during pregnancy, encouraging them to get their vaccination to help protect their baby until they’re old enough for their own immunisations.
There’s always going to be a waiting period before babies can be vaccinated, so protecting those around them is just as important. It’s already challenging being a first-time parent, let alone having your pēpi so unwell—that’s why this matters so much.
Now, I want to talk about herd immunity. People hear that phrase and think it’s something to do with cows—but for some diseases, like measles, herd immunity protects people who can’t be vaccinated. That includes babies who are too young or people undergoing treatments that weaken their immune system.
We saw what happens without herd immunity during the 2019 measles outbreak in Samoa. Over 80 people died—most of them tamariki—from a population of just 200,000. To put that in perspective, that would be like 83 people dying in Hamilton—devastating for families and the whole community.
So Lily, what would you say to parents or caregivers about the role immunisation plays in protecting not just their child, but vulnerable tamariki in our communities?
When we think about vaccination, we often just focus on our own child—we want to protect them from illness. But when you have very contagious diseases like measles, which spread quickly through cough droplets in the air, the more people who are vaccinated, the harder it is for that disease to spread.
Measles is extremely contagious. To achieve herd immunity and protect those who can’t be vaccinated, we need a 95% vaccination rate. That covers the 5% who can’t be immunised—whether due to allergic reactions, chemotherapy, other medical reasons, or being too young.
For less contagious diseases like polio, herd immunity can be achieved at around 80%. But for highly contagious illnesses, the rate must be much higher.
Ultimately, the higher the immunisation rate, the better protected our whole community is, especially those whose immune systems aren’t strong enough to fight disease.
Lastly, Lily, what advice would you give to a parent or caregiver who’s sitting on the fence about getting their child immunised?
I think back to when I was immunising my own daughter. Even as a health professional who knew the benefits, it was still upsetting to take her in and see a needle put in her.
But the experience was made so much better by the wonderful nurses. They made me feel comfortable, allowed me to breastfeed her during the vaccination, and when she was older, they distracted her with bubbles. She barely noticed the needle.
There are things we can do to make immunisation less stressful and more positive.
I hope after today you’ve learned more about these conditions and can think, “If I can protect my baby against these serious illnesses, why wouldn’t I?”
If you’re unsure, keep looking for that person who will truly listen to your concerns and guide you through what vaccination means. It might not be the first person you talk to, but find the one who understands you and will explain it clearly, in a way that respects your decision-making.
I believe vaccination is a really powerful tool in our kete for keeping well.
Kia ora, Lily. That really helps explain a lot about immunisations—why they exist and why we should be using them to protect our tamariki. Thank you for joining us on HealthCast.
Kia ora Beth. And thank you, everybody, for listening. I hope you learned something new from this kōrero.
Immunisations do save lives, and there are many places you can go to get your tamariki immunised. You can contact your local GP, pharmacy, or other health providers. To book an immunisation, visit BookMyVaccine.health.nz.
