The Samoan director-general of health says too many parents are neglecting their duty of looking after their children by failing to get them vaccinated.

The death toll has reached 33 and there have been a record number of new cases in the past 24 hours. 

But most parents with children aged six months to four years still haven't got them vaccinated against the disease

It's Samoa's youngest that are dying in this crisis - and some are following official advice.

Scared mothers are bringing their children to get vaccinated.

"I'm a mother of eight. I know the feeling...losing a child, it's very hard," said Donna Esera.

Seven days into a mass vaccination campaign, demand for help remains high.

"For the first day, we have had more than 700 people vaccinated just at this particular site. And now we are having an average of 100 a day," said Red Cross disaster management coordinator Lauvao Isara.

Emergency clinics are critical to stopping the spread of disease and they have to be well organised. 

Patients get their names and details taken down, and then get their injections from nurses, before their details are recorded again.

 Police are on-site at every clinic to ensure vaccinations are administered in accordance with the State of Emergency rules. It's compulsory for all people aged 19 years old or younger to get the vaccine.

But far too many are ignoring the call to get vaccinated - coverage of the most at risk hasn't even reached 40 percent.

"We are still worried that most of the kids are not coming forward or not being brought by their parents," said director-general of health Dr Take Naseri.

In many cases when they do turn up at the hospital they're seriously unwell, or in some cases near death.

"Most are presenting late. The average is five to six days since the onset of symptoms," Dr Naseri told Newshub.

"Some parents are still not taking up their responsibilities to look after their children," said Lepea village representative Lago Lago Sesega.

Another 249 new cases have been recorded in the last 24 hours.

Middlemore hospital nurse, Tori Prendergast says there's a huge demand on both staff and medical equipment at the rural hospital she's working at.

"They're experiencing an increase in capacity both as inpatients and a surge in capacity at the ED due to the measles outbreak".

Samoa has requested help from as far afield as the UK - and say the situation is only escalating.