Abbink F; Avoort HGAM van der; Berbers WAM; Binnendijk RS van; Boot HJ; Duynhoven YTHP van; Geraedts JLE; Gerritsen AAM; Greeff SC de; Hofhuis A; et al. (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2007-05-31)
In 2006 several changes were made in the Dutch National Immunisation Programme (NIP): Hepatitis B vaccination at birth was added for children born to mothers positive for hepatitis B surface antigen; a new vaccine for diphtheria, tetanus, pertussis (a-cellular), poliomyelitis and Haemophilus influenzae (DTaP-IPV/Hib) was introduced; vaccination against pneumococcal disease was added at two, three, four and eleven months; risk groups for hepatitis B receive a combined vaccine for DTaP-IPV/Hib and HBV at the same ages; DT-IPV and aP at the age of four years were combined in one vaccine; and new MMR vaccines were introduced. As new information became available in 2006, the desirability to introduce vaccinations in the NIP for the following diseases could be (re)considered: hepatitis B (universal vaccination), rotavirus, varicella and human papillomavirus. For respiratory syncytial virus and meningococcal serogroup B disease no candidate vaccines are available yet. Extension of the programme with available vaccines for hepatitis A, influenza and tuberculosis is not (yet) recommended. The NIP in the Netherlands is effective and safe. However, continued monitoring of the effectiveness and safety of the NIP is important as changes are made regularly. Maintaining high vaccine uptake is vital to prevent (re)emergence of diseases. Furthermore, the programme should be regularly reviewed as new vaccines become available.
Abbink F; Oomen PJ; Zwakhals SLN; Melker HE de; Ambler-Huiskes A (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2006-08-03)
In 2005 national coverage levels for all vaccines used in the Netherlands showed a further increase as compared to 2004. Immunization coverage figures exceed the 95% level and meet the standards provided by the World Health Organisation. The national immunization coverage in the Netherlands has proven, over the years, to be excellent.This report describes the progress made in the Dutch National Immunization Programme (NIP). Immunization coverage figures as at 1 january 2005 are presented for all vaccines in the NIP for age cohorts born in 1994, 1999 and 2002. Vaccination coverage for the most vulnerable group (infants < 6 months of age) showed an increase compared to previous years, largely exceeding the 97% level. Vaccination coverage levels for infants (DTP-IPV and Hib) were reported to be higher than ever before. The same result was seen in MMR vaccination coverage levels for both infants and 9-year olds, and in DPT vaccination coverage levels for 4-year olds. Although high national immunization coverage can mask variations within country, regional and municipal immunization coverage figures improved again. Almost all provinces reported over 90% immunization coverage for all vaccines used. Exceptions were Zeeland and Flevoland. Areas with low immunization coverage are - once again - concentrated in the so-called 'Bible-belt' where groups of orthodox reformed people live who refuse vaccination for religious reasons. Continuous attention and joint efforts of all parties engaged in the NIP will be needed to ensure that the population of the Netherlands is well informed on immunization and motivated to have their children immunized. Recent outbreaks of Measles and Rubella show the existence of a large group of unvaccinated people in the Netherlands. Importing diseases like measles and polio remains a risk.
Abbink F; Al MJ; Berbers GAM; Binnendijk RS van; Boot HJ; Duynhoven YTHP van; Gageldonk-Lafeber AB van; Greeff SC de; Kimman TG; Meijer LA; et al. (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2005-07-05)
The national immunisation programme in the Netherlands is very effective and safe. To improve the success and effectiveness of the immunisation programme, vaccination of other (age)groups is indicated. Extension of the programme with new target diseases can result in considerable health gain for some diseases. The target diseases are largely under control. However, monitoring the effectiveness of the programme is important. Maintaining high vaccin uptake is vital to prevent (re)emergence of disease. Vaccination of (young) adults now (pertussis) and in the future (mumps, measles, rubella, hepatitis B) could give further improvement. Also other vaccination strategies need attention such as maternal or newborn vaccination for pertussis. The switch to a DTPa-IPV/Hib combination vaccine in 2005 should be monitored carefully both for pertussis and other components. The national immunisation programme could be extended with new target diseases. Pneumococcal vaccination for children is expected to give important health gain. The desirability to introduce varicella vaccination - possibly in combination with mumps, measles and rubella - needs further study. When effective and safe vaccines become available for meningococcal serogroup B, respiratory syncytial virus and human papillomavirus, extension of the immunisation programme might be advisable. Extension of the programme with available vaccines for influenza, hepatitis A or tuberculosis is not (yet) recommended. For these diseases the current policy needs to be continued, possibly with lowering the age of influenza vaccination from 65 years to 50 years of age. The desirability to vaccinate children against influenza needs additional investigation, like pneumococcal vaccination for elderly. Vaccination against HSV-2 or rotavirus is not possible yet. The health gain is expected to be limited for HSV-2. When a vaccine for rotavirus comes available a cost-effectiveness analysis is needed.
Abbink F; Oomen PJ; Zwakhals SLN; Melker HE de; Ambler-Huiskes A (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2005-06-07)
This report describes the progress of the National Immunization Programme (NIP) in the Netherlands. Immunization coverage figures as at 1 january 2004 are presented for all vaccines used in the NIP for agecohorts born in 1993, 1998 and 2001.For years national immunization coverage in the Netherlands has been excellent. For 2004 national coverage levels for all vaccines used increased and exceeded 95% for the first time. The slow but steady decrease in coverage for infants reported since 1996 has been restored to a level of coverage exceeding 97%.Although high national immunization coverage can mask variations within country, regional and municipal immunization coverage also improved over the past year. All provinces reported over 90% immunization coverage for all vaccines used and municipal immunization coverage levels below 60%, previously observed each year, were not reported.Areas with low immunization coverage are - once again - concentrated in the so called 'Bible-belt' where groups of orthodox reformed people live who refuse vaccination for religious reasons.In spite of the progress made for the past year under review, joint efforts are still needed to obtain and sustain high immunization coverage. Particularly because it is already known that immunization coverage for the birthcohorts following 2001 was negatively affected by the massive attention paid to the introduction of the new DTaP-IPV-Hib vaccine by the media. Continuous attention and joined efforts of all parties engaged in the NIP will be needed to ensure that the population of the Netherlands is well educated and motivated to have their children immunized.
Abbink F; Avoort HGAM van der; Berbers WAM; Binnendijk RS van; Boot HJ; Borgen K; Duynhoven YTHP van; Gerritsen AAM; Greeff SC de; Hahni SJM; et al. (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2006-09-18)
The National Immunisation Programme in the Netherlands is effective and safe. The target diseases are largely under control. However, in 2004/2005 a rubella outbreak occurred among individuals who had declined vaccination on religious grounds. Furthermore, there have been incidents of mumps (among vaccinated individuals) and measles (among unvaccinated individuals) in 2004 and 2005. In January 2005 the diphtheria, tetanus, whole-cell pertussis and Haemophilus influenzae vaccine was replaced by a combination vaccine including an acellular pertussis component and subsequently a decrease in adverse events was noticed. From January 2006 onwards, children of hepatitis B antigen-positive mothers will receive an extra vaccination at birth. The National Immunisation Programme could be extended with new target diseases. In April 2006, pneumococcal vaccination for infants will be introduced and to evaluate the effects of vaccination it is desired to enhance the surveillance of invasive pneumococcal disease. The desirability to introduce vaccinations for chickenpox, shingles, human papillomavirus and rotavirus must be considered on the short-term, because of the availability of vaccines for these diseases. To gain insight into the health and economic effects of these vaccinations, cost-effectiveness studies are advised. Due to various reasons, extension of the programme with vaccinations against influenza, hepatitis A, meningococcal serogroup B, respiratory synctial virus and tuberculosis is not yet recommended. Monitoring the effectiveness of the National Immunisation Programme remains important. Maintaining high vaccine uptake is vital to prevent (re)emergence of disease.
Abbink F; Greeff SC de; Hof S van den; Melker HE de (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2004-04-19)
This document provides an overview of the occurrence of the target diseases included in the National Immunization Programme (NIP) of the Netherlands (period 1997-2002). Currently children are immunized against diphteria, pertussis, tetanus, poliomyelitis, invasive Haemophilus influenza type b, mumps, measles, rubella, invasive meningococcal infections type C and hepatitis B. Information from different surveillance systems was used to describe trends in mortality and morbidity for the period 1997-2002. The main sources used were the Central Bureau of Statistics for mortality figures, the National Medical Registration for hospital admissions and the Medical Inspectorate of health for notifications of the notifiable diseases. It is evident that the diseases included in the immunization programme are under control due to high immunization coverage levels; the European Region has been declared polio-free and very few cases of diphteria, tetanus, mumps and rubella were reported for the given period in the Netherlands. However, several findings stress the importance of maintaining high vaccination coverage levels and continuous monitoring of the target diseases. Pertussis, for example, shows that a disease can still be endemic with epidemic peaks despite high vaccination coverage levels. Furthermore, the recent outbreak of measles shows that clustering of unvaccinated individuals plays an important role in the (re)occurrence of disease. The essential dynamics of an immunization programme were illustrated by the actions taken in reponse to the considerable increase in cases of meningococcal infections. A nationwide vaccination campaign was organized and vaccination against meningococcal disease type C was succesfully introduced in the NIP in 2002. The report concludes with recommendations for the different target diseases.
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