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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