Abstract

Vaccination coverage under the National Immunisation Programme
In 2013 the level of vaccination under the Dutch National Immunisation Programme (RVP) remained high and virtually unchanged compared to the previous reporting year. Depending on the type of vaccination and the target group, the average degree of participation ranged from 92 to 99% with the exception of participation in the HPV vaccination programme, which stood at 58%.
One possible way of further raising the overall coverage of vaccination is to increase the participation of older children in the programme. Ninety-two percent of Dutch nine-year-olds receive their second MMR jab, falling short of the defined target of at least 95% participation. Improvement can be achieved in this area. Although the rate of participation in the HPV vaccination programme once again increased slightly in 2013, it remains relatively low at 58%.

Important events in 2013
On 3 October 2013, the Health Council of the Netherlands published an advisory report entitled 'The Individual, Collective and Public Importance of Vaccination'. In this report the Council advocates a more flexible approach to evaluating new vaccines for inclusion in the National Immunisation Programme. In some cases new vaccines may be beneficial to certain groups or to the population as a whole, even if they do not meet the criteria for inclusion in the National Immunisation Programme. The Council suggests in its report that the Centre for Infectious Disease Control (CIb) could develop professional guidelines for the broader administration of vaccines, supported by public information about vaccines and their use and with due attention to adequate surveillance.

Some six years after the introduction of a dedicated vaccination programme to combat pneumococcal infections, the number of children suffering from such diseases has decreased dramatically. It is no longer necessary to give babies four jabs: three is enough. The Minister of Health, Welfare and Sport made this decision on the recommendation of the Health Council. The required changes to the vaccination programme were coordinated by the National Institute for Public Health and the Environment (RIVM), and implemented successfully.

The Minister has also decided to cease funding the RVP programme under the Exceptional Medical Expenses Act (AWBZ), and to include it in the Public Health Act. The Ministry of Health, Welfare and Sport started the necessary preparations in 2013, based on the principle that effective measures must be taken to assure the RVP programme is retained in its current form. This complex process will be continued in 2014. In the central government budget, the required AWBZ funding will be temporarily transferred to the Ministry of Health, Welfare and Sport. This will be followed by an amendment of the Public Health Act to enable inclusion of the National Immunisation Programme. The plan is for this amendment to enter into force in 2018.

In 2013 a measles epidemic broke out that affected mainly children in the Reformed denomination who had not been vaccinated. In response, additional so-called 'MMR0 jabs' for children of six months and older were offered in Reformed communities and in municipalities with a low level of vaccination. In total, 8075 BMR0 vaccinations were administered, compared with 1784 vaccinations during the same period in 2012.

In 2013 the Netherlands faced the threat of the possible introduction of polio from Israel and later via refugees from Syria. A number of countermeasures were implemented, including vaccinating children from Syria below the age of five as quickly as possible, and monitoring sewage water quality more closely.