Het Rijksvaccinatieprogramma in Nederland. Ontwikkelingen in 2006

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.In 2006 traden verschillende veranderingen op in het Rijksvaccinatieprogramma (RVP) in Nederland: kinderen die geboren worden uit moeders die chronisch geinfecteerd zijn met hepatitis B krijgen vlak na de geboorte een hepatitis B vaccinatie; er is een ander vaccin geintroduceerd voor difterie, kinkhoest (a-cellulair), tetanus, poliomyelitis en Haemophilus influenzae (DaKTP/Hib); vaccinatie tegen pneumokokken is toegevoegd op de leeftijd van 2, drie, vier en elf maanden; risicogroepen voor hepatitis B krijgen op diezelfde leeftijden een combinatievaccin voor DaKTP/Hib en hepatitis B; DTP en aK zijn gecombineerd in een vaccin op vierjarige leeftijd; en er zijn nieuwe BMR vaccins geintroduceerd. Op basis van informatie die in 2006 beschikbaar is gekomen wordt geadviseerd de introductie van vaccinaties voor de volgende ziekten te overwegen: hepatitis B (universele vaccinatie), rotavirus, waterpokken en humaan papillomavirus. Voor respiratoir syncytieel virus en meningokokken B zijn nog geen kandidaatvaccins beschikbaar en uitbreiding van het RVP met beschikbare vaccins voor hepatitis A, influenza en tuberculose wordt nog niet aanbevolen. Het RVP is effectief en veilig, maar voortdurende bewaking hiervan is groot belang, omdat er regelmatig veranderingen optreden. Handhaven van de hoge vaccinatiegraad is essentieel om terugkeer van ziekten te voorkomen. Verder moet regelmatig bekeken worden of het RVP aangepast moet worden aangezien er steeds nieuwe vaccins beschikbaar komen

Parents' perceived vulnerability and perceived control in preventing Meningococcal C infection: a large-scale interview study about vaccination

<p>Abstract</p> <p>Background</p> <p>Parents' reported ambivalence toward large-scale vaccination programs for childhood diseases may be related to their perception of the risks of side-effects or safety of vaccination and the risk of contracting the disease. The aim of this study is to evaluate parents' perceptions of their child's risk contracting a Meningococcal C infection and parents' perceived control in preventing infection in relation to their evaluation of the safety, effectiveness and usefulness of vaccination.</p> <p>Methods</p> <p>In a large-scale interview study, a random sample of parents was interviewed after their children had received vaccination against Meningococcal C in a catch-up campaign. Questions were asked about the perceived relative vulnerability of their child contracting an infection, perceived control in preventing an infection, and parents' evaluation of the safety, usefulness and effectiveness of vaccination.</p> <p>Results</p> <p>61% of 2910 (N = 1763) parents who were approached participated. A higher perceived relative vulnerability of their own child contracting the disease was related to a more positive evaluation of the vaccination campaign, while a lower perceived vulnerability did not result in a more negative evaluation. A higher perceived control in being able to prevent an infection was, however, related to a more critical attitude toward the safety, usefulness and effectiveness of vaccination.</p> <p>Conclusion</p> <p>Perceived relative vulnerability contracting an infection and parents' perceived control in preventing an infection seem to influence parents' evaluation of the vaccination programme. Future studies should determine if, and under which circumstances, these perceptions also affect parents' vaccination behaviour and would be relevant to be taken into account when educating parents about vaccination.</p

Vermoede bijwerkingen van vaccinaties van het Rijksvaccinatieprogramma. Tweede jaarrapport - Rapportages in 1995

Adverse events following immunisation (AEFI) in the National Vaccination Programme of the Netherlands (RVP) have been monitored through an enhanced passive surveillance system by RIVM since 1962. From 1984 onward evaluation is done in close collaboration with the National Health Council. Reports from Health Care workers are recieved mainly by telephone through the operating vaccine information and advisory service. Further data are obtained, if necessary, from parents, general practitioners, paediatricians etc. After supplementation and verification of data a (working)diagnosis is made and causality assessed. In this report on 1995 an overview of all recieved AEFI is made and causality assessed. In this report on 1995 an overview of all recieved AEFI is presented with classification according to case definitions and causality. Reporting bias, background rates of specific events and possible pathophysiology of symptoms are discussed. On a total of approximately 2 million vaccinations 800 AEFI were submitted. Of these 1% (8) was unclassifiable because of missing information. In 81% (641) of the classifiable events a possible causal relation with vaccination was established and in 18% (151) the events were judged to be coincidental. Compared with 1994 there was again a rise in the number of notifications Thorough evaluation revealed no increase of true side effects in the Netherlands but a further decrease in underreporting

Adverse events following immunisation in the Dutch National vaccination programme ; part 1. reports in 1994

Adverse events following immunisation (AEFI) in the Dutch National Vaccination Programme (RVP) have been monitored by RIVM since 1962 through an enhanced passive surveillance system. From 1984 onwards evaluation is done in collaboration with the National Health Council. Reports from health care workers are received mainly by telephone through the operating vaccine information and advisory service. Further data are obtained if necessary from parents, general practitioners, pediatricians etc. After supplementation and verification of data a (working)diagnosis is made and causality assessed. In this report on 1994 an overview of all received AEFI is presented with classification according to case definitions and causality. Reporting bias, background rates of specific events and possible pathophysiology of symptoms are discussed. On a total of approximately 2 million vaccinations 712 AEFI were submitted. Of these 2%(16) was unclassifiable because of missing information. In 85%(590) of the classifiable events a possible causal relation with vaccination was established and in 15%(106) the events were judged to be coincidental. Compared with 1993 there was a rise in the number of notifications. Thorough evaluation revealed no increase of true side effects after implementation of Hib vaccination in the Netherlands. The increase in reported AEFI appears to be due to a decrease in underreporting.Vermoede bijwerkingen van vaccinaties van het Rijksvaccinatieprogramma (RVP) worden in Nederlandcentraal geregistreerd door het RIVM sinds 1962. De bewaking van de veiligheid van het RVP, vanaf 1984 in nauwe samenwerking met de Gezondheidsraad, is gebaseerd op een passief systeem, dat steunt op vrijwillige spontane meldingen. Omdat behoefte bestaat aan een completer beeld van de binnengekomen meldingen is besloten alle meldingen van vermoede bijwerkingen per kalenderjaar te rapporteren. Trends in aard en aantal worden zo sneller zichtbaar en vergelijkingen tussen verschillende jaren, vaccins en eventueel vaccinatieschema's zijn daarmee mogelijk. Dit is het eerste jaaroverzicht dat is opgesteld. In 1994 zijn over een totaal van circa 2 miljoen vaccinaties 712 postvaccinale gebeurtenissen gemeld; bij 12 kinderen was het een meervoudige melding met vermoede bijwerkingen na twee verschillende vaccinaties. Wegens gebrek aan gegevens was in 2% (16) van de gevallen geen beoordeling op causaliteit mogelijk. Van de wel beoordeelbare meldingen werd in 85% (590) een mogelijk causaal verband met de vaccinaties vastgesteld; deze gelden daarmee als bijwerking. De overige 106 (15%) postvaccinale gebeurtenissen waren coincidenteel. De toename van het aantal meldingen die al in 1993 zichtbaar werd lijkt te berusten op een afname van onderrapportage en niet op een werkelijke stijging in het aantal bijwerkingen

Adverse events following immunisation in the Dutch National vaccination programme ; part 1. reports in 1994

Vermoede bijwerkingen van vaccinaties van het Rijksvaccinatieprogramma (RVP) worden in Nederlandcentraal geregistreerd door het RIVM sinds 1962. De bewaking van de veiligheid van het RVP, vanaf 1984 in nauwe samenwerking met de Gezondheidsraad, is gebaseerd op een passief systeem, dat steunt op vrijwillige spontane meldingen. Omdat behoefte bestaat aan een completer beeld van de binnengekomen meldingen is besloten alle meldingen van vermoede bijwerkingen per kalenderjaar te rapporteren. Trends in aard en aantal worden zo sneller zichtbaar en vergelijkingen tussen verschillende jaren, vaccins en eventueel vaccinatieschema's zijn daarmee mogelijk. Dit is het eerste jaaroverzicht dat is opgesteld. In 1994 zijn over een totaal van circa 2 miljoen vaccinaties 712 postvaccinale gebeurtenissen gemeld; bij 12 kinderen was het een meervoudige melding met vermoede bijwerkingen na twee verschillende vaccinaties. Wegens gebrek aan gegevens was in 2% (16) van de gevallen geen beoordeling op causaliteit mogelijk. Van de wel beoordeelbare meldingen werd in 85% (590) een mogelijk causaal verband met de vaccinaties vastgesteld; deze gelden daarmee als bijwerking. De overige 106 (15%) postvaccinale gebeurtenissen waren coincidenteel. De toename van het aantal meldingen die al in 1993 zichtbaar werd lijkt te berusten op een afname van onderrapportage en niet op een werkelijke stijging in het aantal bijwerkingen.Adverse events following immunisation (AEFI) in the Dutch National Vaccination Programme (RVP) have been monitored by RIVM since 1962 through an enhanced passive surveillance system. From 1984 onwards evaluation is done in collaboration with the National Health Council. Reports from health care workers are received mainly by telephone through the operating vaccine information and advisory service. Further data are obtained if necessary from parents, general practitioners, pediatricians etc. After supplementation and verification of data a (working)diagnosis is made and causality assessed. In this report on 1994 an overview of all received AEFI is presented with classification according to case definitions and causality. Reporting bias, background rates of specific events and possible pathophysiology of symptoms are discussed. On a total of approximately 2 million vaccinations 712 AEFI were submitted. Of these 2%(16) was unclassifiable because of missing information. In 85%(590) of the classifiable events a possible causal relation with vaccination was established and in 15%(106) the events were judged to be coincidental. Compared with 1993 there was a rise in the number of notifications. Thorough evaluation revealed no increase of true side effects after implementation of Hib vaccination in the Netherlands. The increase in reported AEFI appears to be due to a decrease in underreporting.RIV

Bijwerkingen van vaccinaties van het Rijksvaccinatieprogramma in Nederland. Nummer V Rapportage in 1998

Adverse events following immunisation (AEFI) in the National Vaccination Programme of the Netherlands (RVP) have been monitored through an enhanced passive surveillance system by RIVM since 1962. From 1984 onwards evaluation is done in close collaboration with the National Health Council. Reports from Health Care workers are received mainly by telephone through the operating vaccine information and advisory service. Further data are obtained, if necessary, from parents, general practitioner, paediatrician etc. After supplementation and verification of data a (working) diagnosis is made and causality assessed. In this report on 1998 an overview of all received AEFI is presented with classification according to case definitions and causality. Reporting bias, background rates of specific events and possible pathophysiology of symptoms are discussed. On a total of approximately 2 million vaccinations 1100 AEFI were submitted. Of these 1.5% (16) was unclassifiable because of missing information. In 80% (877) of the classifiable events a possible causal relation with vaccination was established and in 18% (197) the events were judged to be coincidental. Compared to 1997 there was again a rise in the number of notifications. This increase is thought to be due, both to decreased underreporting, increased awareness and apprehension as possibly also to some increase in true side effects, mainly fever and crying.Sinds 1962 bewaakt het RIVM de veiligheid van het Rijksvaccinatieprogramma. Vanaf 1984 gebeurt dat in nauwe samenwerking met de Gezondheidsraad. Het merendeel van de meldingen komt binnen via de telefonische informatiedienst van het RIVM, waarbij de meeste meldingen afkomstig zijn uit de jeugdgezondheidszorg.Nadere informatie wordt zo nodig verkregen van ouders en behandelende artsen. Na aanvulling en verificatie wordt aan de hand van de (werk)diagnose de causaliteit beoordeeld. Alle in 1998 binnengekomen meldingen zijn in dit rapport opgenomen en gerubriceerd naar aard van de gebeurtenis en naar causaal verband. Onderrapportage, vertekening en specifieke beelden worden besproken. Er zijn 1100 meldingen binnengekomen, op ongeveer twee miljoen vaccinaties. Hiervan waren er 16 (1,5%) niet te beoordelen vanwege ontbrekende informatie. Bij 80% (877) van de meldingen werd een mogelijke causaal verband vastgesteld en bij 197 meldingen (18%) werd een oorzakelijk verband onwaarschijnlijk of afwezig geacht. Vergeleken met 1997 was er opnieuw een stijging in het aantal meldingen. Deze stijging kan deels worden veroorzaakt door verdere afname van onderrapportage, verhoogde aandacht en bezorgdheid. Mogelijk is er ook enige toename in frequentie van werkelijke bijwerkingen, vooral van beelden met koorts en huilen

Bijwerkingen van vaccinaties van het Rijksvaccinatieprogramma in Nederland. Nummers III - IV Rapportages in 1996 en 1997

Adverse events following immunisation (AEFI) in the National Vaccination Programme of the Netherlands (RVP) have been monitored through an enhanced passive surveillance system by RIVM since 1962. From 1984 onwards evaluation is done in close collaboration with National Health Council. Reports from Health Care workers are recieved mainly by telephone through the operating vaccine information and advisory service. Further data are obtained, if necessary, from parents, general practitioners, peadiatricians etc. After supplementation and verification of data a (working) diagnosis is made and causality assessed. In this report on 1996 and 1997 an overview of all received AEFI is presented with classification according to case definitions and causality. Reporting bias, background rates of specific events and possible pathophysiology of symptoms are discussed. On a total of approximately 2 million vaccinations per year 732 and 822 AEFI were submitted in 1996 and 1997 respectively. Of these 1,6% (12) and 2% (17) were unclassifiable because of missing information. In 78% (565) and 80% (642) of the 22% (155) and 20% (163) the events were judged to be coincidental. Compared to 1995 the number of reports stabilised, with similar distribution and causality