Het Rijksvaccinatieprogramma in Nederland : Surveillance en ontwikkelingen in 2014-2015

In Nederland is de vaccinatiegraad binnen het Rijksvaccinatieprogramma (RVP) hoog, waardoor weinig mensen de ziekten krijgen waartegen zij worden ingeënt. Alleen de deelname aan de vaccinatie van meisjes tegen het humaan papillomavirus (HPV) ligt lager. Na de vaccinaties komen weinig ernstige bijwerkingen voor. Bijwerkingen die gerapporteerd worden zijn doorgaans niet ernstig van aard zijn. Continue monitoring is nodig om een optimaal vaccinatieprogramma te behouden. Wijzigingen in het vaccinatieschema in 2014-2015 Sinds januari 2014 is de vaccinatie tegen het HPV-virus, dat baarmoederhalskanker kan veroorzaken, teruggebracht naar twee prikken. De vaccinatie wordt aan alle twaalfjarige meisjes aangeboden. Ontwikkelingen voor RVP-ziekten Door de uitbreiding van het pneumokokkenvaccin met drie typen in 2011 is het aantal kinderen gedaald dat van deze drie typen ziek werd. Deze daling was ook te zien onder volwassenen, die mogelijk indirect door de vaccinatie van kinderen zijn beschermd.Kinkhoest nam in 2014 weer toe na een daling in 2013. Het aantal zieken was minder hoog dan tijdens de epidemie in 2012. De bof kwam weinig voor in 2014, al steeg het aantal meldingen weer in de eerste maanden van 2015. De meeste mazelengevallen zijn in de eerste twee maanden van 2014 gerapporteerd, aan het einde van de epidemie die in 2013 begon. De mazelen kwam voor in gebieden waar mensen zich om religieuze redenen vaak niet laten vaccineren. Er zijn geen gevallen van polio gemeld. Vorig jaar waren de controles op polio geïntensiveerd in regio's in Nederland waar vluchtelingen worden opgevangen. Dit betrof vluchtelingen uit enkele niet-Europese landen waar het aantal poliogevallen was gestegen, zoals Syrië. Aangezien polio in die landen in 2014 minder voorkwam zijn de controles tot een normaal niveau teruggebracht. Ontwikkelingen voor toekomstige RVP-kandidaten De Gezondheidsraad kan de minister adviseren om het aantal ziekten die onder het RVP vallen uit te breiden. Het RIVM houdt in de gaten hoe ziekten die hiervoor in aanmerking komen, zich ontwikkelen. In 2014 kwamen uitzonderlijk weinig infecties met het rotavirus voor. Ook daalde het aantal zieken door meningokokken serogroep B. Het aantal mensen met het waterpokken, gordelroos en hepatitis A is de afgelopen jaren stabiel gebleven.In the Netherlands, participation in the National Immunisation Programme (NIP) is high, resulting in low incidences of most diseases included in the NIP. Yet coverage for vaccination against human papillomavirus (HPV) in girls is lower. Only a few severe adverse events following immunisation occurred. Reported adverse events are mostly mild and transient. Continuous monitoring of effectiveness and safety is necessary for the programme to remain optimal. Changes in the vaccination schedule in 2014-2015 Since 2014, girls have been receiving a reduced number of doses against human papillomavirus (HPV). Two doses of HPV vaccine are offered to 12-year-old girls. Developments for diseases included in the NIP The switch to the 10-valent pneumococcal vaccine (PCV10) in 2011 reduced the number of invasive pneumococcal diseases caused by the additional PCV10 serotypes in the vaccinated age groups. A decrease in the incidence of IPD caused by the additional PCV10 serotypes was also seen in the adult age groups, which is probably due to indirect protection. The incidence of pertussis increased in 2014 after a lower incidence in 2013, but was somewhat lower than during the epidemic year 2012. The incidence of mumps was low in 2014, but a resurgence of mumps and an endemic transmission were encountered in the first few months of 2015. The majority of the measles cases reported in 2014 belonged to the measles epidemic in the Bible Belt, which started in 2013. No cases of polio were reported. The environmental routine surveillance, which was intensified in the region where refugees were first cared for in 2013, was changed to routine level again in April 2015. Developments for future NIP candidates The Health Council could advise the Dutch Minister of Health, Welfare and Sports on expansion of the NIP. The National Institute for Public Health and the Environment in the Netherlands (RIVM) investigates developments in potential future NIP candidates. In 2014, the rotavirus season was exceptionally low. A decrease in meningococcal serogroup B disease was seen in 2014. Incidences of varicella zoster virus and hepatitis A remained stable over the previous years.Ministerie van VW

Case-based reported mortality associated with laboratory-confirmed influenza A(H1N1) 2009 virus infection in the Netherlands: the 2009-2010 pandemic season versus the 2010-2011 influenza season

<p>Abstract</p> <p>Background</p> <p>In contrast to seasonal influenza epidemics, where the majority of deaths occur amongst elderly, a considerable part of the 2009 pandemic influenza related deaths concerned relatively young people. In the Netherlands, all deaths associated with laboratory-confirmed influenza A(H1N1) 2009 virus infection had to be notified, both during the 2009-2010 pandemic season and the 2010-2011 influenza season. To assess whether and to what extent pandemic mortality patterns were reverting back to seasonal patterns, a retrospective analyses of all notified fatal cases associated with laboratory-confirmed influenza A(H1N1) 2009 virus infection was performed.</p> <p>Methods</p> <p>The notification database, including detailed information about the clinical characteristics of all notified deaths, was used to perform a comprehensive analysis of all deceased patients with a laboratory-confirmed influenza A(H1N1) 2009 virus infection. Characteristics of the fatalities with respect to age and underlying medical conditions were analysed, comparing the 2009-2010 pandemic and the 2010-2011 influenza season.</p> <p>Results</p> <p>A total of 65 fatalities with a laboratory-confirmed influenza A(H1N1) 2009 virus infection were notified in 2009-2010 and 38 in 2010-2011. During the pandemic season, the population mortality rates peaked in persons aged 0-15 and 55-64 years. In the 2010-2011 influenza season, peaks in mortality were seen in persons aged 0-15 and 75-84 years. During the 2010-2011 influenza season, the height of first peak was lower compared to that during the pandemic season. Underlying immunological disorders were more common in the pandemic season compared to the 2010-2011 season (p = 0.02), and cardiovascular disorders were more common in the 2010-2011 season (p = 0.005).</p> <p>Conclusions</p> <p>The mortality pattern in the 2010-2011 influenza season still resembled the 2009-2010 pandemic season with a peak in relatively young age groups, but concurrently a clear shift toward seasonal patterns was seen, with a peak in mortality in the elderly, i.e. ≥ 75 years of age.</p

Factors associated with death in hospitalized pneumonia patients with 2009 H1N1 influenza in Shenyang, China

<p>Abstract</p> <p>Background</p> <p>During the spring of 2009, a pandemic influenza A (H1N1) virus emerged and spread globally. We describe the clinical characteristics and factors associated with the death of patients who were hospitalized with 2009 H1N1 influenza pneumonia in Shenyang, China, from November to December 2009.</p> <p>Methods</p> <p>We carried out a retrospective chart review of 68 patients who were hospitalized with pneumonia and confirmed to have 2009 H1N1 virus infection by a real time RT-PCR assay of respiratory specimens.</p> <p>Results</p> <p>Of the 68 patients we studied, 30 (44%) were admitted to an intensive care unit and 10 (14.7%) died. The median age of patients was 41 years (range, 18-66), and only one patient was over 65 years of age. The male to female ratio was 2.78:1 (50:18). Of the 68 patients, 23 (34%) had at least one underlying medical condition, 9 (13%) had a cigarette index ≥400 and 22 (32%) were obese. All patients underwent chest radiography on admission and the findings were consistent with pneumonia in all cases. All patients were treated with oseltamivir and treatment was initiated at a median time of seven days after the onset of illness. The laboratory test results indicated lymphopenia, hypoproteinemia and elevated lactic dehydrogenase and C reactive protein levels. Of the 68 patients, 33 (52%) showed a reduction in CD4 T cell counts. Of the 58 patients who survived, 31 (53%) had lymphopenia and 27 recovered from this condition after five days. Of the 10 patients who died, nine (90%) had lymphopenia and only two patients recovered from this condition after five days. Obesity and recovery from lymphopenia after five days were factors associated with death, as determined by multivariate logistic-regression analysis (obesity, odds ratio = 23.06; lymphocytopenia reversion, odds ration = 28.69).</p> <p>Conclusions</p> <p>During the evaluation period in Shenyang, China, 2009 H1N1 influenza caused severe illness requiring hospitalization in 68 patients, 10 (14.7%) of which died. Many of these patients were considered healthy adults and few were elderly (65 years or older). Obesity and lymphopenia, which was not restored after five days of treatment, were factors associated with poor outcomes of 2009 H1N1 influenza infection.</p

Pathogenesis, diagnosis and management of pneumorrhachis

Pneumorrhachis (PR), the presence of intraspinal air, is an exceptional but eminent radiographic finding, accompanied by different aetiologies and possible pathways of air entry into the spinal canal. By reviewing the literature and analysing a personal case of traumatic cervical PR after head injury, we present current data regarding the pathoanatomy, clinical and radiological presentation, diagnosis and differential diagnosis and treatment modalities of patients with PR and associated pathologies to highlight this uncommon phenomenon and outline aetiology-based guidelines for the practical management of PR. Air within the spinal canal can be divided into primary and secondary PR, descriptively classified into extra- or intradural PR and aetiologically subsumed into iatrogenic, traumatic and nontraumatic PR. Intraspinal air is usually found isolated not only in the cervical, thoracic and, less frequently, the lumbosacral regions but can also be located in the entire spinal canal. PR is almost exceptional associated with further air distributions in the body. The pathogenesis and aetiologies of PR are multifold and can be a diagnostic challenge. The diagnostic procedure should include spinal CT, the imaging tool of choice. PR has to be differentiated from free intraspinal gas collections and the coexistence of air and gas within the spinal canal has to be considered differential diagnostically. PR usually represents an asymptomatic epiphenomenon but can also be symptomatic by itself as well as by its underlying pathology. The latter, although often severe, might be concealed and has to be examined carefully to enable adequate patient treatment. The management of PR has to be individualized and frequently requires a multidisciplinary regime

Het Rijksvaccinatieprogramma in Nederland : Ontwikkelingen in 2011

Dit rapport geeft een overzicht van de mate waarin ziekteverwekkers uit het Rijksvaccinatieprogramma (RVP) in 2010 en 2011 voorkwamen. Daarnaast geeft het een overzicht van veranderingen in deze verwekkers, de gebruikte vaccins en bijwerkingen na vaccinatie. Hetzelfde geldt voor ontwikkelingen over nieuwe vaccins, die in de toekomst eventueel in het RVP worden opgenomen. De vaccinatiegraad is al vele jaren hoog, waardoor weinig mensen ziekten krijgen waartegen via het RVP wordt gevaccineerd (namelijk difterie, tetanus, polio, Haemophilus inflluenzae type b ziekte, rubella en meningokokken serogroep C). Ook in het onderzochte jaar blijkt het RVP effectief en veilig. Continue monitoring is nodig om het programma te optimaliseren. Kinkhoest, pneumokokken en meningokokken C In 2010 nam het aantal jonge kinderen met kinkhoest af, doordat het RVP in 2005 is overgegaan op een ander (acellulair) vaccin. Ook blijft het effect van de in 2001 toegevoegde booster op 4-jarige leeftijd zichtbaar tot en met 13 jaar. Wel neemt sinds 2004 het aantal adolescenten en volwassenen met kinkhoest toe. Het aantal mensen dat een pneumokokkenziekte kreeg, veroorzaakt door een type waartegen wordt gevaccineerd, is sterk afgenomen. Bij kinderen jonger dan 2 jaar is deze afname 87 procent. Bij de oudere leeftijdsgroepen was de daling minder door een toename van niet-vaccin typen. Per 1 maart 2011 is overgegaan op een pneumokokkenvaccin dat beschermt tegen tien typen in plaats van tegen zeven typen. In 2009 en 2010 zijn de eerste twee gevallen van meningokokken C gerapporteerd in gevaccineerde personen sinds deze vaccinatie in 2002 is geïntroduceerd. Beiden hadden een immuunziekte. Hepatitis B Het aantal gevallen met hepatitis B in 2010 is met 8 procent verminderd ten opzichte van 2009, voornamelijk doordat deze ziekte minder vaak is gemeld in mannen die seks hebben met mannen (MSM). Dit maakt aannemelijk dat het vaccinatieprogramma dat in 2002 voor deze groep is ingesteld, effectief is. Per 1 augustus 2011 krijgt iedereen die nadien is geboren de hepatitis B-vaccinatie. Mazelen, bof en HPV Mazelen kwam in 2010 en 2011 vaker voor in West-Europa, waardoor meer, doorgaans niet gevaccineerde, Nederlanders aldaar deze ziekte opliepen. De bofuitbraak in 2009 onder studenten, die daar doorgaans tegen zijn gevaccineerd, ging door in 2010 en 2011. De vaccinatiegraad (drie doses) voor de eerste groep 12-jarigen die tegen baarmoederhalskanker (HPV) zijn gevaccineerd was 52,5 procent in 2011; de vaccinatiegraad voor de inhaalcampagne onder 13- tot 16-jarigen steeg van 47 procent naar 52,3 procent. Toekomstige kandidaten Van de ziekten die in de toekomst mogelijk onder het RVP gaan vallen, komt meningokokken groep B sinds 2001 jaarlijks minder vaak voor. Maagdarminfecties veroorzaakt door Rotavirus neemt daarentegen verder toe in 2010 (naar 2180 ten opzichte van 1935 in 2009). In 2010 is het aantal hepatitis A-gevallen toegenomen tot het niveau van 2006 (1,6 gevallen per 100.000inwoners). Voor waterpokken en gordelroos zijn geen grote veranderingen waargenomen in 2010. Veiligheid Er waren geen ongebruikelijke meldingen in het afgelopen jaar ten aanzien van de veiligheid van de vaccins binnen het Rijksvaccinatieprogramma.This report presents the developments of the National Immunisation Programme (NIP) in 2011, supported by updated surveillance data on current and potential target diseases. For many years, the participation level in the NIP has been high, which resulted in low incidences for most target diseases in 2011, i.e. diphtheria, tetanus, poliomyelitis, Haemophilus influenzae type b disease, rubella and meningococcal serogroup C disease. As in previous years, the NIP was effective and safe in the reporting period. Continuous monitoring is needed to further optimise the programme. Pertussis, pneumococcal disease and meningococcal C disease In 2010, the number of pertussis cases in young children was reduced due to the switch from whole-cell to acellular vaccine in 2005. The protective effect of the preschool booster introduced in 2001 at 4 years of age remained visible up to 13 years of age. In contrast, the incidence of pertussis has been increasing in adolescents and adults since 2004. The decrease in the number of cases of invasive pneumococcal disease (IPD) was caused by a decrease in the incidence of vaccine types in the vaccinated cohorts (87 percent in children < 2 years of age) and to a lesser extent in other age groups. However, this effect is partly counterbalanced by the increased incidence of non-vaccine types due to type replacement. On 1st March 2011, the 10-valent pneumococcal vaccine replaced the 7-valent vaccine. In 2009 and 2010, the first two cases of meningococcal group C disease in previously vaccinated persons were reported since the introduction of vaccination in 2002. Both persons had an immune disorder. Hepatitis B For hepatitis B the number of cases in 2010 was 8 percent lower than in 2009, mostly due to the decreasing number of acute HBV notifications in men who have sex with men (MSM). This suggests that the targeted vaccination programme introduced in 2002 has been effective. From birth cohort August 2011 onwards, a universal infant HBV vaccination has been included in the NIP. Measles, mumps and human papillomavirus (HPV) In Western Europe, the incidence of measles that increased in 2010 and 2011 reflected an increase in the number of imported cases in the Netherlands in 2011. The mumps outbreak that started among the highly vaccinated student population in late 2009, continued throughout 2010 and 2011. In 2011, interim vaccination coverage for three doses HPV vaccine in the first cohort of 12-yearold girls was 52.5 percent; the coverage among girls for the catch-up campaign increased from 47 percent to 52.3 percent. Future candidates With regard to potential new target diseases, it is noteworthy that the incidence of meningococcal serogroup B disease has further decreased every year since 2001. The incidence of rotavirus associated gastroenteritis, however, continued to rise in 2010. In 2010, the number of hepatitis A cases increased to the level of 2006 (1.6 cases per 100,000 inhabitants). For varicella and herpes zoster no striking changes occurred in 2010. Safety There were no unusual reports in the past year regarding the safety of the vaccines used in the NIP.VW

Het Rijksvaccinatieprogramma in Nederland : Ontwikkelingen in 2013

In 2012 was er een grote kinkhoestepidemie in Nederland. Het betrof voornamelijk kinderen tussen 0 en 2 maanden oud, kinderen van 8 jaar en ouder, en volwassenen. Het aantal kinkhoestmeldingen was in de eerste helft van 2013 laag. De uitbraak van de bof die eind 2009 begon, is in 2013 verminderd, al verspreidt het virus zich nog wel in Nederland. Daarnaast is er sinds mei 2013 een uitbraak van mazelen in Nederland, vooral onder orthodox-gereformeerden met een lage vaccinatiegraad. Verwacht wordt dat de uiteindelijke omvang van deze uitbraak groter zal zijn dan de vorige in 1999/2000. Dit blijkt uit het jaaroverzicht van het RIVM over de mate waarin ziekten voorkomen waartegen gevaccineerd wordt via het Rijksvaccinatieprogramma (RVP), en de ontwikkelingen daarin. Het geeft ook inzicht in de vaccins die zijn gebruikt en welke bijwerkingen daarbij optraden. Ontwikkelingen over nieuwe vaccins, die eventueel in de toekomst in het RVP worden opgenomen, zijn ook beschreven. Doordat de vaccinatiegraad al vele jaren hoog is, krijgen weinig mensen de ziekten waartegen via het RVP wordt gevaccineerd. Het vaccinatieprogramma is bovendien veilig, waarbij er relatief weinig bijwerkingen voorkomen die doorgaans niet ernstig van aard zijn. Wel blijft voor een optimaal vaccinatieprogramma continue monitoring van effectiviteit en bijwerkingen nodig. Andere ontwikkelingen Uit het overzicht blijkt ook dat er tijdens de eerste weken van de mazelenepidemie ook een kleine uitbraak van rodehond heeft plaatsgevonden op een orthodox-gereformeerde school. Dit veroorzaakte het grootste aantal zieken door rodehond sinds 2004/2005. In Syrië en Israël is het poliovirus verspreid. In Nederland zijn er tussen medio 2012 tot 1 november 2013 geen gevallen van polio gemeld. Verder zijn er in 2013 in Europese landen enkele gevallen van meningokokken C gerapporteerd onder mannen die seks hebben met mannen (MSM). In Nederland is dat onder mannen die tot deze risicogroep kunnen behoren niet gemeld. Effectiviteit pneumokokkenvaccin Uit onderzoek naar de effectiviteit van het pneumokokkenvaccin blijkt dat het vaccin evenveel bescherming biedt als het aantal prikmomenten wordt verlaagd. De Gezondheidsraad heeft geadviseerd om minder prikken in het prikschema op te nemen.2012, a large pertussis outbreak occurred in the Netherlands. The highest incidences were among infants aged 0-2 months, children of eight years and older, adolescents and adults. The number of pertussis notifications in the first six months of 2013 was found to be low. The mumps outbreak that started among students in late 2009 diminished in 2013, but there are still indications of endemic transmission. In addition, an outbreak of measles started in May 2013 among the Reformed Orthodox population, who have low vaccine coverage. The outbreak is expected to continue with a final size that may exceed that of the 1999/2000 outbreak. This information is included in this annual report of the National Institute for Public Health and the Environment (RIVM) which gives an overview of how often diseases included in the National Immunisation Programme (NIP) occur and presents developments in the NIP. The report also indicates which vaccines are used and which adverse events were reported after vaccination. Developments with regard to potential target diseases for vaccines are also included. The participation level in the NIP has been high for many years, resulting in low incidences of most target diseases. The programme is also safe with relatively few side effects reported, and these are usually mild and transient. For an optimal programme, continuous monitoring of effectiveness and safety remains necessary. Other developments During the first weeks of the measles epidemic in June 2013, a small and restricted rubella outbreak was identified at an Orthodox school. This was the largest rubella outbreak since 2004/2005. In Syria and Israel, respectively, cases of poliovirus and the transmission of poliovirus were identified in 2013. In 2012 and 2013 (at 1 November), no cases of poliomyelitis were reported in the Netherlands. In June 2013, a meningococcal C outbreak among men who have sex with men (MSM) was reported in Europe. No meningococcal serotype C cases among men that may belong to this risk group were reported in the Netherlands. Effect of pneumococcal vaccine Research showed that the protection of the pneumococcal vaccine is similar in a schedule with a reduced number of doses compared to the current schedule. Therefore, the Dutch Health Council advised on 27 November 2013 in favour of a schedule with a reduced number of doses.Ministerie van VW

Het Rijksvaccinatieprogramma in Nederland : Surveillance en ontwikkelingen in 2019-2020

Under the National Immunisation Programme (NIP), 1,520,301 children and pregnant women were vaccinated in the Netherlands in 2019. Together, they received a total of 2,929,264 vaccinations. National immunisation coverage rose slightly for the first time in five years. In 2019, there were no notifications for diphtheria, tetanus, rubella, and polio. As in previous years, the number of notifications was low for Haemophilus influenzae type b (Hib; 39). The number of measles notifications was relatively high (84). The number of mumps cases (131) was double the number reported in the previous year. The number of notifications of hepatitis B (1205) remained stable. The number of notifications of meningococcal W disease (62) decreased after introduction of MenACWY-vaccination into the NIP (for 14-month-olds and 14-year-olds). This ended the rise in notifications from 2015 to 2018 (from 9 to 103). The number of pertussis notifications (6383) increased compared with 2018. Since the end of 2019, pregnant women are vaccinated against pertussis to prevent severe pertussis in infants. From March 2020 to June, during the Dutch COVID-19 response measures, including social distancing and school closure, the reported incidence of pertussis, invasive pneumococcal disease, meningococcal disease and mumps dropped. The Ministry of Health, Welfare and Sport has decided in April 2020 to cancel the implementation of rotavirus vaccination for children with an high risk for severe disease in the NIP. A new study showed lower vaccine-effectiveness estimates for high-risk infants than expected. The ministry asked for a new advise of the Health Council, which is expected in 2021. In 2020, the intention was to offer pneumococcal vaccination to elderly 60, 65, 70 and 75 years of age. Due to the COVID-19 pandemic, however, priority in this year has been given to the oldest age groups (73- to 79-year-olds).In 2019 zijn 1.520.301 kinderen en zwangere vrouwen gevaccineerd via het Rijksvaccinatieprogramma (RVP). In totaal kregen zij 2.929.264 vaccinaties. De landelijke vaccinatiegraad is voor het eerst sinds 5 jaar licht gestegen. Er waren in 2019 geen meldingen van difterie, tetanus, rodehond en polio. Net als in de vorige jaren waren er weinig meldingen van Haemophilus influenzae type b (Hib; 39). Het aantal meldingen van mazelen was met 84 relatief hoog. Het aantal meldingen van bof (131) was twee keer hoger dan in 2018. Het aantal meldingen van hepatitis B (1205) bleef stabiel. Het totale aantal meldingen van meningokokken W ziekte (62) daalde nadat de vaccinatie hiertegen in het Rijksvaccinatieprogramma is opgenomen (voor de leeftijd van 14 maanden en 14 jaar). Daarmee kwam een einde aan de stijging van 2015 tot 2018 (9 tot 103). Het aantal meldingen van kinkhoest (6383) was hoger dan in 2018. Sinds eind 2019 krijgen zwangeren een vaccinatie tegen kinkhoest (de zogeheten 22 wekenprik) om ernstige kinkhoest bij jonge baby's te voorkomen. Van maart 2020 tot en met juni zijn er tijdens de corona-maatregelen, waaronder social distancing en de sluiting van scholen, minder gevallen van kinkhoest, invasieve pneumokokkenziekte, meningokokkenziekte en bof gemeld. Het ministerie van VWS besloot in april 2020 de invoering van de vaccinatie tegen het rotavirus voor kinderen die een groter risico lopen om er ernstig ziek van te worden in het Rijksvaccinatieprogramma uit te stellen. Een nieuwe studie laat zien dat het vaccin deze risicogroep minder goed tegen dit virus beschermt dan was verwacht. Het ministerie heeft de Gezondheidsraad om een nieuw advies gevraagd. Dit wordt in 2021 verwacht. In 2020 zou de pneumokokkenvaccinatie worden aangeboden aan ouderen van 60, 65, 70 en 75 jaar. Vanwege de uitbraak van het nieuwe coronavirus heeft de staatssecretaris van VWS op advies van de Gezondheidsraad besloten om de vaccinatie in dat jaar aan te bieden aan de oudste leeftijdsgroepen (73 tot en met 79-jarigen).Ministerie van VW

Het Rijksvaccinatieprogramma in Nederland : Surveillance en ontwikkelingen in 2015-2016

In 2015 kregen bijna 770.000 kinderen van 0 tot 19 jaar samen 1.547.000 vaccinaties binnen het Rijksvaccinatieprogramma (RVP). De deelname aan het RVP is met 92 tot 99 procent (afhankelijk van de vaccinatie) nog steeds hoog. Een uitzondering daarop is de vaccinatie tegen het humaan papillomavirus (HPV) met 61 procent. De deelname voor pasgeborenen is voor het tweede achtereenvolgende jaar met ongeveer 0,5 procent gedaald. Meldingen van RVP-ziekten Het aantal gemelde gevallen van de meeste ziekten waartegen via het RVP wordt ingeënt, was wederom laag. Dit gold ook voor het aantal meldingen van mazelen (7) na de grote epidemie in 2013/2014. Kinkhoest kwam in 2015 minder vaak voor (39 per 100.000) dan in het epidemische jaar 2014 (55 per 100.000). Eén zuigeling overleed aan kinkhoest. Het aantal gevallen van ernstige pneumokokkenziekte - veroorzaakt door de drie typen waarmee het pneumokokkenvaccin werd uitgebreid in 2011 - bleef bij kinderen jonger dan 5 jaar zeer laag (0,5 per 100.000). Door de indirecte bescherming kwam het bij andere leeftijdsgroepen ook minder vaak voor. In 2015 en de eerste helft van 2016 kwam de bof vaker voor dan in 2014 (bij respectievelijk 89, 45 en 40 mensen). Meldingen van mogelijke bijwerkingen van vaccins In 2015 is het aantal meldingen van mogelijke bijwerkingen van vaccins gestegen (1494 ten opzichte van 982 in 2014). Het betrof vooral meldingen van (heftige) lokale ontstekingsreacties en koorts bij 4-jarigen. Ook nam het aantal meldingen van vermoeidheid bij 12-jarige meisjes toe na media-aandacht over eventuele bijwerkingen van de HPV vaccinatie. De aard van de gemelde bijwerkingen was in vergelijking met voorgaande jaren niet ernstiger. Meldingen van ziekten voor potentiële RVP-vaccins In 2015 en 2016 steeg het aantal gevallen van meningokokkenziekte veroorzaakt door serogroep W (MenW); meestal waren dit personen van 65 jaar of ouder. Na het extreem lage aantal gevallen in 2014 had 2015 een gemiddeld rotavirus seizoen, met de piek in maart. Tot en met juni 2016 was het aantal gevallen van rotavirus weer laag, waarbij het 'seizoen' ook later begon dan normaal.In 2015, nearly 770,000 children aged 0 to 19 years received a total of 1,547,000 vaccinations within the National Immunisation Programme (NIP). Participation in the NIP, which was between 92% and 99% (depending on the vaccination), was still high. An exception was vaccination against human papillomavirus (HPV), which was 61%. The participation of newborns dropped by about 0.5% for the second consecutive year. Notifications of NIP target diseases The number of reported cases of most NIP target diseases was again low. This was also true for the number of reported measles cases (7) after the great epidemic in 2013/2014. Pertussis was less frequently reported in 2015 (39 per 100,000) than in the epidemic year 2014 (55 per 100,000). One infant death due to pertussis was reported. The incidence of cases of invasive pneumococcal disease - caused by the three additional types which were included in the pneumococcal vaccine in 2011 - was very low in children under 5 years (0.5 per 100,000), and a decrease was seen in other age groups due to herd protection. In 2015 and the first half of 2016, mumps was more common than in 2014 (n=89, n=45 and n=40, respectively). Notifications of adverse events following immunisation In 2015, an increased number of reports of possible side effects of vaccines was reported (1,494 versus 982 in 2014). These were mainly reports of (pronounced) local inflammation and fever in 4-year-olds. The number of reports of fatigue in 12-year-old girls increased after media attention on possible side effects of the HPV vaccination. The severity of the reported adverse events was comparable with previous years. Notifications of potential NIP target diseases In 2015 and 2016, the number of invasive meningococcal serogroup W (MenW) cases increased; these were mostly in people aged 65 years or older. After the extremely low number of cases in 2014, 2015 had an average rotavirus season with the peak in March. Until June 2016, the number of cases of rotavirus was also low, with a later start of the season than usual.Ministerie van VW

The National Immunisation Programme in the Netherlands : Surveillance and developments in 2019-2020

Under the National Immunisation Programme (NIP), 1,520,301 children and pregnant women were vaccinated in the Netherlands in 2019. Together, they received a total of 2,929,264 vaccinations. National immunisation coverage rose slightly for the first time in five years. In 2019, there were no notifications for diphtheria, tetanus, rubella, and polio. As in previous years, the number of notifications was low for Haemophilus influenzae type b (Hib; 39). The number of measles notifications was relatively high (84). The number of mumps cases (131) was double the number reported in the previous year. The number of notifications of hepatitis B (1205) remained stable. The number of notifications of meningococcal W disease (62) decreased after introduction of MenACWY-vaccination into the NIP (for 14-month-olds and 14-year-olds). This ended the rise in notifications from 2015 to 2018 (from 9 to 103). The number of pertussis notifications (6383) increased compared with 2018. Since the end of 2019, pregnant women are vaccinated against pertussis to prevent severe pertussis in infants. From March 2020 to June, during the Dutch COVID-19 response measures, including social distancing and school closure, the reported incidence of pertussis, invasive pneumococcal disease, meningococcal disease and mumps dropped. The Ministry of Health, Welfare and Sport has decided in April 2020 to cancel the implementation of rotavirus vaccination for children with an high risk for severe disease in the NIP. A new study showed lower vaccine-effectiveness estimates for high-risk infants than expected. The ministry asked for a new advise of the Health Council, which is expected in 2021. In 2020, the intention was to offer pneumococcal vaccination to elderly 60, 65, 70 and 75 years of age. Due to the COVID-19 pandemic, however, priority in this year has been given to the oldest age groups (73- to 79-year-olds)