Dutch national immunization schedule: compliance and associated characteristics for the primary series.

In the Netherlands, the recommended priming immunization schedule for diphtheria, tetanus, pertussis and polio (DTaP-IPV) is at 2, 3 and 4 months of age. We evaluated the compliance with the recommended schedule, as well as its characteristics. We included all infants born between 2007 and 2012 who received minimally one DTaP-IPV vaccination (n = 1,061,578). Infants complied with the schedule if they received the first vaccination between 6 and 9 weeks of age, and the second and third vaccination 2-6 weeks after the first and second vaccination. We examined associations between compliance and several characteristics using log-binomial regression. Compliance for the first, second and third vaccination was 81.6, 88.3 and 84.2%, respectively. Compliance with the total recommended schedule was 64.5%, and increased from 60.1% for 2007 to 68.5% for 2012. Compliance was higher for full-term infants (65.9%), infants with normal birth weight (66.0%) and when both parents were born in the Netherlands (66.8%). CONCLUSION: Delayed vaccination during the primary vaccination schedule occurs in one sixth of the Dutch children. Efforts to improve compliance should be focused in particular on preterm infants, infants with low birth weight and infants whose parents are not born in the Netherlands. What is Known: • A delayed start of vaccination leads to a longer period at risk for infectious diseases, e.g. pertussis • Delayed vaccination is associated with several factors including prematurity, low birth weight, family size, birth order, low socioeconomic status and health status of the child What is New: • Compliance with the recommended priming immunization schedule for diphtheria, tetanus, pertussis and polio was 64.5%, and increased from 60.1% for 2007 to 68.5% for 2012 • If the first vaccination was delayed, there was a higher chance that the following vaccinations were administered 'out-of-schedule' as well, resulting in even a higher age at second and third vaccination.

Comparatively low attendance during Human Papillomavirus catch-up vaccination among teenage girls in the Netherlands: Insights from a behavioral survey among parents.

BACKGROUND: The Dutch Human Papillomavirus (HPV) catch-up vaccination program in 2009 appeared less successful than expected. We aimed to identify the most important determinants of refusing the vaccination. METHODS: Two thousand parents of girls born in 1996 targeted for HPV vaccination received an invitation letter to participate in a questionnaire study. Two study groups were defined: the first group consisted of parents of girls who had accepted the vaccine and already received the first dose of HPV vaccination. The second group consisted of parents whose daughters were not vaccinated. The questionnaire consisted of a broad spectrum of possible determinants that were revealed after literature search and discussions with the stakeholders. RESULTS: Four hundred sixty nine questionnaires (24%) were returned, 307 (31%) from those who accepted and 162 (16%) from those who declined the vaccine. The decision not to accept the vaccine was largely determined by: (i) perception that the information provided by the government about the vaccine was limited or biased (OR 13.27); (ii) limited trust, that the government would stop the vaccination program if there were serious side effects (OR 9.95); (iii) lack of knowledge about the effectiveness of the vaccine (OR 7.67); (iv) concerns about the side effects of the vaccine (OR 4.94); (v) lack of conviction that HPV can be extremely harmful (OR 3.78); (vi) perception that the government is strongly influenced by vaccine producers (OR 3.54); and (vii) religious convictions (OR 2.18). CONCLUSIONS: This study revealed several determinants for HPV vaccination uptake after implementation of the HPV vaccine for adolescent girls. These determinants should be taken into consideration in order to successfully implement HPV vaccination into National Immunization Programs.

[High vaccination coverage of the National Immunization Programme in the Netherlands]. / Hoge vaccinatiegraad van het Rijksvaccinatieprogramma in Nederland.

OBJECTIVE: To describe vaccination coverage of the National Immunization Programme (NIP) in the Netherlands for the years 2006-2008. DESIGN: Descriptive, retrospective. METHOD: Vaccination coverage was determined per vaccination and birth cohort based on data from the vaccination-registration system 'Praeventis'. This new system enables more accurate testing for compatibility with NIP guidelines. Furthermore, it was determined on an individual level whether the desired vaccination status was reached before a certain target age (1, 2, 5 or 10 years). RESULTS: In the final year reported, all national vaccination percentages came up to the WHO standards. Vaccination coverage for babies ranged from 94.5% for diphtheria, whooping cough, tetanus and polio (DTaP-IPV) to 96.0% for measles, mumps and rubella (MMR). The coverage for toddlers and school-aged children was over 90% for each of the vaccinations. In 5 of the 12 Dutch provinces and 128 of the 443 municipalities, one or more vaccination percentages were below the standard of 90%. Vaccination coverage for the second MMR vaccination and for hepatitis B vaccination in children of whom one or both parents were born in a country where the incidence of hepatitis B is higher than average, was relatively low (92.5% and 90.7%, respectively). CONCLUSION: Vaccination coverage in the Netherlands is high. In general, vaccination coverage for toddlers and school-aged children requires extra attention. This applies in particular to the second MMR vaccination and to vaccination in children of whom one or both parents were born in a country where the incidence of hepatitis B is higher than average.

Delayed start of diphtheria, tetanus, acellular pertussis and inactivated polio vaccination in preterm and low birth weight infants in the Netherlands.

BACKGROUND: It is recommended that preterm (PT) and low birth weight infants be vaccinated according to standard guidelines. We studied the timeliness of the first diphtheria, tetanus, acellular pertussis and inactivated polio vaccination in the Netherlands, by gestational age (GA) and birth weight (BW). METHODS: We included all vaccinated children born during 2006-2010. Data from the national immunization register were used to determine the vaccination age and the proportion of timely vaccinated infants (<70 days). Results were compared between groups based on GA (extreme PT: <32, PT: 32-36, full term (FT): ≥37 weeks) and BW. Characteristics associated with the timeliness of vaccination were studied by Cox regression analyses. RESULTS: The median vaccination age was lower with a higher GA/BW. The proportion of timely vaccinated infants was 66% for extreme PT, 76% for PT and 82% for FT infants. Similar results were seen by BW. Overall, the proportion of timely vaccinated infants increased from 2006 (77%) until 2010 (85%) and there were regional differences and differences by ethnicity. In extreme PT and PT infants, living in a very highly urbanized municipality and being light for GA were associated with less timely vaccination. Being vaccinated in a hospital was associated with a timelier vaccination in extreme PT infants. However, the reverse was seen for PT infants. CONCLUSIONS: In the Netherlands, PT and low birth weight infants were less often timely vaccinated than FT infants and were, therefore, at increased risk of vaccine-preventable infections. In FT infants, the timeliness of vaccination is better but could also be optimized.