[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.

[Antenatal screening in the Netherlands for HIV, hepatitis B and syphilis is effective]. / Prenatale screening op hiv, hepatitis B en syfilis in Nederland effectief.

OBJECTIVE: Evaluation of the effectiveness of antenatal screening in the Netherlands for HIV, hepatitis B virus (HBV) and syphilis, in preventing mother-to-child transmission. DESIGN: Descriptive. METHODS: The results of antenatal screening in the period 2006-2008 were compared with data from pregnant women and newborns from other data sources. RESULTS: Each year, around 185,000 pregnant women were screened for HIV, HBV and syphilis. Refusal rates for the screening tests were low, and were highest (0.2%) for HIV. Prior to the introduction of screening, 5-10 children were born with HIV annually. After the introduction of screening in 2004, only 4 children were born with HIV (an average of 1 per year). Two of these mothers had become pregnant prior to 2004; the third mother was HIV negative at screening and probably became infected after screening; the fourth mother's background was unknown. Congenital syphilis was diagnosed in fewer than 5 newborns annually and 5 children were infected with HBV. In 3 of these the mothers were HBeAg positive (a marker for high infectivity). We estimated that 5-10 HIV, 50-75 HBV and 10 syphilis cases in newborns had been prevented annually as a result of screening. CONCLUSION: The screening programme was effective in detecting HIV, HBV and syphilis in pregnant women and in preventing transmission to the child. Since the introduction of the HIV screening the number of children born with HIV has fallen dramatically.