- Today's ageing population means that more people will be eligible for influenza vaccination every year, so the programme will become more expensive.
- European research is being carried out into the number of children who suffer influenza-related complications and are hospitalized, how many die, and what their vaccination costs would be, in order to assess whether it would be useful to vaccinate healthy children against influenza. Only six countries in Europe recommend annual seasonal influenza vaccination for children between 6 months and 2 or 3 years old. Only Finland has added influenza vaccination to the routine childhood vaccination programme (since the 2007-8 influenza season). In the US, influenza vaccination is recommended for all children below the age of 18 and older than 6 months. The research is being coordinated by the Netherlands Institute for Health Services Research (Nederlands Instituut voor onderzoek van de gezondheidszorg, NIVEL).
- Much research is being done into further improving influenza vaccines (e.g. by adding adjuvants or by developing inhalation vaccines) so that they generate a better immune response; to optimizing the production process (cell culture instead of virus culture in chicken eggs); and to simplifying administration (needle-free or intradermal injection).
- If the Health Council recommends that vaccination be given
against pneumococci and/or varicella zoster to those aged 60 and
over, and the VWS follows this advice, then this vaccination could
be added to the organization and infrastructure of the NPG
programme. This too would have profound consequences on
The first influenza vaccines date from 1953, and the Netherlands has a long history of providing influenza vaccine to those running an increased risk of complications from influenza. Until 1993 the Health Council provided annual advisory reports on which risk groups were eligible for influenza vaccination; the Health Care Inspectorate (Inspectie voor de Gezondheidszorg, IGZ) notified the professional groups involved annually.
From 1993 onwards this vaccination began to take on the character of a national programme. Funded by the Ministry of Health, The Dutch Influenza Foundation (Nederlandse Influenza Stichting, NIS) actively provided public information material through Postbus 51 television advertisements. In 1993 the NHG published the first influenza 'professional standard' promulgating an active invitation policy. At the same time, risk patients were being systematically identified. In 1996, based also on the advice of the Health Council, the influenza vaccination programme was widened to include all those aged 65 or over.
From 1997 this policy took the form of the NPG programme; from then on, influenza vaccination for risk groups was no longer funded out of routine health care payed for by insurance companies but via subsidized health care. In 1997 the SNPG was set up; it became the subsidy recipient, and entered agreements with GPs on implementation and with the NVI (then the Stichting tot bevordering van de Volksgezondheid en Milieuhygiëne, SVM) on the purchase and distribution of vaccines. On 1 January 2006, the management of the NPG was transferred from the Health Care Insurance Board (College voor Zorgverzekeringen, CVZ) to the RIVMNational Institute for Public Health and the Environment /CvB. In 2008 the Ministry of Health, following the Health Council's advice, widened the NPG target group to include healthy people from 60-64 years. As of 2008, patients with recurrent folliculitis are no longer considered a risk group.
In 2009 the SNPG website was completely redesigned and rebuilt to reflect its function as a digital NPG portal, with links to all the information needed by everyone involved in the programme.
As of 2010 influenza vaccines are ordered through a specially-designed web application. GPs can use the same application to declare their vaccination expenses. Also from 2010, care organizations such as mental health institutes and rehabilitation centres housing medically indicated persons who have no GP of their own can order free influenza vaccines for these people through the NPG. This policy is aimed at raising the security of vaccine supply for these risk groups. The administration of these vaccines is not reimbursed through the NPG but through the Exceptional Medical Expenses Act (Algemene Wet Bijzondere Ziektekosten, AWBZ).