Every year, RIVM National Institute for Public Health and the Environment provides an overview of surveillance and developments in the National Immunisation Programme (NIP). One striking event in 2013 was the measles epidemic that ran until February 2014 and was particularly widespread in areas where vaccination uptake was low. Vaccination schedules were also altered: the pneumococcal vaccination changed from four to three injections and the HPV vaccination from three to two injections. Participation in the NIP in the Netherlands remains at a high level. Continuous monitoring is still necessary to maintain this effective and safe vaccination programme.
Between May 2013 and February 2014 there was a major epidemic of measles, particularly in areas where the numbers vaccinated are low. A total of 2,640 people were reported with measles, 182 of whom were admitted to hospital. One patient died. June 2013 saw a minor outbreak of rubella in an Orthodox reformed school with a low vaccination uptake. Fifty-four people were reported with rubella. This was the highest figure since 2004-2005.
There were no reports in the Netherlands in 2013 of diphtheria, polio or tetanus. After the large- scale epidemic in 2012, cases of whooping cough decreased sharply in 2013 although a slight increase was observed again in the first quarter of 2014. The number of cases of mumps also decreased in comparison with 2010-2012, a period during which mumps occurred frequently among students. The number of reported cases of acute hepatitis B was the lowest in 2013 since 1976. The figure for meningitis C has dropped enormously since the introduction of the vaccination in 2002. Since the expansion of the pneumococcal vaccine by three types in 2011, the number of cases caused by these three types has dropped.
Changes in the vaccination schedule
The number of injections against pneumococci in the vaccination schedule has been reduced by one injection to three since November 2013. This change was made on the advice of the Health Council of the Netherlands because this reduced number provides just as much protection. Since January 2014, the vaccination of girls against the HPV virus, which can cause cervical cancer, has been reduced to two injections. This vaccination is offered to all twelve-year-old girls. Three injections are still necessary if girls start this vaccination programme after their fifteenth birthday.
In global terms, polio patients were found in eight countries in 2013, including Syria. Poliovirus had disappeared in Syria since 1999. Since the war, the vaccination level against polio has decreased considerably. In order to prevent the spread of polio in the Netherlands, Syrian refugees younger than five are vaccinated against polio when they arrive at a Dutch asylum-seekers centre. Routine checks in areas with low levels of vaccination have, in addition, been intensified and extended to areas in the Netherlands where refugees are housed.