Annually RIVM provides an overview of key events and developments in the National Immunisation Programme (NIP). Remarkably, a measles epidemic occurred in 2013, starting in May, mainly in areas with low vaccination coverage. In 2012 it was a whooping cough epidemic, which especially struck children of 0-2 years, children aged 8 years and adults. The pneumococcal vaccine also proved to be effective against pneumococcal disease in reduced doses. The participation level in the NIP has been high for many years, resulting in low incidences of most target diseases. For an optimal programme, continuous monitoring of effectiveness and safety remains necessary.
The diseases included in the current NIP are: diphtheria, pertussis, tetanus, poliomyelitis, Haemophilus influenzae serotype b (Hib) disease, mumps, measles, rubella, meningococcal serogroup C disease, hepatitis B, pneumococcal disease and human papillomavirus (HPV) infection. NIP is safe with relatively few side effects reported, and these are usually mild and transient.
Measles Outbreak
Since May 2013, the spread of measles occured in areas with less than 90% vaccination coverage. These areas are home to people who have religious objections to vaccination. Until the end of December, more than 2,500 patients with measles were reported. The actual number of cases is greatly underestimated. During the epidemic, one patient deceased from complications of measles. Several measures were put in place to protect against measles. At the end of 2013, the number of measles patients is greatly reduced. 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.
Effective 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.
Other developments
In The Netherlands a large pertussis outbreak occurred in 2012. 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.
International perspective
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.