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The National Immunisation Programme in the Netherlands Surveillance and Developments in 2016-2017

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The National Immunisation Programme in the Netherlands Surveillance and Developments in 2016-2017 The National Immunisation Programme in the Netherlands Surveillance and developments in 2016-2017 The National Immunisation Programme in the Netherlands Surveillance and developments in 2016-2017 RIVM Report 2017-0143 Colophon © RIVM 2017 Parts of this publication may be reproduced, provided acknowledgement is given to: National Institute for Public Health and the Environment, along with the title and year of publication. DOI 10.21945/RIVM-2017-0143 Editors: T.M. Schurink-van ‘t Klooster, H.E. de Melker Authors: R. van Alebeek, K. Benschop, B. van Benthem, G.A.M. Berbers, R. van Binnendijk, J.A. Bogaards, H.J. Bootsma, I. Brinkman, P. Bruijning-Verhagen, A. Buisman, J. Cremer, R. Donken, E. Duizer, C.A.C.M. van Els, A. van der Ende, M. Ensink, I.H.M. Friesema, M. van Gent, B. de Gier, S. Gouma, F. van Heiningen, W. van der Hoek, S. Hofstraat, M. Hooiveld, K. Hulshof, A. Janga-Jansen, P. Jochemsen, P. Kaaijk, J. van de Kassteele, P.B. van Kasteren, J.M. Kemmeren, H. van den Kerkhof, A.J. King, F.R.M. van der Klis, M.J. Knol, H. Korthals Altes, B. Lehmann, E.A. van Lier, M. Luinstra-Passchier, W. Luytjes, N.A.T. van der Maas, M.J.J. Mangen, S. McDonald, A. Meijer, H.E. de Melker, L. Mollema, S. Monge, M. Nielen, D.W. Notermans, H. Pasmans, E. Pinelli, R. Prettner, V. Qendri, F.A.G. Reubsaet, K. Romijnders, N.Y. Rots, W.L.M. Ruijs, T.M. Schurink-van ‘t Klooster, J. van Slobbe, A.W.M. Suijkerbuijk, A.C. Teirlinck, I.K. Veldhuijzen, H. Vennema, J.D.M. Verberk, R.A. Vos, P. van der Weele, P.J. Woestenberg en T. Woudenberg Contact: H.E. de Melker Centre for Epidemiology and Surveillance of Infectious Diseases [email protected] This investigation has been performed by order and for the account of Ministry of Health, Welfare and Sports, within the framework of V/151103, Development future National Immunisation Programme Contents Synopsis 4 Publiekssamenvatting 5 Preface 8 Comprehensive summary 9 Uitgebreide samenvatting 19 1 Introduction 29 2 Vaccination coverage 33 3 Acceptance of vaccination 37 4 Burden of disease 45 5 Adverse events 51 6 Various research topics addressing evaluation of the NIP in a broader sense 69 7 Current National Immunisation Programme 79 7.1 Diphtheria 80 7.2 Haemophilus influenzae disease 82 7.3 Hepatitis B 87 7.4 Human papillomavirus (HPV) infection 93 7.5 Measles 112 7.6 Meningococcal disease 117 7.7 Mumps 129 7.8 Pertussis 133 7.9 Pneumococcal disease 142 7.10 Poliomyelitis 153 7.11 Rubella 156 7.12 Tetanus 158 8 The immunisation programme on Bonaire, St. Eustatius and Saba 161 9 Future NIP candidates 167 9.1 Hepatitis A 168 9.2 Respiratory syncytial virus infection 174 9.3 Rotavirus infection 180 9.4 Varicella zoster virus (VZV) infection 186 10 Vaccines under development for other potential future NIP target diseases 197 List of abbreviations 203 Appendix 209 Appendix 1 Surveillance methodology 210 Appendix 2 Morbidity and mortality figures 219 Appendix 3 Overview of vaccin changes in the NIP since 2000 248 Appendix 4 Composition of vaccines used in the NIP 250 Appendix 5 Overview of recent RIVM publications (01-08-2017 to 31-07-2017) 253 Appendix 6 Overview of relevant websites 260 Surveillance and developments in 2016-2017 | 3 Synopsis The National Immunisation Programme in the Netherlands Surveillance and developments in 2016-2017 In 2016, about 760,000 children aged 0 to 19 years received a total of 2,140,000 vaccinations within the National Immunisation Programme (NIP). Participation in the NIP was high (more than 90% depending on the vaccine), but dropped by around 0.5% for newborns for the third consecutive year. The participation in vaccinations against human papillomavirus (HPV) declined from 61 to 53 per cent. The number of reports (1,483) of adverse events following immunisation (in total 3,665) in 2016 was comparable to the number of reports in 2015. NIP target diseases The number of reported cases of most NIP target diseases was again low. However, the number of cases of Haemophilus influenzae type b (Hib) disease in 2016 (n=44) was considerably higher than in the previous five years (22-34 cases), with the highest incidence occurring among children under five years of age. Pertussis incidence in 2016 fits within the usual fluctuations. However, six people died from pertussis in 2016. The incidence of cervical cancer cases increased in 2016 (9.3 per 100,000 compared with 7.7 per 100,000 in 2015). In 2017, two fully vaccinated employees were exposed to a wild poliovirus type 2 (WPV2). Due to strict isolation, no transmission was detected. Potential NIP target diseases An increase in the number of meningococcal (Men) disease was observed after more than two decades of decrease. An ongoing increase in the number of cases of MenW disease has been observed (9, 50 and 34, respectively, in 2015, 2016 and the first five months of 2017). Dutch Health Council recommendations The RIVM facilitate the Dutch Health Council with their recommendations on vaccinations and therefore has collected and structured relevant national and international information in background documents concerning rotavirus, meningococcal disease and HPV. The Health Council has advised earlier that maternal pertussis vaccination should be provided. The Ministry of Health, Welfare and Sport (VWS) has expressed a positive attitude towards the advice but still has to make a decision. In 2017, the Health Council also advised that all employees who are in close contact with young infants during work should be offered vaccination against pertussis. In addition, the Dutch Health Council advised in September 2017 positive on vaccination against rotavirus and the minister decided to vaccinate against MenACWY in 2018. Keywords: National Immunisation Programme (NIP), diphtheria, Haemophilus influenzae, hepatitis B, human papillomavirus (HPV), measles, meningococcal disease, mumps, pertussis, pneumococcal disease, poliomyelitis, rubella, tetanus, hepatitis A, respiratory syncytial virus (RSV), rotavirus, varicella zoster virus (VZV). 4 | The National Immunisation Programme in the Netherlands Publiekssamenvatting Het Rijksvaccinatieprogramma in Nederland Surveillance en ontwikkelingen in 2016–2017 In 2016 kregen ongeveer 760.000 kinderen van 0 tot 19 jaar samen 2.140.000 vaccinaties vanuit het Rijksvaccinatieprogramma (RVP). De deelname aan het RVP is hoog (afhankelijk van het vaccin meer dan 90 procent), maar is voor het derde achtereenvolgende jaar met ongeveer 0,5 procent gedaald onder pasgeborenen. Het aantal meisjes dat zich tegen het humaan papillomavirus (HPV) heeft laten vaccineren, is gedaald van 61 naar 53 procent. Het aantal meldingen (1483) van mogelijke bijwerkingen (in totaal 3665) van vaccins in 2016 is vergelijkbaar met het aantal meldingen in 2015. RVP-ziekten Wederom waren er weinig meldingen van mensen die een ziekte kregen waartegen via het RVP wordt ingeënt. Wel was het aantal zieken door Haemophilus influenzae type b (Hib) in 2016 hoger (44) dan in de afgelopen 5 jaar (22-34), vooral onder kinderen jonger dan 5 jaar. Het aantal mensen met kinkhoest in 2016 paste in het normale patroon. Toch overleden dat jaar 6 mensen aan deze ziekte. Het aantal mensen met baarmoederhalskanker is gestegen in 2016 (9,3 per 100.000 vergeleken met 7,7 per 100.000 in 2015). In 2017 zijn twee volledig gevaccineerde werknemers blootgesteld aan wild poliovirus type 2 (WPV2). Door hen strikt te isoleren heeft de ziekte heeft zich niet verder verspreid. Ziekten voor potentiele RVP-vaccins Het aantal mensen met Meningokokkenziekte (Men) neemt toe nadat het meer dan twee decennia is gedaald. Een aanhoudende sterke stijging wordt gezien in Meningokokken serogroep W-ziekte (9, 50 en 34 patiënten in respectievelijk 2015, 2016 en de eerste 5 maanden van 2017). Adviezen Gezondheidsraad Het RIVM faciliteert de Gezondheidsraad voor hun adviezen over vaccinatie en verzamelt daarvoor nationale en internationale informatie over rotavirus, meningokokkenziekte en HPV. De Gezondheidsraad heeft eerder geadviseerd om alle zwangere vrouwen tijdens de zwangerschap een kinkhoestvaccinatie aan te bieden. De minister van VWS staat hier positief tegenover maar moet nog een besluit nemen. Aanvullend heeft de Gezondheidsraad in 2017 geadviseerd om alle werknemers die tijdens hun werk in contact staan met pasgeborenen vaccinatie aan te bieden tegen kinkhoest. Verder adviseerde de Gezondheidsraad in september 2017 positief over vaccinatie tegen rotavirus en besloot de minister diezelfde maand om in 2018 te gaan vaccineren tegen Meningokokkenziekte veroorzaakt door typen A, C, W en Y. Kernwoorden: Rijksvaccinatieprogramma (RVP), difterie, Haemophilus influenzae, hepatitis B, human papillomavirus (HPV), mazelen, meningokokkenziekte, Bof, Kinkhoest, pneumo- kokkenziekte, polio, rodehond, tetanus, hepatitis A, respiratoir syncytieel virus (RSV), rotavirus, varicella zoster virus (VZV). Surveillance and developments in 2016-2017 | 5 Dutch National Immunisation Programme (NIP) Pathogen surveillance Highlights Surveillance 2016 – 2017 Laboratory data RIVM continuously monitors the e ectiveness In 2017, two fully vaccinated employees were exposed to a wild poliovirus type 2 and safety of the NIP (WPV2) spill. In stool and sewage samples of one employee WPV2 was found. Strict Po isolation was implemented. No transmission was detected. Surveillance of vaccine uptake National vaccination coverage data Immunosurveillance Seroprevalence data from a representative sample For the third consecutive year HPV vaccination coverage vaccination coverage for new-borns declined from 61 percent in The HPV16/18 two-dose schedule induces high antibody levels and avidity against HPV is decreasing by about 0.5 percent. 2016 to 53 percent in 2017. vaccine-types up to at least 24 months of follow-up. Surveillance of adverse events D Po Hib HPV Enhanced spontaneous reporting of adverse events following immunisation There was considerable media a ention for vaccination coverage at the end HPV of 2016. Vaccination was a topic of frequent discussion on social media on Pe T HepB Pneu alleged side e ect chronic fatigue syndrome a er HPV vaccination.
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