[Childhood vaccinations anno 2004. I. Effectiveness and acceptance of the Dutch National Vaccination Programme]

Vaccinations are the most effective measures in public health. In the Netherlands after the second world war the morbidity and mortality of infectious diseases were a great problem. Nowadays these diseases are gone or reduced at a minimal level and for the greater part under control. The Dutch National Vaccination Programme aims at 10 infectious diseases. In the Netherlands there has always been a relatively small group of religious people who live together and reject vaccinations. Since the start of the vaccination programme in this group several small epidemics of poliomyelitis and measles have been observed. The other dispersed living non-vaccinated people are protected by herd-immunity, as long as the vaccination coverage is above 90%. During recent years an increasing number of people have doubts over the use and safety of vaccinations. There is a worldwide anti-vaccination movement, in the Netherlands represented by the 'Nederlandse Vereniging Kritisch Prikken'. The finding that there is now a greater spread of areas with a low or insufficient vaccination coverage, is cause for concern because experiences in several countries have shown that infectious diseases with all complications will recur when the vaccination percentage decreases. There is no scientific support for the hypothesis that vaccinations overwhelm or weaken the immune system of infants and there is no objection to start with vaccination at the age of two months. Anthroposofic and homeopathic arguments are neither scientifically, nor practically supported. Good promotion and education about the vaccination programme is of great importance and can be improved. Parents should make decisions based on good, objective information. Possible risks and side effects of vaccination should not be concealed.