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Recently, the Netherlands Health Council (HC) issued an updated advice on rotavirus vaccination. Rotavirus gastro-enteritis primarily affects young children, of whom, in the Netherlands, annually ~2700 end up in the hospital and 5-7 die. In 2017, the HC judged positively on rotavirus vaccination of young children, but also concluded that the cost-effectiveness of general vaccination was unfavorable. Yet, the HC recommended to at least vaccinate vulnerable children in specific risk-groups. Because of the corona crisis, this, however, has not materialized. Meanwhile, the Dutch Risk-group Infant Vaccination Against Rotavirus study has demonstrated that rotavirus vaccination of children in risk-groups is less effective than previously thought. Therefore, the HC now recommends rotavirus vaccination of all children. General vaccination within the Dutch NIP is expected to result in herd-immunity, such that all children, including those in risk-groups, are protected. Nonetheless, the Dutch Ministry of Health has decided to postpone implementation of rotavirus vaccination.

The recent outbreak of serogroup W meningococcal disease in the Netherlands, and the start of the vaccination campaign for adolescents in response, dominated the national headlines in 2018. During this time, the Health Council of the Netherlands prepared an advisory statement, which was released in December 2018, on how meningococcal disease caused by various serogroups could be controlled in the future. The Counsel recommends to include vaccination against serogroups A, C, W and Y for infants and adolescents in the Dutch National Immunization Programme. By contrast, vaccination against serogroup B was not recommended. This article is a commentary on the recommendations in the advisory statement and discusses the epidemiology of meningococcal serogroup B infections in the Netherlands, the effectiveness of the vaccine against this serogroup as well as common side effects, and as such demonstrates the difficult balance between pros and cons and the need for broadly based discussion in the public sphere about the scope of the Dutch National Immunization Programme.

Based on current research, there are no valid reasons to assume that influenza vaccination of people aged 60 and over without any other medical indications, in the context of the national programme of influenza prevention, leads to significant, relevant and cost-effective health benefits. In view of the pressure on health care budgets and the decreasing social willingness to vaccinate, it is of great and urgent importance that the actual effect of influenza vaccination is quantified in a double-blind placebo-controlled randomized trial (RCT) with relevant outcome measures, which does not suffer from the methodological shortcomings of the few previous studies. In order to demonstrate a 10% reduction in hospitalisation for respiratory infections, this RCT should include approximately 100,000 subjects and follow these participants for three years. We consider such a trial feasible in the Dutch situation.

Rotaviruses cause acute gastroenteritis; mostly in young children. Infant rotavirus vaccines have been licensed in Europe and provide excellent protection against severe gastroenteritis, but are not widely implemented due to the perceived benign character of rotavirus disease and unfavourable cost-effectiveness. Rotavirus vaccines are currently unavailable in the Netherlands which leaves a particularly vulnerable group of infants--those with prematurity, low birth weight or severe congenital malformations--at increased risk of rotavirus disease, complications and even death. Rotavirus vaccination should be made available to these infants, but due to the strict age limits for the rotavirus vaccination (which must be started at < 14 weeks), vaccination cannot be adequately organised within the Dutch National Immunisation Programme (NIP) which relies on well-baby clinic visits. Organising rotavirus vaccination for high-risk infants through paediatric secondary care could overcome this problem and be implemented independent of decisions on uptake of rotavirus vaccination within the Dutch NIP.