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- In the first few months of life, newborns are vulnerable to infections.- Vaccination of the pregnant mother leads to transplacental antibody transfer, resulting in the best possible protection of the newborn.- Maternal vaccination has long been given for the prevention of tetanus in developing countries, and for the prevention of pertussis and influenza in developed countries, such as the United States, England and Belgium. These vaccinations give newborns good protection and, to date, no adverse effects are known for the foetus or the pregnancy.- Currently, phase 3 trials during pregnancy are ongoing following maternal vaccination against group B streptococci and respiratory syncytial virus. Here, again, no risks to mother or child have been reported.- Recently, the Dutch Health Council advised that all pregnant women in the Netherlands be vaccinated against pertussis in a vaccination programme.- This paper gives an overview of effectiveness, safety and practicalities of maternal vaccination.

Aim: To study the safety profile of the bivalent human papillomavirus (HPV) vaccine following administration of a first dose to 192,119 13-16-year-old girls in the context of a catch-up campaign., Design: Descriptive., Methods: The safety of the HPV campaign underwent surveillance in three ways: via a spontaneous reporting system, whereby anyone could report a possible undesirable effect; following completion and validation a diagnosis was made and the causal relationship with the vaccination assessed. Secondly, general healthcare service (GGD) physicians reported effects that occurred during the vaccination sessions. Thirdly, we conducted a questionnaire survey of frequent possible side effects, in which we asked about effects that occurred up to 1 week after the vaccine., Results: 446 reports were received via the spontaneous reporting system (degree of reporting: 23.2:10,000). 16% of reports were mainly local effects; 84% were systemic effects, including 8 severe effects. 157 girls consulted their general practitioner or went to a hospital (degree of reporting: 8:10,000). 59% of the reports were of a side effect; in 41% a concurrent event was coincidental. There were 638 reports during the vaccination sessions (degree of reporting 45:10,000). The largest number were vasovegetative effects, including fainting or near-fainting (n = 569; degree of reporting: 40:10,000). The degree of reporting of tightness of the chest or skin effects was 2:10,000. The assistance of a general practitioner or ambulance was summoned for 10 girls (degree of reporting: 0.7:10,000). The questionnaire study (response 68.7%; n = 3646) showed that 92.1% of the girls had local effects. In 1.6% these symptoms were severe. Systemic effects occurred in 91.7%; 0.7% had fever (>or= 39.5 degrees C). 1.5% of girls called for medical assistance., Conclusion: During intensive surveillance of safety of the HPV campaign, no unexpected or serious side effects with a causal relationship with the vaccination occurred following administration of 192,119 doses. In accordance with data from foreign studies, side effects may be common, but are in general mild and short-lived.

Objective: To determine the adverse reactions to the combined vaccine against diptheria, acellular pertussis, tetanus, poliomyelitis and Haemophilus Infuenzae type B (DTP-IPV-Hib) before and after the introduction of an acellular pertussis component., Design: Descriptive., Method: Safety surveillance of the Dutch National Vaccination Programme is performed by the National Institute for Public Health and Environment (RIVM). It is based on an enhanced passive reporting system and complemented by targeted survey-based studies. The data obtained were analysed., Results: The passive surveillance system showed a large increase in reports in 2004, probably linked to increased media attention on the efficacy and safety of the whole-cell DTP-IPV-Hib vaccine. The Health Council recommended transitioning to the use of a DTP-IPV-Hib vaccine with an acellular pertussis component, which was implemented in January 2005. The number of reports dropped sharply in 2005 to a level below that of 2002-2003. Results of a survey study on adverse events following DTP-IPV-Hib vaccination that began in late 2003 and continued in 2005 confirmed the wide coverage ofthe enhanced passive surveillance system and revealed low rates of underreporting of rare adverse events, such as collapse and convulsions., Conclusion: This study confirms the data from the passive surveillance system, which show that the newly introduced acellular DTP-IPV-Hib vaccine is associated with fewer adverse events than the whole-cell vaccine that was used previously.