National Immunisation Programme
Young children are the most vulnerable to infectious diseases. Since every child has the right to the best possible start in life, the Dutch government offers every child vaccinations against 12 infectious diseases. Parents do not have to pay for these vaccinations. Young parents automatically receive an invitation for their baby. Children who live in an asylum shelter receive an invitation for a meeting with Youth Health Care Services. A vaccination plan is tailor-made for them, based on the vaccinations they have already had.
To ensure that children receive maximum protection against these diseases, vaccinations are given in four steps. As from august 2011 all babies receive also vaccination against hepatitis B. Infants whose mothers are hepatitis B carriers also receive hepatitis B vaccination within 48 hours of birth.
It is essential that children complete the vaccination cycle as scheduled. If your child has not been vaccinated as scheduled, you need to seek medical advice to ensure that your child receives adequate protection.
Infectious diseases are diseases caused by bacteria, viruses, fungi or parasites. These are also called micro-organisms. You can get an infectious disease by consuming contaminated food or drinks, by inhaling micro-organisms that float in the air or through contact with someone who is infected. There are many harmless infectious diseases from which you do not become very ill and that disappear by themselves. Other infectious diseases can be dangerous. You can become very ill and develop serious complications. Older people and young children are particularly susceptible to infectious diseases and are at the greatest risk of serious complications or death. Vaccination reduces the risk of serious disease and complications and ensures that dangerous infectious diseases are less common.
For many infectious diseases, herd immunity, group immunity or group protection is of great importance. That means that when many children are vaccinated against a certain infectious disease, this disease becomes less common. Children who are not vaccinated are also less likely to get the infectious disease. They are protected by the group of vaccinated children. In order to create and maintain this group protection, it is important that as many children as possible are vaccinated. If almost all children are vaccinated, a disease may even disappear altogether.
The National Immunisation Programme protects against 12 different infectious diseases. We briefly describe the different diseases and the vaccinations below.
Measles is caused by a virus. This virus is highly contagious and is transmitted through the air by coughing and sneezing. You can get infected by someone with measles in your school class or by walking by someone with measles in the supermarket. You can only contract measles if you have not had measles or have not been vaccinated against measles. Children receive 2 vaccinations against measles, at 14 months and at 9 years of age through the National Immunisation Programme.
Mumpsis called ‘de bof’ (B) in Dutch. It is caused by a virus that is spread through the air. People can infect each other by sneezing and coughing. Before the vaccination against mumps was introduced, approximately 85% of the people contracted the mumps. The mumps frequently caused meningitis and deafness. The MMR vaccination was introduced in 1987. Children receive 2 vaccinations, at 14 months and at the age of 9.
Rubella is called ‘rodehond’ in Dutch. It is a highly contagious disease caused by the rubella virus. Usually you do not become very ill. The virus spreads through coughing and sneezing. The virus is especially dangerous for pregnant women because it can lead to miscarriage or severe birth defects in their unborn child. Children receive 2 vaccinations against rubella, at 14 months and at the age of 9.
Diphtheria is a highly contagious infection with a bacterium. The bacterium can be transmitted through coughing or by touching. Usually you become ill 2 to 5 days after infection. The bacterium often damages tissue, such as the skin or lungs. Before there was a vaccination against diphtheria in the Netherlands, many children died.
Poliomyelitis is also known as child paralysis. Polio is caused by a virus. The virus is transmitted from person to person through contaminated food, infected faeces or contaminated water or through small droplets in the air. The infection can lead to paralysis. Before the vaccination was introduced in 1957, polio occurred often and people regularly died from the disease. The last polio epidemic took place in 1992/1993 among unvaccinated people.
Whooping cough, also known as pertussis, is called ‘kinkhoest’ (K) in Dutch. It is a disease caused by a bacterium. People can infect each other by coughing. Whooping cough is especially dangerous for young babies. They can become very distressed and exhausted. Almost every year, one or two babies die of whooping cough in the Netherlands.
Babies can only be vaccinated once they are six weeks old. The Health Council of the Netherlands therefore recommends that pregnant women should be offered a whooping cough vaccination in the third trimester, i.e. between 28 and 32 weeks.
Tetanus, also known as lockjaw or trismus, is caused by the bacterium Clostridium tetani. As soon as the bacterium (which can be found in street refuse, for example) enters an open wound, a tetanus infection can be contracted. Since 1954, children have been receiving a vaccination against tetanus, 4 times before their first birthday and at the ages of 4 and 9.
Hepatitis B is an inflammation of the liver caused by infection with the hepatitis B virus. It can be transmitted from mother to child at birth, through sexual contact or through contact with infected blood. Children who have contracted hepatitis B are at particular risk of becoming chronic carriers of the virus. Children receive a vaccination against hepatitis B four times before their first birthday.
Hib stands for Haemophilus influenzae type b, a bacterium that occurs occasionally in the nasal cavity of almost all people. The bacterium usually does not pose a danger and you do not become ill or it remains limited to a runny nose, strep throat, ear infection or sinusitis. In young children, the infection can be serious and cause pneumonia, meningitis or a life threatening throat infection. The vaccination against Hib diseases has been part of the National Immunisation Programme since 1993. Children receive four vaccinations against Hib before their first birthday.
Meningococcal disease is a disease caused by a bacterium, the meningococcus. There are several types of this bacterium. Types A, B, C, W and Y are the best known. You can carry the meningococcus in your nose and you do not necessarily become ill from it. The bacterium is transmitted from one person to another by air, by coughing and sneezing, or by direct contact (kissing). At the beginning of this century, many children became ill due to meningococcus C. Vaccination against this disease has been included in the National Immunisation Programme.
Cervical cancer is caused by HPV. HPV is the abbreviation for human papilloma virus. There are many different HPV viruses. Types 16 and 18 are the most dangerous and cause 70% of the cases of cervical cancer. HPV is highly contagious and very common. Approximately 8 out of 10 women who have sex have had an HPV infection at some time in their life. HPV contamination leads to the (pre-stages of) cervical cancer in only 1 out of 100 women. Approximately 700 women in the Netherlands develop cervical cancer each year and 200 women die from it. Since 2009, girls who are 13 receive 2 vaccinations against HPV.
Pneumococcal disease is caused by bacteria. There are many different pneumococci. Many people carry pneumococci and do not become ill. You can infect each another by sneezing, coughing or kissing, even if you are not ill yourself. Pneumococci can cause a middle ear infection, sinusitis and bronchitis, but can also lead to severe pneumonia, meningitis or blood poisoning. You can die from these severe forms. Babies receive 3 vaccinations against pneumococcal disease before their first birthday.
The vaccinations are given from the age of six weeks at the well baby clinic in the neighbourhood. Children who live in an asylum shelter receive an invitation for a meeting with Youth Health Care Services. A vaccination plan is tailor-made for them, based on the vaccinations they have already had.
The DPTP-Hib-HepB vaccination protects children against 6 serious infectious diseases: diphtheria, whooping cough (pertussis), tetanus, polio, Hib disease and Hepatitis B. Before a child turns one year it receives 4 vaccinations at 6-9 weeks, 3 months, 4 months and 11 months.
Since these infectious diseases are especially dangerous for very young children, vaccination is very important at a young age. For complete and long-lasting protection, it is necessary to give the vaccinations multiple times at sufficient intervals. The child receives the vaccination in the arm or leg.
The pneumococcal vaccination protects against 10 types of pneumococci. These types are the main causes of pneumococcal disease in young children. The vaccination against pneumococci is given three times, simultaneously with the
DKTP-Hib-HepB vaccination. A child will then receive a vaccination in both arms or legs.
Children receive their first pneumococcal vaccination when they are between 6 and 9 weeks old. They receive another vaccination when they are 4 and 11 months old. The vaccinations are given at the well baby clinic.
The BMR vaccination, or MMR vaccination in English, protects against mumps, measles and rubella. The first vaccination is effective in 95% of the children. Children receive the MMR vaccination twice, at 14 months and at the age of 9. After 2 vaccinations, more than 99% of the children are protected. The vaccination for toddlers at 14 months is given at the well baby clinic; when children are 9 years of age they receive the vaccination at the Municipal Public Health Service or a Youth and Family Centre. This is different for each region.
Meningococcal C vaccination
The Meningococcal C vaccination protects against the meningococci bacterium, type C. The bacterium is especially dangerous for very young children. Children can become seriously ill in a few days due to meningitis or blood poisoning. Children aged 14 months receive an invitation from the well baby clinic for this vaccination. The vaccination is given at the same time as the MMR vaccination. Thus, they receive 2 vaccinations, both in the upper arm.
In May 2018 the Meningococcal C vaccination will be replaced by the Meningococcal ACW and Y vaccination. Later in 2018 the vaccination of 14 year old children with Meningococcal ACW and Y vaccine will start, organised bij the Municipal Public Health Service or a Youth and Family Centre
The DKTP vaccination, or DPTP vaccination in English, is a booster vaccination. This is necessary because by the time a child is 4 years old, protection against these diseases declines. The vaccination is given in the arm. Parents receive a call-up for this vaccination from the well baby clinic.
At the age of 9, children receive a DTP vaccination against diphtheria, tetanus and polio. The DTP vaccination is the last in the series of child vaccinations against diphtheria, tetanus and polio. This vaccination protects children against these contagious infectious diseases for a long time. The vaccination is given simultaneously with the 2nd MMR vaccination. The vaccination is usually given in the upper arm. The vaccination is given by the Municipal Public Health Service or a Youth and Family Centre. Parents receive a call-up for this vaccination for their child.
The HPV vaccination protects girls against these 2 dangerous types of viruses. HPV types 16 and 18 cause 70% of all cases of cervical cancer. Vaccination protects for about 80% against cervical cancer. To ensure maximum effect from the vaccination it is important that children get the vaccination before they have their first sexual contacts. That is why girls are offered the vaccination in the year they turn 13. Girls 12/13 years of age receive two vaccinations, with an interim period of half a year. 15-year-old girls who would like to receive the vaccination receive a vaccination 3 times. The vaccination is given in the upper arm. The vaccinations are provided by the Municipal Public Health Service or a Youth and Family Centre. That differs by region. Girls receive an invitation by post to get the vaccination.
A side effect is an undesirable effect from a medicine or vaccine. The desired effect from a vaccination is protection against infectious diseases. All other effects are side effects. A sore arm, a red spot, or a swelling at the vaccination site are examples of side effects. Since there is ongoing research on side effects, most side effects from vaccines are known. Side effects are usually innocuous and involve a mild fever or a red, swollen area where the jab is given. Small children may be somewhat listless and often cry longer. Side effects usually disappear within several days. Serious side effects are very rare.
Strict safety requirements are imposed on vaccines. Before a vaccine is brought on the market it is extensively researched and tested. As with medicines, both efficacy and possible side effects are examined. Even if a vaccine has been approved and found to be safe, the investigation on side effects continues. Precisely because vaccines are given to healthy children and people, the organisations involved take a very critical look at side effects.
Reporting a side effect
If you believe that a child has a side effect from a vaccination, you can report this to the well baby clinic or the Municipal Public Health Service that vaccinated your child. You can also report a side effect yourself to the Netherlands Pharmacovigilance Centre Lareb.
Well baby clinic
When their baby is about 4 weeks old, parents receive an invitation from the RIVM about the National Immunisation Programme. This invitation includes a letter, an information brochure, a vaccination certificate and a set of call-up cards for the different vaccinations until the age of 4.
If a child is 2 months old and parents have not yet received an invitation for the first vaccinations, they can contact the Department for Vaccine Supply and Prevention Programmes (DVP) in the region.
The home visit
Approximately 2 weeks after the birth, young parents receive a visit from a nurse from the well baby clinic. This home visit is meant for a first acquaintance. The child is not being medically examined at this time. The medical examination happens a few weeks later at the well baby clinic. During the first visit, parents can ask questions or express their concerns. The staff member of the well baby clinic will also briefly tell you about the invitation to participate in the National Immunisation Programme. After a couple of weeks the child receives the first vaccination, so there is enough time to learn more about vaccination.
The first visit
The nurse who attended a home visit usually makes an appointment to examine the child at the well baby clinic for the first time. The appointment usually finds place at the nearest well baby clinic when the child is 4 weeks old.
Youth health care doctors and nurses work at a well baby clinic. Together they evaluate the health of all children from 0 to 4 years. The children also receive the vaccinations from the National Immunisation Programme at the well baby clinic. There are approximately 880 locations in the Netherlands where the vaccinations are given.
During the first visit, the baby is examined by a youth health care doctor. The doctor or nurse also discusses the sleeping and eating habits of the child with the mother, father or caregiver. The general development of the child is also monitored at the well baby clinic.
Consent for vaccination
When a baby is 6 to 8 weeks old, it also receives the first 2 vaccinations. Before the vaccinations are given, the doctor examines the baby. If the child is not completely fit, it may be decided to postpone the vaccination. The doctor or nurse will also ask the parent for permission to give the vaccination(s). This request for permission is only made for the first vaccination and is recorded in the digital file of Youth Health Care Services ( JGZ).
Follow-up appointments at the well baby clinic
During the first months, the baby is regularly expected at the well baby clinic. During these visits, the doctor examines the child and discusses the child's development with the parents. During these visits, the baby also receives another vaccination. A child receives 9 vaccinations before it is 14 months old.
Contact and questions
If you have any questions and are unable to find an answer on this website, please contact the well baby clinic or the Municipal Public Health Service in your neighbourhood.
Would you like to request a new call-up card for vaccinations?
You can request a new set of call-up cards through the Department for Vaccine Supply and Prevention Programmes (DVP) in your region. If you have a vaccination appointment at your JGZ organisation in the short term, you can simply have it go through. The JGZ organisation will use a duplicate of the call-up card to register the given vaccination.
Where can I request vaccination data or a vaccination certificate?
In connection with our privacy guidelines you must provide the Citizen Service Number, date of birth, name and current address of the person for whom you would like to receive data. If you have lost your vaccination certificate or that of your child you can apply to one of the Department for Vaccine Supply and Prevention Programmes for a duplicate.
Contact information Department for Vaccine Supply and Prevention Programmes
For vaccination data of your child, please contact the office of the region where your child lives. For your own vaccination data, please contact the office in the region where you lived when you were 12 years old.
RIVM-DVP Noord (Groningen, Friesland, Drenthe)
050-3686350 or firstname.lastname@example.org
- RIVM-DVP Oost (Overijssel, Flevoland, Gelderland)
0570-661520 or email@example.com
- RIVM-DVP West (Utrecht, Noord-Holland, Zuid-Holland)
079-3418238 or firstname.lastname@example.org
- RIVM-DVP Zuid (Noord-Brabant, Limburg, Zeeland)
040-2329111 or email@example.com