Influenza vaccination in the Netherlands: A successful system approach

Background: In the Netherlands, the influenza vaccination rate increased from 6% in the eighties up to 16% in the late nineties. The Dutch Influenza Council, founded in the early nineties, started a series of activities in a multitargeted intervention strategy. The increase in vaccination rate is related to the activities in this intervention. Methods: In the yearly reports of the Dutch Influenza Council, all data on government policy, vaccination rate, patient and doctor behavior were assembled, together with data from other sources (Dutch Bureau for Statistics, Prevention project of the Dutch College of General Practitioners). Results: In a timetable, all activities are presented. Patient knowledge on high-risk groups improved. The rise in vaccination rate shows two tops: in 1992 at the start of the Dutch Influenza Council, and in 1996 at the start of the national GP-prevention project. In 1999, the vaccination rate in high-risk groups was 76%. Conclusions: This multitargeted system approach was successful in increasing vaccination rates, especially in high-risk groups. This combined effort of government, private enterprise and national GP organizations sets an example for other national preventive actions.