title: [Insufficient basis for the inclusion of Human papillomavirus vaccination in the National Immunisation Programme in The Netherlands].
abstract: The Dutch Minister of Health, Welfare and Sportintends to implement Human papillomavirus (HPV) vaccination for 12-year-old girls and catch-up vaccination for 13- 16-year-old girls, as part of the National Immunisation Programme from September 2009 onwards. However, due to a well-organised screening programme, cervical cancer is not an important public health problem in the Netherlands any more, which limits the possible impact of HPV vaccination. Vaccine trials thus far have involved a relatively small number ofparticipants with limited follow-up, so the efficacy of the vaccine in preventing cervical cancer is not yet known. There are no data on frequency and severity of possible adverse events and the vaccine has not yet been tested in the intention-to-vaccinate group of 12-year-old girls. Even when we assume that HPV16/18-related cervical cancer is prevented on a lifelong basis, the cost-effectiveness ratio of HPV vaccination is estimated not to be favourable. In conclusion, HPV vaccination does not seem to be urgent in the Netherlands. Therefore we advise studying the safety in 12-year-old girls first while at the same time waiting for the longer follow-up results of ongoing trials.
authors.affiliation: Erasmus MC, afd. Maatschappelijke Gezondheidszorg, Postbus 2040, 3000 CA Rotterdam. i.dekok@erasmusmc.nl
authors.forename: I M C M
authors.initials: IM
authors.lastname: de Kok
authors.forename: J D F
authors.initials: JD
authors.lastname: Habbema
authors.forename: M J E
authors.initials: MJ
authors.lastname: Mourits
authors.forename: J W W
authors.initials: JW
authors.lastname: Coebergh
authors.forename: F E
authors.initials: FE
authors.lastname: van Leeuwen
mesh_terms: D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D017589:Immunization Programs; D009426:Netherlands; D027383:Papillomaviridae / Q000276:immunology; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines