title: The 2009 influenza A (H1N1) pandemic. Management and vaccination strategies in The Netherlands.
abstract: Prior to 2009, The Netherlands had prepared itself extensively for a potential pandemic. Multidisciplinary guidelines had been drafted to control transmission and limit adverse outcomes for both a phase of early incidental introduction and for a phase with widespread transmission. The Ministry of Health had ensured a supply and distribution schedule for antivirals and negotiated a contract for vaccine purchases. During the pandemic, existing surveillance was expanded, the established infectious disease response structure was activated, and the previously prepared protocols for communication, diagnostics, use of antivirals, and vaccination implementation were operationalized and implemented. When the pandemic turned out to be less severe than many had anticipated, risk communication and rapid modification of guidelines and communication became a major challenge. Antivirals and pandemic vaccines were reserved for those at high risk for severe outcomes only. Overall, the impact of the pandemic was comparable to the impact of an average seasonal influenza epidemic, but with a shift in (severe) outcomes from the very young and elderly toward young adults. Established prepared protocols enabled timely coordinated responses. In preparing for the worst, sufficient attention must be given to preparing for a mild scenario as well.
authors.affiliation: RIVM - Centre Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, 3720 BA, Bilthoven, The Netherlands. marianne.van.der.sande@rivm.nl
authors.forename: M A B
authors.initials: MA
authors.lastname: van der Sande
authors.forename: A
authors.initials: A
authors.lastname: Jacobi
authors.forename: A
authors.initials: A
authors.lastname: Meijer
authors.forename: J
authors.initials: J
authors.lastname: Wallinga
authors.forename: W
authors.initials: W
authors.lastname: van der Hoek
authors.forename: M
authors.initials: M
authors.lastname: van der Lubben
mesh_terms: D018563:Disease Notification / Q000379:methods / Q000706:statistics & numerical data; D058015:Health Communication / Q000379:methods*; D006285:Health Planning / Q000379:methods / Q000458:organization & administration; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control*; D032541:Mass Vaccination / Q000458:organization & administration* / Q000706:statistics & numerical data; D009426:Netherlands / Q000453:epidemiology; D058873:Pandemics / Q000517:prevention & control* / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods
chemical_list: D007252:Influenza Vaccines