title: Dutch influenza vaccination rate drops for fifth consecutive year.
abstract: OBJECTIVE
  To determine the prevalence and trend of the influenza vaccination-rate of the overall target population in the period 2008-2013, with a specific focus on groups at risk such as patients with cardiovascular diseases, lung diseases, diabetes and aged 60 years and older.
  
  
  METHODS
  In an observational longitudinal study electronic medical records data from the Dutch representative network of general practices, LINH, were analyzed. For each influenza vaccination season, 2008-2013, the number of vaccinated and unvaccinated patients at risk are compared by chi-square tests (χ(2)) for linear trends, linear-by-linear association. The level of significance was set at p<0.001 based on the large number of available records.
  
  
  RESULTS
  The influenza vaccination rate of the overall at risk group decreased significantly from 71.5% in the 2008 season, to 59.6% in the 2013 vaccination season. The difference of 11.9% was gradual over the years, with a mean decrease of 2.4% per year. The decrease was seen in all specified groups at risk, but was mainly among patients aged 60-65 years (mean yearly decrease of 3.3%).
  
  
  CONCLUSIONS
  For the fifth subsequent year, we notice a lowering trend of the influenza vaccination rate in the population at risk. Reports in the mass media on questioning the effectiveness of the vaccination program may have been an influence; as well as the relatively light outbreaks of influenza in the past years, which may have affected the sense of urgency. The gradual decrease in vaccination rates over recent years requires further research and a public health debate is needed on the usefulness and necessity of the vaccination program.
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands. Electronic address: Margot.Tacken@radboudumc.nl.
authors.forename: Margot A J B
authors.initials: MA
authors.lastname: Tacken
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands. Electronic address: Birgit.Jansen@radboudumc.nl.
authors.forename: Birgit
authors.initials: B
authors.lastname: Jansen
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands. Electronic address: Jan.Mulder@radboudumc.nl.
authors.forename: Jan
authors.initials: J
authors.lastname: Mulder
authors.affiliation: National Primary Care Research Group (NPCRG), University of Manchester, United Kingdom. Electronic address: stephen.campbell@manchester.ac.uk.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Campbell
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands; National Primary Care Research Group (NPCRG), University of Manchester, United Kingdom. Electronic address: Joze.Braspenning@radboudumc.nl.
authors.forename: Jozé C C
authors.initials: JC
authors.lastname: Braspenning
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data* / Q000639:trends; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Immunization; Influenza vaccination; Uptake