Dutch measles outbreak not a surprise to doctors who warned of declining vaccine rates

Specialists had already expected that the Netherlands would have to deal with measles again, as is now the case in Eindhoven. The Radboudumc in Nijmegen had issued a warning about this at the beginning of the week. “Dutch hospitals are currently expecting a possible outbreak of measles. Specialists are not wondering if the outbreak will come but when,” the teaching hospital reported on its website.

The branch of the GGD public health service in the Brabant-Zuidoost area immediately made a connection to the drop in vaccination rates, which has been a national trend for years. Last summer, the National Institute for Public Health and the Environment (RIVM) warned that just below 90 percent of young children are still not receiving the vaccinations from the National Immunization Program (RVP).

This is of concern for the RIVM as measles can have severe consequences and can also lead to death on rare occasions. “A high rate of vaccinations is essential to protect people against severe diseases and to prevent outbreaks of these diseases.“

Measles and whooping cough are very contagious diseases that are “a kind of canary in a coal mine,” said professor of infections and immunity Marien de Jonge in the message from the Radboudumc. “They raise their head when the vaccination rates drop.” Whooping cough has also been prevalent in the Netherlands in the last few months, which the RIVM linked to the deaths of four babies already this year, an abnormally high figure at this point in March.

The question is how big the outbreak will be in Eindhoven and the surrounding areas. The GGD has received 15 reports, which are mainly concerning toddlers who have become infected. They were all unvaccinated. It remains to be seen how far the disease that causes measles will spread.

Large outbreaks come along once every 10 to 15 years. The last time that this happened in the Netherlands was in 2013. Erasmus MC measles researcher Rory de Vries told the AD last week that he expected an outbreak.

According to statistics from GGD and RIVM, the vaccination rate in Brabant-Zuidoost is just above the national average. The percentages are lower in the city of Eindhoven. Around 88.1 percent of the babies born in 2020 had been given the mumps, measles, rubella combination vaccine jab. This is a higher percentage than in Amsterdam, Rotterdam, and The Hague. The municipality of The Hague shared on Thursday that they are worried about the declining vaccination rates. The rates are below 75% in some areas. It must be at least 95% to rule out a measles outbreak.

Doctors, and not the government, should be responsible for warning people against measles and convincing them to have their children vaccinated, said caretaker State Secretary for Health, Welfare, and Sport, Maarten van Ooijen. He thinks that people will be more receptive to information from “white lab coats," the minister added. “Everything else is at best superfluous and at worst counterproductive.”

The state secretary expressed concern that the number of measles infections has increased in the last few years and that vaccination rates are dropping. “We need to use everything in our power to improve vaccination rates.”

Doctors may be more successful in convincing the people who are skeptical about vaccinations than a government campaign, for example, said Van Ooijen, who claims that the coronavirus pandemic proved this. “Misinformation” about vaccines was spread at that time, which is still ongoing and “really needs to be suppressed,” according to the state secretary.

Some pediatricians and other specialists have spoken out in favor of the idea of only letting those children who have been vaccinated against measles into daycare centers. The state secretary believes such a measure could backfire as skeptical parents would become even more distrusting. “What we need to do is put everything in trust,” said Van Ooijen. He added that the choice of vaccination should remain with the parents.

“The measles outbreak in Eindhoven is an example of the dire consequences of the fact that people no longer get vaccinated,” said the Dutch Patient Federation. The organization is worried about the declining trend in vaccination rates. Vaccinations are essential to prevent the necessity of medical care, the federation stated.

“That is why we want to re-emphasize the importance of vaccinations."