Once vaccines have been declared safe and effective, they must be administered as quickly and carefully as possible. The first to be vaccinated will over 60s, people in high-risk groups, and care workers working with them or in direct contact with Covid patients. In doing so, the government is following the advice of the Health Council of the Netherlands. It has bought large quantities of the vaccines, along with syringes and special freezers, and will conduct an extensive information campaign about the importance of vaccination, which is free and voluntary.
The programme is expected to start in the first few months of 2021, according to health minister Hugo de Jonge’s strategy, sent to the lower house of parliament today. The logistical operation is in full swing, but there are still many unknowns: which vaccines will be authorised for the European market, when deliveries will begin, and which are suitable for specific target groups. We do not know for sure when vaccination will start, who will vaccinated when, and how long it will take to administer vaccines to everyone who wants them.
“The vaccine is our most important asset in overcoming this crisis and putting the pandemic behind us,” De Jonge said. “That way, we can go back to a situation where you can celebrate your birthday with friends, hug your grandmother, stop working at home every day, and go to a concert or football match. Yet it’s not the vaccine that will make the difference, but vaccination. One little jab in your arm will prevent disease, save lives, and make sure we can pick up our old lives bit by bit. So it’s very important to get vaccinated. Not for yourself, but for one another. We all have a responsibility to protect one another.”
Purchase of vaccines The Netherlands can look forward to access to vaccines from at least six different manufacturers. It has contracts with five, and is still in negotiations with Moderna. The contracts will be concluded from the EU for all 27 member states, and the Netherlands has an active role in this process.
All vaccines are currently in the final or penultimate testing phase. The European Medicines Agency (EMA) and the Dutch Medicines Evaluation Board will then assess their effectiveness, quality and safety. If all vaccines reach the finishing line and are authorised by the EMA, which is not yet certain, the Netherlands will have more than 50 million doses at its disposal. Because most vaccines require two doses per person, this is enough for more than 29 million people. In addition, most contracts include scope for additional supplies, and discussions are ongoing with other manufacturers. The Netherlands has earmarked EUR 700 for the purchase of the vaccines.
Health Council advice, and order of vaccinations The cabinet has adopted the Health Council of the Netherlands’ vaccination strategy, aimed at reducing serious illness and mortality. The strategy is in line with the government’s objectives in combating the virus: to protect vulnerable people and prevent further overburdening of the healthcare sector. From a socioeconomic point of view, it is also wise to vaccinate the elderly and vulnerable first: the sooner they are protected against the virus, the sooner we can put the most restrictive measures behind us. The first to be vaccinated will therefore be the over 60s, people in medical risk groups, and those caring for them.
As soon as the EMA approves the first vaccines, they will start being delivered to the Netherlands. They will arrive in parts, and manufacturers expect about 3.5 million people to be vaccinated in the first quarter of 2021. There will not be enough doses to include all over-60s and people at medical risk immediately. The government will make the first vaccines available to the approximately 155,000 residents of nursing homes, people with mental disabilities living in institutions, and employees of these institutions, which will also work out how to include informal carers.
These will be followed by other groups such as over-60s with medical conditions, over-60s without such conditions, under-60s with conditions, people caring for these groups, and those in direct contact with Covid patients. As more vaccines are supplied in the following months, other groups may be added.
Logistics The RIVM, the public health institute that also coordinates the national vaccination programme for other diseases, is managing the preparation and implementation of Covid vaccinations. In recent months, it has bought 25 million syringes, and super freezers for vaccines that have to be kept at a temperature of minus 70 degrees. It is also arranging secure storage locations, and transport and distribution. There will be a national registration system specifically for the Covid vaccination, which is important in order to register, monitor, and warn of any side effects.
“Fortunately, the Netherlands has experience with large vaccination campaigns,” De Jonge says. “Everything will be ready when vaccines are delivered, probably in the first few months of 2021. If the manufacturers manage to deliver as early as December, we can get straight to work.”
The RIVM and health ministry are talking to GPs, local health centres, and hospitals about the roles and responsibilities involved in administering the vaccines. As far as possible, this will be in line with the existing and proven system used for flu vaccinations. The cost of the whole operation, excluding the purchase of vaccines, is estimated at between €900 million and €1 billion.
Communication The EMA is assessing the Covid vaccines as rigorously as any other, but there are inevitably questions and concerns about their safety and effectiveness. Communication is therefore an important element of the vaccination strategy, targeted both at the public as a whole, and at specific groups such as healthcare workers, young people, and people with literacy issues. The campaign will also focus on refuting disinformation, so that people know where to find reliable data and make informed choices.