Josephine van Dongen

Chapter 7 172 Secondly, within the study protocol the upper limit for vaccination with first dose was 14 weeks (which is earlier than according to the product information) and not all hospitals in the Netherlands par ticipated. The window of oppor tunity for rotavirus vaccination was thereby narrow and limited to care in par ticipating hospitals. The Dutch healthcare infrastructure has limited NICU and neonatal post-IC/HC beds, creating a relatively fast referral policy for medical risk infants to general pediatric wards.This might have reduced the amount of vaccinated infants. This limitation would be obsolete if rotavirus vaccination was not offered in a study specific setting. Conclusions To conclude, implementation of a targeted rotavirus vaccination strategy in secondary and ter tiary care facilities in the Netherlands, yielded a suboptimal vaccination coverage among infants with MRC. Alternatively, implementation strategies including involvement of the existing NIP structure should be considered.