We studied the effect of pandemic influenza A(H1N1) on the relatively high vaccination rate for seasonal influenza of the Dutch National Influenza Prevention Programme (NIPP) (see Box 1) in the past years (Kroneman et al., 2003 and Blank et al., 2009), and identified the relationships between vaccination rates for seasonal and A(H1N1) influenza in at-risk groups and staff in general practices. In a retrospective cohort study of at-risk groups (2009–2010) data were extracted on age, gender,

diagnoses (based on medical history and medication), and vaccines from electronic medical records in 72 general practices (262,958 listed patients). The practices belong to a representative Dutch network of general practices, LINH, (www.linh.nl, Tacken et al., Pictilisib cost 2004). Practice staff was questioned Alisertib research buy by a written survey about their own vaccination; their vaccination rate was calculated separately for doctors and nurses. By sharing our data, we want to show that it is possible to reach relatively high uptake rates for pandemic as well as seasonal vaccinations using a combined strategy. Having satisfied themselves to the vaccines safety and effectiveness, the Dutch government decided to augment the regular seasonal 2009–2010 NIPP with vaccination for influenza A(H1N1). Both types of vaccinations

were made available free-of-charge to general practices for the at-risk groups and for practice staff. Two doses –at least two weeks apart– were scheduled, with the pandemic A(H1N1) vaccination started two

weeks after the seasonal influenza vaccine. (Gezondheidsraad, 2009). In our study, 83,524 patients were identified as at-risk of developing serious complications from influenza (31.8%). Offering the separate vaccinations in general practice against seasonal and A(H1N1) influenza for groups at-risk resulted in a vaccination rate of 70.4% and and 71.9% respectively. We found 63.5% of the groups at-risk were vaccinated using both vaccines. The vaccination rates for A(H1N1) and seasonal influenza were very similar in the different indication groups. Information on vaccination status of practice staff was received from 64 practices (88.9%) with 189 general practitioners and 299 practice nurses. The vaccination rate among general practitioners was 88.9% for A(H1N1) vaccinations and 74.1% for seasonal influenza, but surprisingly, among the practice nurses the rates were significantly lower (p < .001): 73.6% and 54.2% respectively. The vaccination rate of practice staff as well as of the patients at-risk was quite high that could explain why we did not find any significant correlation between them. Because of the stable results of the seasonal vaccination rate, we concluded that overall, the A(H1N1) vaccination did not affect the high vaccination rate for seasonal influenza. The uptake in the groups at-risk was comparable for A(H1N1) and seasonal influenza.