Since July 2017, the Dutch blood service tests all blood donations for hepatitis E virus infection, at an estimated cost of 3 million Euros anually. The Dutch health authority (VWS) has requested the Health Council’s advice on whether to continue or terminate this test. Three questions were posed to guide the Health Council’s advice: (1) Is testing blood donations the most (cost)effective way to protect vulnerable patients? (2) Is it safe and efficient to test only a subset of all blood donations? (3) Can vulnerable patients be protected by safety measures outside of the blood supply?