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The decrease in childhood vaccination coverage in the Netherlands from birth cohort 2008 to 2020 and its sociodemographic determinants
Joyce Pijpers, Annika M. van Roon, Maarten Schipper, F. Marijn Stok, Susan van den Hof et al. ·
Summary
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Abstract
Abstract Introduction To understand differences in vaccination coverage between population subgroups in the Netherlands over time, we studied sociodemographic factors associated with measles-mumps-rubella (MMR) and diphtheria-tetanus-pertussis-poliomyelitis (DTaP-IPV) vaccination. Methods We conducted a national retrospective database study including children born in 2008-2020. Individual-level data-linkage allowed examination of associations of sociodemographic variables with MMR and DTaP-IPV vaccination status at 2 years of age. Coverage for each variable, stratified by birth cohort, was calculated. Multivariable Poisson regression assessed independent associations and changes in coverage over time. Results MMR coverage decreased in all population subgroups (overall 95% to 89% in 2008 and 2020 cohorts), with more substantial declines in some groups. The multivariable analysis showed that Dutch children of non-Dutch origin, particularly those of Moroccan and Turkish origin showed more pronounced declines (−25% and -12% compared to children of Dutch origin in cohort 2020, respectively). Among children not attending day care and children living in larger families (≥4 children), a faster decline in coverage was observed compared to those attending day care and living in smaller families (both -12% in cohort 2020). Among children of self-employed mothers and children in the lowest income households, lower coverage was observed compared to children of mothers in employment and children in the highest income households (−8% and -7% in cohort 2020, respectively). Nearly identical trends were observed for DTaP-IPV vaccination. Conclusion Our study reveals a significant decline in childhood vaccination coverage in the Netherlands, with increasing disparities between sociodemographic groups. This is crucial for prioritising vaccination efforts to protect public health equitably.