Large differences in MMR and DTaP-IPV vaccination coverage among primary schools by denomination, the Netherlands, 2024.
Pijpers, Joyce van Roon, Annika van den Hof, Susan van Gaalen, Ruben de Melker, Hester Hahné, Susan
Pijpers, Joyce
van Roon, Annika
van den Hof, Susan
van Gaalen, Ruben
de Melker, Hester
Hahné, Susan
Series / Report no.
Open Access
Type
Journal Article
Article
Article
Language
en
Date of publication
2025-12-23
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Large differences in MMR and DTaP-IPV vaccination coverage among primary schools by denomination, the Netherlands, 2024.
Translated Title
Published in
Vaccine 2025; 72:128137
Abstract
BACKGROUND: Recently, the number of measles and pertussis cases increased worldwide, including in the Netherlands. As schools are important in transmission of several vaccine-preventable diseases, we systematically assessed childhood vaccination coverage in the Netherlands among primary school children by birth cohort for all school denominations.
METHODS: We linked nationwide vaccination data with sociodemographic registries for children born 2013-2020 attending primary school on 01-10-2024. Vaccination status for MMR (at 14 months), DTaP-IPV (at (2)3-5-11 months), and DTaP-booster (at 4 years) was retrieved from the immunisation register. Vaccination coverage was stratified by school denomination, birth year and sociodemographic characteristics. Poisson regression assessed independent associations between denomination and vaccination uptake.
RESULTS: MMR and DTaP-IPV coverage was high (>94 %) in general, Catholic, Protestant, collaborative, and other schools, but lower in Anthroposophical (78 % MMR, 77 % DTaP-IPV), Islamic (74 % MMR, 75 % DTaP-IPV), and Orthodox Protestant schools (57 % MMR, 58 % DTaP-IPV). DTaP-IPV booster coverage was lower than the primary series, ranging from 50 % (Orthodox Protestant) to 88 % (Catholic/Protestant). Primary coverage remained stable for most denominations (overall 95 %) but declined at Islamic schools (MMR: 87 % to 59 %, DTaP-IPV: 88 % to 60 %) and moderately at Orthodox Protestant schools (MMR: 60 % to 54 %, DTaP-IPV: 60 % to 55 %), while coverage at Anthroposophical schools fluctuated (MMR: range 76-81 %, DTaP-IPV: range 74-79 %). Adjusting for sociodemographic variables had little impact.
CONCLUSIONS: Although most unvaccinated children attend schools with high coverage, clustering at Orthodox Protestant, Anthroposophical, and increasingly Islamic schools poses ongoing outbreak risks. Further research on vaccination barriers, drivers, and the role of social networks is needed to better understand vaccination decisions.