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Pijpers, J. (2026)

Sociodemographic determinants of COVID-19 and routine childhood vaccination coverage in the Netherlands

Doctoral Thesis
Vaccination is a key element in preventing infectious diseases and protecting population health. In the Netherlands, children receive vaccinations through the National Immunisation Programme against diseases such as measles, mumps, rubella, diphtheria, pertussis, tetanus and polio. Although vaccination coverage was historically high, it has declined in recent years, while inequalities in coverage between population groups have increased.

This dissertation investigated which sociodemographic and socioeconomic characteristics are associated with childhood vaccination coverage and how these differences have changed over time. National vaccination data were linked to register data from Statistics Netherlands (CBS), allowing the researchers to identify groups with lower vaccination coverage and areas where under-vaccination is concentrated.

The findings show declines in MMR and DTP-IPV vaccination coverage across several population groups, with particularly large...Show moreVaccination is a key element in preventing infectious diseases and protecting population health. In the Netherlands, children receive vaccinations through the National Immunisation Programme against diseases such as measles, mumps, rubella, diphtheria, pertussis, tetanus and polio. Although vaccination coverage was historically high, it has declined in recent years, while inequalities in coverage between population groups have increased.

This dissertation investigated which sociodemographic and socioeconomic characteristics are associated with childhood vaccination coverage and how these differences have changed over time. National vaccination data were linked to register data from Statistics Netherlands (CBS), allowing the researchers to identify groups with lower vaccination coverage and areas where under-vaccination is concentrated.

The findings show declines in MMR and DTP-IPV vaccination coverage across several population groups, with particularly large decreases in some groups. Differences were associated with factors such as migration background, income, family size and childcare attendance. The study also examined COVID-19 vaccination and changes in routine childhood vaccination during the pandemic period.

The results highlight the importance of targeted vaccination strategies for groups with low or declining coverage. Such approaches may help reduce health inequalities, increase protection against infectious diseases and prevent local outbreaks, particularly in communities where unvaccinated children are concentrated.
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Vaccination coverage
Infectious diseases
Epidemiology
All authors
Pijpers, J.
Supervisor
Hof, S. van den; Gaalen, I.A. van
Co-supervisor
Melker, H.E. de
Committee
Rosendaal, F.R.; Bruijning-Verhagen, P.C.J.L.; Das, M.; Muijsenbergh, M.E.T.C. van den
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2026-09-30
ISBN (print)
9789465376530