Improving Vaccination Uptake in the Netherlands: Analysis of Preventive Youth Health Care’s Strategy

Abstract Issue/problem National immunisation coverage has dropped worldwide in recent years. This study describes an expanding vaccination approach and its impact for children 4-18 years in Dutch preventive youth health care. Description of the problem Vaccination records for all children 4-18 years residing in Flevoland in 2022, 2023 and 2024 were analyzed. Characteristics of four groups of children were compared; 1) those vaccinated at the day they were invited, 2) those vaccinated during regular rounds after rescheduling their initial appointment, 3) Regretful opt-outs, referring to children from different cohorts who received vaccinations more than one year after their invitation, 4) newly arrived children in the Netherlands. Univariable statistical analyses were conducted using R, focusing on socioeconomic status, migration background, gender, age, proximity to vaccination location, and residence. Results Analyses were conducted for the vaccinations DTP (n = 5513), MMR (n = 5760) and Meningococcal ACWY (n = 5771). An additional 5,768 children were vaccinated after regular rounds. Regretful opt-outs for DTP, MMR, and MenACWY more often had a migration background, lower socio-economic status (both p < 0.001) and were vaccinated about a year later than the regular cohort. Regretful opt-outs for DTP and MMR were more often residing in urban settings, while MenACWY opt-outs are less common there (p < 0,001). Distance to vaccination sites were not significantly different between groups. Lessons Investing in supplementary initiatives to enhance vaccination uptake demonstrated their crucial role, reaching children who missed their initial appointments. Findings suggest the need for targeted interventions to address socioeconomic disparities and regional differences in vaccination uptake. Key messages • Addressing missed vaccinations during and beyond regular rounds boosts vaccination rates. • Health care organizations should ensure all children receive missed vaccinations during regular rounds.