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Dutch national immunization schedule: compliance and associated characteristics for the primary series
Elsemieke D Scheepers1, Alies van Lier1, Ingrid H Drijfhout1
1Centre for Infectious Disease Control, Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Postbox 1 (internal postbox 75), 3720 BA, Bilthoven, The Netherlands.
Insights
Compliance with the recommended diphtheria, tetanus, pertussis, and polio (DTaP-IPV) vaccination schedule in the Netherlands was 64.5% in 2007-2012. Delayed primary vaccinations increase the risk of infectious diseases, particularly for preterm infants and those with low birth weight.
Area of Science:
- Pediatrics
- Public Health
- Immunology
Background:
- The recommended primary immunization schedule for diphtheria, tetanus, pertussis, and polio (DTaP-IPV) in the Netherlands is at 2, 3, and 4 months of age.
- Delayed vaccination increases the period of vulnerability to infectious diseases like pertussis.
- Factors influencing delayed vaccination include prematurity, low birth weight, socioeconomic status, and parental birthplace.
Purpose of the Study:
- To evaluate compliance with the recommended DTaP-IPV vaccination schedule in the Netherlands.
- To identify characteristics associated with compliance or non-compliance.
- To understand the implications of delayed primary vaccinations.
Main Methods:
- Analysis of DTaP-IPV vaccination data for infants born between 2007 and 2012 (n=1,061,578).
- Defined compliance based on specific age windows for the first, second, and third DTaP-IPV vaccinations.
- Utilized log-binomial regression to examine associations between compliance and infant/parental characteristics.
Main Results:
- Overall compliance with the complete DTaP-IPV schedule was 64.5%, showing an increasing trend from 60.1% in 2007 to 68.5% in 2012.
- Individual vaccination compliance rates were 81.6% (first), 88.3% (second), and 84.2% (third).
- Higher compliance was observed in full-term infants, those with normal birth weight, and infants whose parents were both born in the Netherlands.
Conclusions:
- Approximately one-sixth of Dutch children experience delayed primary vaccinations.
- Efforts to improve vaccination compliance should target preterm infants, low birth weight infants, and children of non-Dutch parents.
- A delayed first vaccination significantly increases the likelihood of subsequent vaccinations also being administered outside the recommended schedule.
Abstract:
In the Netherlands, the recommended priming immunization schedule for diphtheria, tetanus, pertussis and polio (DTaP-IPV) is at 2, 3 and 4 months of age. We evaluated the compliance with the recommended schedule, as well as its characteristics. We included all infants born between 2007 and 2012 who received minimally one DTaP-IPV vaccination (n = 1,061,578). Infants complied with the schedule if they received the first vaccination between 6 and 9 weeks of age, and the second and third vaccination 2-6 weeks after the first and second vaccination. We examined associations between compliance and several characteristics using log-binomial regression. Compliance for the first, second and third vaccination was 81.6, 88.3 and 84.2%, respectively. Compliance with the total recommended schedule was 64.5%, and increased from 60.1% for 2007 to 68.5% for 2012. Compliance was higher for full-term infants (65.9%), infants with normal birth weight (66.0%) and when both parents were born in the Netherlands (66.8%).
Conclusion:
Delayed vaccination during the primary vaccination schedule occurs in one sixth of the Dutch children. Efforts to improve compliance should be focused in particular on preterm infants, infants with low birth weight and infants whose parents are not born in the Netherlands. What is Known: • A delayed start of vaccination leads to a longer period at risk for infectious diseases, e.g. pertussis • Delayed vaccination is associated with several factors including prematurity, low birth weight, family size, birth order, low socioeconomic status and health status of the child What is New: • Compliance with the recommended priming immunization schedule for diphtheria, tetanus, pertussis and polio was 64.5%, and increased from 60.1% for 2007 to 68.5% for 2012 • If the first vaccination was delayed, there was a higher chance that the following vaccinations were administered 'out-of-schedule' as well, resulting in even a higher age at second and third vaccination.