The European Journal of Public Health
Volume 24 Issue 2 April 2014
http://eurpub.oxfordjournals.org/content/current
Vaccine uptake determinants in The Netherlands
Alies van Lier1, Jan van de Kassteele2, Pieter de Hoogh3, Ingrid Drijfhout4 and Hester de Melker1
1 Department of Epidemiology and Surveillance (EPI), Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
2 Expertise Centre for Methodology and Information Services (EMI), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
3 Regional Coordination of Programmes/Purchase, Storage and Distribution (RCP/IOD), Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
4 Preparedness and Response Unit (LCI), Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Correspondence: Alies van Lier, Department of Epidemiology and surveillance (EPI), National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Postbox 1 (Internal Postbox 75), 3720 BA Bilthoven, The Netherlands, Tel: +31 (0) 30 274 33 67, Fax: +31 (0) 30 274 44 09, e-mail: alies.van.lier@rivm.nl
http://eurpub.oxfordjournals.org/content/24/2/304.abstract
Abstract
Background: Combining existing data on background characteristics with data from immunization registers might give insight into determinants of vaccine uptake, which can help to improve communication strategies and invitation policy of National Immunisation Programmes.
Methods: The study population consisted of children born in 2005 as registered in the Dutch national immunization register Præventis. A hierarchical logistic regression model was used to quantify associations between individual vaccination status and proxy variables for ethnic background (individual level), socio-economic status (postcode level) and religious objection to vaccination (municipal level).
Results: Most children whose both parents were not born in The Netherlands had a somewhat lower full vaccine uptake, for example, children whose both parents were born in Turkey [odds ratio = 0.7 (0.6–0.8)] or in Morocco [odds ratio = 0.8 (0.7–0.9)]. The partial uptake was also relatively high (3.7–8.0%) compared with children whose both parents were born in The Netherlands (3.1%). Municipalities with higher religious objection to vaccination and postcode areas with lower socio-economic status were also associated with a lower full uptake. Conclusions: Despite the high vaccination coverage in The Netherlands, we were able to identify determinants of vaccine uptake by combining existing data sets. This might be an example for other countries. The impact of ethnic background and socio-economic status is not as well known in The Netherlands as the effect of religious objection to vaccination, and deserves more attention. Groups that have a relatively high partial uptake deserve special attention because they do not reject vaccination in general.