Eurosurveillance - Volume 31, Issue 15, 16 April 2026

A surge in pertussis occurred in the Netherlands in 2023–24. Infant vaccination uptake decreased from 95% in 2011 to ca 86% in 2024. Maternal vaccination was introduced in 2019, with uptake ca 70%.

To describe pertussis epidemiological trends in the Netherlands.

We conducted a retrospective study using pertussis notification data from 2012 to 2024 and estimated infant and maternal vaccine effectiveness (VE) with the screening method.

During the COVID-19 pandemic, pertussis notifications dropped from ca 6,000 in 2013–19 to 79 in 2021 (incidence ca 35 to < 0.01/100,000 population). Notifications surged from May 2023, peaking in March 2024, resulting in 18,208 notifications in 2024 (102/100,000). Notifications and hospitalisations in 2024 were highest among infants aged 0–5 months (573 and 304/100,000) followed by infants aged 6–11 months (446 and 92/100,000). Annually, 0–2 deaths were reported; in 2023–24, 10 deaths were reported (6 infants, 4  ≥ 60-year-olds). In 2024, 83% of mothers of notified infants aged 0–2 months were unvaccinated. In 2020–24, maternal VE against pertussis in infants aged 0–2 months was 91%. In 2012–24 primary series VE was 98% at age 1, 92% at age 3, 92% post-booster at age 5, and 71% at age 9 years.

Low population immunity after 2 years of reduced circulation likely contributed to the highest pertussis incidence ever recorded in the Netherlands, posing a particular threat to unprotected infants. Maternal and infant VE are high, underscoring the public health priority of enhancing vaccination uptake.

Pneumococcal conjugate vaccines (PCVs) have reduced vaccine-type (VT) invasive pneumococcal disease (IPD) in older adults through direct and indirect effects. However, non-vaccine-type serotypes have emerged. Since the recently licensed PCV20 and PCV21 vaccines differ in serotype composition, epidemiological data are essential to guide adult vaccination policy.

We aimed to assess serotype-specific IPD dynamics in older adults in Israel and evaluate the potential impact of implementing either the PCV20 or PCV21 vaccine in the adult National Immunisation Programme (NIP).

In a national active IPD surveillance study in Israel, 2009–2024, on adults aged ≥ 65 years, IPD incidence per 100,000 population was assessed by age group, individual serotype and VT group.

We recorded 3,553 IPD episodes. All-IPD incidence was relatively stable between 2014/15 and 2023/24, excluding the COVID-19 period. In the late PCV13 period (2014–2019, 1,210 IPD episodes) and late/post COVID-19 pandemic (2021-2024, 608 episodes) periods, incidence of serotypes unique to PCV21 (VT21-only) was consistently higher than that of those unique to PCV20 (VT20-only). During 2022–2024, VT21-only IPD constituted 25.5% of all-IPD cases compared with 10.9% for VT20-only. Of the VT20-only serotypes, serotype 14 showed the highest late/post-pandemic incidence (1.76 per 100,000).

The PCV21 vaccine currently demonstrates broader serotype coverage than PCV20 among older adults in Israel. However, the spectrum of serotypes only partially overlap. Potential further serotype-specific dynamics following PCV20 implementation in the paediatric NIP and unknown actual effectiveness of newly introduced vaccine serotypes make it difficult to accurately predict impact following implementation.

Vaccinations against COVID-19 were integrated into routine care in Germany in April 2023. However, evidence of the impact of seasonal vaccination remains limited.

To assess the clinical and economic impact of COVID-19 vaccination in routine care during the early SARS-CoV-2-endemic phase in Germany.

A retrospective cohort study using statutory health insurance data from two German federal states (Saxony and Thuringia), covering over 3 million individuals, was conducted. Adults aged ≥ 18 years vaccinated against COVID-19 between 1 September and 30 November 2023 were matched 1:1 with unvaccinated individuals using propensity scores. Outcomes during the 4-month follow-up included occurrence of SARS-CoV-2 infection, long COVID, other respiratory infections, hospitalisations, mortality, healthcare costs and indirect costs caused by sick leave. Rate and hazard ratios (RR, HR) with 95% confidence intervals (CI) were calculated. Sensitivity analyses tested robustness.

A total of 146,132 individuals (73,066 per group) were matched. COVID-19 vaccination was associated with reduced rates of long COVID (RR: 0.43; 95% CI: 0.26–0.70), respiratory infections (RR: 0.91; 95% CI: 0.87–0.95) and COVID-19-related hospitalisations (RR: 0.41; 95% CI: 0.31–0.54). All-cause mortality was 25% lower among COVID-19-vaccinated individuals (HR: 0.76; 95% CI: 0.70–0.82). Healthcare costs were lower in the vaccinated cohort, particularly for inpatient care, e.g. EUR 1 million savings in COVID-19-related hospitalisations. Indirect costs caused by sick leave were also reduced by EUR 1.3 million.

Seasonal COVID-19 vaccinations in routine care settings were associated with substantial clinical and economic benefits. These real-world findings support continued implementation of national immunisation recommendations during the endemic phase of SARS-CoV-2 circulation.