Eurosurveillance - Current Issue -Volume 31, Issue 19, 14/May/2026

Invasive Haemophilus influenzae type b (iHib) disease incidence in < 5-year-olds decreased after vaccine introduction but increased between 2011 and 2023 in the Netherlands. The National Immunisation Programme changed products in 2011 (from DTaP-IPV/Hib to DT3aP-HBV-IPV/Hib) and 2018 (to DT5aP-HBV-IPV-Hib) and schedule from 3 + 1 to 2 + 1 doses in 2020.

We aimed to estimate overall, product- and schedule-specific vaccine effectiveness (VE) against iHib disease to inform vaccination strategies.

We conducted a matched case–control study extracting iHib cases born ≥ 2005 and aged 6–119 months from 2005–2023 national reference laboratory data. We selected 10 controls per case matched on birth date and sex from the population register and obtained vaccination data from the vaccination registry. Using conditional logistic regression, we estimated matched odds ratios (mOR) and VE among 6–10-month-olds (eligible only for the primary series) and 11–119-month-olds.

We included 250 iHib cases and 2,487 controls. Among children aged 11–119 months, VE against iHib of the full schedule was 96% (95% CI: 88–99), 95% (95% CI: 91–97) and 98% (95% CI: 94–99) for any DTaP-IPV/Hib, DT3aP-HBV-IPV/Hib and DT5aP-HBV-IPV-Hib, respectively. It was 97% (95% CI: 93–99) for 2 + 1, 96% (95% CI: 93–98) for 3 + 1 doses, and > 95% for the respective primary series. No differences in VE by time since vaccination were observed between products or schedules.

Changes in VE against iHib after recent product or schedule changes do not explain the increasing iHib incidence. The high VE supports pursuing optimal vaccination coverage.

Although electronic health records are increasingly used for automated surveillance (AS) of healthcare-associated infections (HAIs), implementation is still a challenge. To develop more targeted implementation initiatives across Europe, knowledge about the current state of AS and potential to implement AS systems is needed.

To assess the adoption and feasibility of AS based on the 2022–2023 European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey (PPS).

The 2022–2023 ECDC PPS included questions on the degree of AS and digital data storage for seven HAIs. Descriptive analyses of the responses were performed and stratified by geographic region and hospital characteristics. Categorical variables were analysed as such and converted to ordinal scales.

Overall, 992 hospitals from 24 European countries participated. Across all seven HAIs, fully manual surveillance was the most common method (from healthcare-associated pneumonia (HAP) 38.8% to Clostridioides difficile infection (CDI) 45.4%). A considerable proportion, i.e. 19.3% (HAP) to 29.8% (CDI), employed some form of automation (automated denominator 5.3–11.3%; semi-automated 12.2–16.9%; fully automated 1.8–2.9%). Many hospitals not employing AS had required source data digitally stored. Generally, tertiary hospitals had higher levels of automation and digital data storage compared with other hospital types. Smaller hospitals (≤ 250 beds) had lower levels of automation, but a similar level of digital data storage compared with larger hospitals.

This study highlights variability in AS implementation and digital potential across European hospitals and underscores the need for targeted strategies to advance AS adoption and optimise surveillance.