Surveillance and vaccine effectiveness of pertussis, the Netherlands, 2012 to 2024, with an unprecedented surge in 2023 and 2024

BACKGROUNDA 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%.AIMTo describe pertussis epidemiological trends in the Netherlands.METHODSWe conducted a retrospective study using pertussis notification data from 2012 to 2024 and estimated infant and maternal vaccine effectiveness (VE) with the screening method.RESULTSDuring 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.CONCLUSIONLow 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.