In 2020, fewer people fell ill from a disease against which vaccination is included in the National Immunisation Programme (NIP) than in 2019. This is most likely due to coronavirus measures, such as social distancing, handwashing, and travel restrictions.

Surveillance data and scientific developments

The NIP surveillance report specifies the number of people who fell ill from one of the 12 infectious diseases that the NIP covers. The report also analyses how severe the diseases are, and how well the vaccines work. This analysis is based on information such as the number of people that fell ill and how often people were admitted to a hospital due to the disease. The report compares these numbers with the figures from previous years as well as figures from different countries.

The report also describes infectious diseases that have not yet been included in the NIP. Examples are chickenpox and rotavirus. 

Fewer people fell ill than in 2019

Particularly pertussis, mumps, pneumococcal disease, and measles were notified less often. Pertussis notifications even decreased by 85%. In 2020 there were only 2 cases of measles, while 84 cases were reported in 2019. 

The number of notifications of chronic hepatitis B decreased by about one third compared to 2019. This is probably not an actual decrease, since people visited their doctors less often due to the COVID-19 pandemic. This led to fewer hepatitis B tests being performed than is usually the case. 

The only exception to the decreased number of notifications was Haemophilus influenzae type b (Hib). This is a bacterium that almost all people carry in their nose at some point in their lives. In 2020, the number of notifications increased to 68, while there were only 39 notifications in 2019. RIVM currently investigates the probable cause of this increase.

There were once again no notifications of either rubella or polio in 2020. There were 3 patients with diphtheria and 2 patients with tetanus. The number of notifications for meningococcal disease type W decreased further after the vaccine was added to the NIP in 2018. 

Notifications per disease in 2019 and 2020


Notifications 2019

Notifications 2020







Pneumococcal disease

2,400 (approximately)

1,500 (approximately)
















Meningococcal disease type W



Hepatitis B (chronic and acute)



Haemophilus influenzae type b



Increase in national vaccination coverage

Vaccination coverage increased slightly for the second year in a row. This was the case for children of 2 years of age, of which 0.5% more children were fully vaccinated as compared to 2019. The vaccination coverage for HPV vaccination for girls even increased by 10%. The children that were 2 years old in 2020 did receive most of their vaccine(s) before the coronavirus outbreak. It seems that the coronavirus measures had little negative impact on the NIP in 2020. Click here for more information about vaccination coverage.

Rotavirus vaccination

In June 2021, the Health Council recommended offering the rotavirus vaccine to all children. Based on this advice, the minister or secretary of state of Health, Welfare and Sport will decide whether or not the vaccine will be added to the NIP. 

New chapter on COVID-19 added

This year, a new chapter on COVID-19 has been added to the report. The most important point from this chapter is that COVID-19 vaccines are very effective. This is apparent from research conducted by RIVM. RIVM also monitors COVID-19 vaccination coverage. At the time of publication of the surveillance report, vaccination coverage for full vaccination is 84.9% for everyone aged 18 or above. It remains as important as ever to aim for the highest possible vaccination coverage.