---
title: "Post-vaccination adverse events and reduced COVID-19 booster uptake in the Netherlands"
id: "pubmed-42603508"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42603508"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42603508/"
doi: "10.1016/j.vaccine.2026.129043"
published_at: "2026-09-17T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Post-vaccination adverse events and reduced COVID-19 booster uptake in the Netherlands
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42603508
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42603508/)
- **DOI:** [10.1016/j.vaccine.2026.129043](https://doi.org/10.1016%2Fj.vaccine.2026.129043)
- **Published At:** 2026-09-17T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This prospective cohort analysis used participants from the Vaccine Study COVID-19 (VASCO) in the Netherlands who were eligible for autumn booster vaccination between 2022 and 2024. The study assessed associations between post-booster **adverse events (AE)** and subsequent booster uptake. - Participants completed a questionnaire on local and systemic AE one month after booster vaccination; analyses adjusted for demographics and prior SARS-CoV-2 infection. - In 2022, 11,010 participants completed the AE questionnaire; in 2023, 14,824 did so. Revaccination rates in the subsequent years were 73.7% (following 2022) and 87.0% (following 2023). - The occurrence of **systemic AE** after the 2022 booster was associated with lower odds of revaccination in 2023 (OR 0.84, 95% CI 0.76–0.93). - Increasing severity of systemic AE corresponded to progressively lower revaccination odds: moderate AE OR 0.79 (95% CI 0.66–0.94); severe AE OR 0.45 (95% CI 0.34–0.60). - Longer duration of systemic AE (>5 days) was associated with reduced uptake (OR 0.72, 95% CI 0.54–0.95). - Severe local AE (OR 0.38, 95% CI 0.23–0.60) and seeking medical care for AE (OR 0.50, 95% CI 0.34–0.73) were also linked to lower subsequent booster uptake. - Similar patterns were observed for revaccination in 2024 after AE reported in 2023. - The authors conclude that experiencing systemic AE—particularly when severe or prolonged—or severe local AE after a booster was associated with lower likelihood of obtaining later boosters, and recommend addressing experienced AE in communication strategies to support vaccination campaign success.
## Clinical Analysis & Structured Key Points
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Epub 2026 Aug 15. # Association between post-vaccination adverse events and subsequent COVID-19 booster uptake in the Netherlands [Anne J Huiberts](https://pubmed.ncbi.nlm.nih.gov/?term=Huiberts+AJ&cauthor_id=42603508)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#full-view-affiliation-1 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands. Electronic address: anne.huiberts@rivm.nl."), [Maud M J Smits](https://pubmed.ncbi.nlm.nih.gov/?term=Smits+MMJ&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#full-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands."), [Christina E Hoeve](https://pubmed.ncbi.nlm.nih.gov/?term=Hoeve+CE&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#full-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands."), [Hester E de Melker](https://pubmed.ncbi.nlm.nih.gov/?term=de+Melker+HE&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#full-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands."), [Susan van den Hof](https://pubmed.ncbi.nlm.nih.gov/?term=van+den+Hof+S&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#full-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands."), [Mirjam J Knol](https://pubmed.ncbi.nlm.nih.gov/?term=Knol+MJ&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#full-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands.") Affiliations Expand ### Affiliations * 1 Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands. Electronic address: anne.huiberts@rivm.nl. * 2 Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands. * PMID: **42603508** * DOI: [ 10.1016/j.vaccine.2026.129043 ](https://doi.org/10.1016/j.vaccine.2026.129043) Free article Item in Clipboard # Association between post-vaccination adverse events and subsequent COVID-19 booster uptake in the Netherlands Anne J Huiberts et al. Vaccine. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Vaccine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Vaccine%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Vaccine%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42603508/) . 2026 Sep 17:90:129043. doi: 10.1016/j.vaccine.2026.129043. Epub 2026 Aug 15. ### Authors [Anne J Huiberts](https://pubmed.ncbi.nlm.nih.gov/?term=Huiberts+AJ&cauthor_id=42603508)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#short-view-affiliation-1 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands. Electronic address: anne.huiberts@rivm.nl."), [Maud M J Smits](https://pubmed.ncbi.nlm.nih.gov/?term=Smits+MMJ&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#short-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands."), [Christina E Hoeve](https://pubmed.ncbi.nlm.nih.gov/?term=Hoeve+CE&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#short-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands."), [Hester E de Melker](https://pubmed.ncbi.nlm.nih.gov/?term=de+Melker+HE&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#short-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands."), [Susan van den Hof](https://pubmed.ncbi.nlm.nih.gov/?term=van+den+Hof+S&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#short-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands."), [Mirjam J Knol](https://pubmed.ncbi.nlm.nih.gov/?term=Knol+MJ&cauthor_id=42603508)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42603508/#short-view-affiliation-2 "Centre for Infectious Disease Control, National Institute for Public Health and Environment \(RIVM\), Bilthoven, the Netherlands.") ### Affiliations * 1 Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands. Electronic address: anne.huiberts@rivm.nl. * 2 Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands. * PMID: **42603508** * DOI: [ 10.1016/j.vaccine.2026.129043 ](https://doi.org/10.1016/j.vaccine.2026.129043) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Introduction:** This study aimed to assess whether the occurrence, severity, and duration of AE following COVID-19 booster vaccination were associated with subsequent booster uptake during the 2022-2024 autumn booster campaigns in the Netherlands. **Methods:** We included participants from the Vaccine Study COVID-19 (VASCO), an ongoing prospective cohort study, who were eligible for booster vaccination in 2022-2024. Participants completed a questionnaire on AE one month after booster vaccination. Logistic regression was performed to assess the association between the occurrence, severity, and duration of local and systemic AE, and revaccination during the subsequent year. We adjusted for demographics and prior SARS-CoV-2 infection. **Results:** In 2022 and 2023, 11,010 and 14,824 participants were vaccinated and completed the AE questionnaire. Of these, 73.7% and 87.0% were revaccinated in subsequent years. The occurrence of systemic AE in 2022 was associated with a lower odds of revaccination in 2023 (OR: 0.84 [95%CI, 0.76-0.93]). The likelihood of revaccination declined with increasing severity- moderate (0.79 [0.66-0.94]) and severe AE (0.45 [0.34-0.60]) - and longer duration (>5 days: 0.72 [0.54-0.95]) of systemic AE. Also, severe local AE (0.38 [0.23-0.60]) and seeking medical care for AE (0.50 [0.34-0.73]) were associated with reduced vaccination uptake. Similar associations were observed for revaccination in 2024. **Conclusion:** This study found a lower likelihood of subsequent COVID-19 booster uptake after experiencing systemic AE, particularly when severe or prolonged, or when experiencing a severe local AE. These findings underscore the need to address experienced AE in communication strategies, as this may influence the success of vaccination campaigns. **Keywords:** Adverse events; COVID-19 vaccination; Cohort study; Vaccine acceptance. Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ Association between adverse events after COVID-19 vaccination and anti-SARS-CoV-2 antibody concentrations, the Netherlands, May 2021 to November 2022: a population-based prospective cohort study. ](https://pubmed.ncbi.nlm.nih.gov/38904110/) Holwerda MR, Hoeve CE, Huiberts AJ, den Hartog G, de Melker HE, van den Hof S, Knol MJ.Holwerda MR, et al.Euro Surveill. 2024 Jun;29(25):2300585. doi: 10.2807/1560-7917.ES.2024.29.25.2300585.Euro Surveill. 2024.PMID: 38904110Free PMC article. * [ Predictors of moderate-to-severe side-effects following COVID-19 mRNA booster vaccination: a prospective cohort study among primary health care providers in Belgium. ](https://pubmed.ncbi.nlm.nih.gov/39390398/) Domen J, Abrams S, Digregorio M, Van Ngoc P, Duysburgh E, Scholtes B, Coenen S.Domen J, et al.BMC Infect Dis. 2024 Oct 10;24(1):1135. doi: 10.1186/s12879-024-09969-8.BMC Infect Dis. 2024.PMID: 39390398Free PMC article. * [ Evaluation of adverse events and comorbidity exacerbation following the COVID-19 booster dose: A national survey among randomly-selected booster recipients. ](https://pubmed.ncbi.nlm.nih.gov/40644466/) Frankenthal D, Zatlawi M, Karni-Efrati Z, Keinan-Boker L, Glatman-Freedman A, Bromberg M.Frankenthal D, et al.PLoS One. 2025 Jul 11;20(7):e0326231. doi: 10.1371/journal.pone.0326231. eCollection 2025.PLoS One. 2025.PMID: 40644466Free PMC article. * [ SARS-CoV-2 infection following booster vaccination: Illness and symptom profile in a prospective, observational community-based case-control study. ](https://pubmed.ncbi.nlm.nih.gov/37777159/) Antonelli M, Penfold RS, Canas LDS, Sudre C, Rjoob K, Murray B, Molteni E, Kerfoot E, Cheetham N, Pujol JC, Polidori L, May A, Wolf J, Modat M, Spector T, Hammers A, Ourselin S, Steves C.Antonelli M, et al.J Infect. 2023 Dec;87(6):506-515. doi: 10.1016/j.jinf.2023.08.009. Epub 2023 Sep 28.J Infect. 2023.PMID: 37777159Free PMC article. * [ COVID-19 severity and risk of SARS-CoV-2-associated asthma exacerbation by time since booster vaccination: a longitudinal analysis of data from the COVIDENCE UK study. ](https://pubmed.ncbi.nlm.nih.gov/40379262/) Vivaldi G, Talaei M, Pfeffer PE, Shaheen SO, Martineau AR.Vivaldi G, et al.BMJ Open Respir Res. 2025 May 15;12(1):e003158. doi: 10.1136/bmjresp-2025-003158.BMJ Open Respir Res. 2025.PMID: 40379262Free PMC article. 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