In Poland, children are required to be vaccinated against such serious diseases as polio, whooping cough and measles. Unfortunately, each year over 50 Polish parents decide not to give their children vaccines. Meanwhile, refugees from Ukraine are still reaching our country, where even fewer children are given immunizations. Why is catching up on immunology so important? And should you also opt for additional vaccinations? Prof. Leszek Szenborn, head of the Department and Clinic of Paediatrics and Infectious Diseases at the Medical University and University Teaching Hospital in Wrocław.
- The vaccination calendar in Poland includes obligatory vaccinations for children and adolescents, incl. for rubella, mumps or diphtheria
- In addition to the basic vaccinations, there are also recommended ones, e.g. for pneumococci or meningococci
- The expert explains that taking all these preparations is important – it is the best possible form of protection against pathogens. This is particularly important in the context of refugees coming to Poland from Ukraine
- From 24 to 30 April we are celebrating the European Vaccination Week
- More current information can be found on the Onet homepage.
The two-year pandemic has put our focus on COVID-19, but sadly some of us have forgotten that other vaccinations are just as important.
Prof. Leszek Szenborn: Maybe we have not so much forgotten as the pandemic has made it difficult for us to access doctors or to vaccination points. In recent years, we have seen two very significant changes in our immunization program in Poland: we have been carrying out universal pneumococcal vaccination since 2017, and this year we have started vaccination against rotavirus. It may be hard to believe, but it has already produced some fantastic results. The fact is, during the pandemic, many infectious diseases disappeared, and rotaviruses also disappeared. However, after removing the masks and after the children returned to kindergartens and schools, the rotaviruses returned. However, older children are ill, and not the youngest, who usually suffered from this infection and required hospitalization.
The pneumococcal vaccination program has been in operation for five years. How do you rate him?
In fact, it has been five years since the launch of the free pneumococcal immunization program for all children under five. From the point of view of the doctor who runs the ward for diseases caused by bacteria and viruses, I confirm that at present we practically do not have these pneumococcal infections and meningitis. When I was a young doctor, I used to see such sick children practically all the time. The highest number of infections was observed in children up to 5 years of age – the introduction of free vaccinations significantly reduced the incidence of this group. I have no doubts that what we are seeing today is mainly due to vaccinations. However, there is also a pandemic that temporarily limited the incidence of infectious diseases.
A question arises that parents often ask themselves: if we have such an extensive calendar of compulsory vaccinations, is there really a need for additional vaccinations?
The calendar is actually getting better, but we have two vaccinations that are very important for the child’s health and well-being. Because well-being is not only the absence of disease, but also the fact that we are not worried about the risk of getting sick. It would be good if we had universal HPV vaccinations and meningococcal vaccinations. Really the entire population could benefit from the former.
On the other hand, meningococci relatively rarely cause diseases, but if they do, they are very serious and carry a risk of loss of life. Despite improvements in care, the availability of antibiotics and intensive care units, it was not possible to reduce the mortality below 10%. among those who are sick. On the other hand, in countries that have been vaccinating against meningococcus for many years, the number of cases has been reduced. The UK is the leader, which vaccinates all meningococci, including those from group B (also dominant in Poland), group C, which is the second very important pathogen when it comes to meningococcus, but also from the group within the ACWY quadrivalent vaccine. These vaccinations are also recommended as travel medicine. Another vaccine worth recommending is the hepatitis A vaccine. While it is not compulsory, it is available, cheap and very effective. This is important especially for holiday trips to slightly poorer warm countries.
At what age should children be vaccinated against meningococcus?
As with pneumococci and rotaviruses, vaccination should be started as early as possible for the best results. It is best to start as soon as the age of two months to build up immunity to the time of loss of maternal antibody donation, which occurs as early as 5-6. month of life. We should not delay this decision until the child goes to kindergarten, because then the benefit from vaccination is smaller.
Should children be vaccinated against smallpox, and why should they also be considered in preschool children?
Regardless of age, any child who has not developed chickenpox will benefit from the vaccination. I must admit that on the one hand it is indeed a mild disease, but still 10 percent. children suffering from chickenpox experience various complications. Life-threatening complications of smallpox unfortunately still happen. It is important to understand that a child does not die from smallpox, but dies from bacterial superinfections. In all cases of chickenpox, even if it is not associated with an intense rash, it is generally pruritus. The child is scratching. Scratches cause micro or larger wounds through which the bacteria on the skin penetrate: streptococci and staphylococci. Within hours, they can cause inflammation and the release of toxins in the blood. This, in turn, leads to a sharp decline in health. Such cases have happened, for example, after the so-called “smallpox party”, that is, the deliberate exposure of the child to infection. Having lived with chickenpox does indeed give you immunity for life, but only before you get smallpox. Almost everyone has a wild pox virus that will activate after some time and cause a severe disease, which is known to most shingles. It is worth mentioning that today we also have vaccines that reduce the risk of shingles that can be given to adults.
Professor, another very difficult topic: several hundred thousand children from Ukraine have crossed our border in the last few weeks. Can we try to compare vaccination schedules and types of vaccines?
These differences could only be significant if they were related to diseases posing an epidemic risk. This does not apply to pneumococci, for example, because their carrier is common. The fact that people from Ukraine are not vaccinated against them does not matter to us. Problems can arise from measles, whooping cough and poliomyelitis. Especially the latter. It is a very dangerous disease which, thanks to vaccinations, has not been present in Poland for many years. Unfortunately, there were polio cases in Ukraine in 2015 and 2021.
What is important: now we should persuade Ukrainian children to supplement the missing vaccinations, and after three months of stay of Ukrainian children in Poland, it will be obligatory. Visits to the doctor, hospital or admission to school or kindergarten should be a good opportunity to check and refer for vaccination. The most important thing is to ensure that they receive a booster dose of measles, whooping cough and polio vaccines. Such regulations have been introduced, for example, by Germany – unvaccinated children are not allowed to enter schools there.
Another non-obligatory vaccine, which may be important in the case of mass migration, is vaccination against hepatitis A. The most dangerous fact, however, is the fact that many Polish children do not have their preventive vaccinations carried out on time! They are most often older children and adolescents, because the vaccination crisis in the group of infants and young children was not so severe. Let us recall that annually in Poland over 50 parents are not obliged to vaccinate their children. Worse still, this number, unfortunately, is increasing. The result was the measles epidemic in 2018-19, which came to us from Ukraine three years ago.
Making up for late vaccinations is absolutely necessary …
Of course. First of all, it gives us peace of mind. Vaccination is like insurance: if we do not take out the policy, we cannot sleep well. Let’s do what we can, i.e. vaccinate as soon as possible, complete the missing vaccinations or start those that we have not yet started. It is always worth changing your mind about vaccinations, especially when we see their beneficial effects. Vaccination against the SARS-CoV-2 virus saved us. For a year we were all afraid for ourselves, for our family members, and only the vaccine calmed this fear down a bit. Unfortunately, some people have paid the highest price. For example, over 500 people dealing with health care lost their lives. There is no doubt: it is better to get vaccinated than to get sick!
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Authorized press interview prepared by Journalists for Health Association in connection with the XXX edition of the workshops in the series Where Do You Go Medicine? Fri. Vaccination practice in Poland and new challenges, organized on the occasion of the European Immunization Week, April 2022.