Poland’s vaccine refusals double in five years, alarming officials [Advocacy Lab Content]

In recent years Poland has witnessed a disturbing surge in the rejection of mandatory immunisations, with the vaccine refusal rate doubling in five years, and thirteen-fold in a decade.

Poland’s National Institute of Public Health – National Research Institute (NIZP PZH – PIB) reports that throughout the last five years, the tally of refusals for mandatory vaccinations has nearly doubled, soaring from 48,600 refusals in 2019 to 87,300 in 2023.

“Vaccines are often victims of their success. Their effectiveness in preventing diseases can sometimes lead to them becoming less visible to the public, which in turn reduces vigilance,” Professor Aneta Nitsch-Osuch, Chair of the Vaccination Section of the Polish Society of Family Medicine, told Euractiv.

The numbers give cause for concern

While vaccinations are undoubtedly one of the greatest achievements in public health, an increasing number of people are opting out of vaccinating their children.

In Poland, refusals of mandatory vaccinations have been monitored since 2003 by the NIZP PZH – PIB. Collected data pertains to individuals subject to vaccination in a given year, including children and adolescents up to the age of 19.

Professor Jarosław Pinkas, a national consultant in public health, commented on the NIZP PZH – PIB data, telling Euractiv: “The increase in the number of refusals in Poland is a concerning phenomenon, and this trend has persisted for some time now.”

Indeed, the data indicates that in Poland, from 2003 to 2009, the number of cases of vaccine evasion ranged from 3,077 to 4,993, reaching its lowest point in 2009 with 3,077 cases. However, over the next decade, the refusal rate has increased by a staggering thirteen-fold.

As Professor Pinkas points out, the declining vaccination rates have consequences not only in the medical sphere but also in the economic and social realms, leading to many avoidable costs.

Ways to improve

In response to threats posed by the increase in vaccination refusals, Polish experts have developed a document outlining strategic recommendations for 2023-2027, with a focus on building trust in protective vaccinations.

The authors of the report highlight that the increase in refusals for mandatory vaccinations can be attributed to various factors, including low public education regarding vaccinations, a lack of health literacy, inadequate doctor-patient communication, healthcare system organisation issues, and the escalating activities of anti-vaccine movements.

One of the authors of the document, Professor Pinkas, told Euractiv that it is worth noting that some parents who refuse vaccinations cite concerns about their children’s health. “This underscores the urgent need for education and promotion of reliable, evidence-based knowledge, as well as ongoing dialogue, especially with parents of young children,” he added.

Professor Nitsch-Osuch echoed similar sentiments in a conversation with Euractiv, noting that the percentage of staunch vaccine opponents (those with unwavering beliefs unaffected by arguments) in developed countries’ populations is low, typically ranging from 1-2%.

However, what is concerning for Nitsch-Osuch, and what should prompt action, is the growing number of individuals exhibiting so-called vaccine-hesitant attitudes. “The percentage of such patients ranged from 20-40% in European countries, and unfortunately, it is on the rise,” she told Euractiv.

It is precisely these individuals who are hesitant, doubtful, and questioning that the physicians should dedicate more time and attention to patiently explain and clarify.

As she observed from her own experience, that kind of approach is valuable. “Often, it takes more than one visit to change attitudes towards vaccinations, but it is worth it,” she said.

European point of view

European countries have autonomy in shaping health policy regarding vaccinations. “Neither the European Union nor the Council of Europe has implemented a uniform policy in this area, so the number of vaccines, age of vaccine administration, and implementation of vaccination programs (mandatory or voluntary) differ between European countries,” Professor Pinkas said.

These differences in health policy regarding vaccinations between European countries stem largely from historical conditions. Pinkas explained that in numerous Central and Eastern European countries, formerly part of the Eastern Bloc, vaccinations are mandatory. Conversely, Western European and Scandinavian nations usually adopt a voluntary approach to vaccination policy.

The high vaccination rates in these regions are credited to the population’s robust health literacy and awareness of the crucial role vaccinations play in preventing infectious diseases.

“However, it should be noted that in recent years, due to the increasing number of cases of childhood infectious diseases, some countries where vaccination was previously voluntary have revised their health policy and introduced mandatory vaccinations or expanded the list of mandatory vaccines,” he added.

[By Paulina Mozolewska, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]

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