Poland is prioritising disease prevention at all ages

In the 1990s, vaccination against measles and pertussis reached 98% in Poland. However, childhood vaccine uptake has declined over several decades and measles vaccine uptake is now 86%. At the same time, adult vaccination rates have historically been lower than uptake among children – a record that health authorities are actively working to address. 

Poland holds the Presidency of the European Council for the next six months and it aims to make disease prevention a priority. This is in keeping with a nationwide drive to reframe vaccination as a central feature of maintaining good health at all ages and stages of life. 

Policymakers and health professionals are on board with this approach to preventative health, but a significant minority of the population remains hesitant. In Poland, uptake of COVID-19 vaccines during the pandemic was lower than the European average, and Polish people living elsewhere in Europe tended to have relatively low HPV and flu vaccine uptake. The arrival of significant numbers of people from Ukraine – where vaccination rates are very low – further depressed overall vaccine uptake. 

Authorities in Poland are responding to the challenge with a dedicated website, multimedia information campaigns and targeted promotion of the national adult vaccination schedule, and by making adult vaccinations available in pharmacies. 

‘Life-course immunisation is important to maintain health system sustainability and promote economic prosperity,’ said Professor Maria Ganczak, head of the Department of Infectious Diseases at the University of Zielona Góra, and vice-president of the Infectious Disease Control Section of the EUPHA. ‘Prevention of infectious diseases through immunisation eases pressure on health systems. Similarly, as retirement age increases and people work to older ages, immunisation across the life course is becoming more relevant to workforce productivity.’

Mandates and recommendations: A brief history of vaccination in Poland

Poland’s vaccination programme, popularly known as the Children’s Vaccination Calendar, was introduced in the 1960s and has expanded over time. It now obliges parents to vaccinate children against twelve infectious diseases: tuberculosis, hepatitis B, rotavirus, diphtheria, tetanus, pertussis, poliomyelitis, Hib, pneumococcus, measles, mumps and rubella. Every child who stays in Poland for more than three months must be vaccinated. Otherwise, parents can be fined – although this is a lengthy procedure which is often not enforced. 

The inclusion of new vaccines in the free immunisation programme tends to be slow. For example, 5-in-1 and 6-in-1 combination vaccines, as well as the MenB and MenACWY vaccines available in several European countries, are not on the list in Poland. The delays are attributed to a lack of resources. 

In addition, chickenpox vaccination is mandatory for selected risk groups. And, alongside this list of mandatory vaccines which are available free of charge, there are several recommended vaccines which can be purchased privately.  

The distinction between free mandatory vaccines and paid-for recommended vaccines was complicated further after the COVID-19 pandemic which saw the introduction of a new category: free but recommended (i.e. not mandatory). Vaccines in this category include COVID-19 vaccinations, HPV vaccines, and pertussis vaccination for pregnant women. 

Shifting the public mindset from thinking about vaccines as a positive voluntary element of staying healthy, rather than a mandatory children’s health measure, takes time. Some vaccines are supported by wider health policy goals such as healthy ageing or cancer prevention. 

The HPV vaccine, which prevents cervical cancer, is offered to adolescents (aged 12-13). While this vaccine is a feature of Poland’s National oncology Strategy (2019), the EU Beating Cancer Plan and a WHO strategy to eliminate cervical cancer, uptake remains low. 

In 2021, authorities published a strategy to vaccinate adolescent girls and boys against HPV. A campaign launched in the middle of 2023 aims to vaccinate 60% of adolescents by 2028. Initial uptake is estimated to be around 18%. Since September 2024, the vaccine has been offered not only in health centres, but in schools when requested by the school principal.

Broadening the availability of vaccines can improve uptake. That is why pharmacy-based vaccination has been introduced for flu vaccines in people aged 65 and older; pneumococcal vaccination for over 65s and people in risk groups; and COVID-19 vaccination for adults. With the exception of the COVID-19 vaccine, a prescription from a doctor is required for free vaccination in the pharmacy. 

This approach is part of Poland’s effort to advance life-course immunisation and support public health in an ageing population. The Polish Society of Vaccinology and the National Institute of Public Health promote adult vaccination, aiming to address the country’s historically low flu vaccine uptake: fewer than 20% of people aged over 65 years have their annual flu jab. 

‘As an infectious disease specialist, I have been vaccinating patients for forty years – not only healthy adolescents or adults, but also vulnerable populations, such as pregnant women, individuals with chronic or immunocompromising conditions, and older adults.,’ Professor Maria Ganczak said. ‘I have seen how life-course immunisation benefits health by significantly lessening the morbidity and mortality caused by vaccine-preventable diseases. And more, the life-course approach has enabled my adult patients to age with reduced risk of disease, thereby enabling their healthy, active and productive aging.’

For more on vaccination in Poland, visit szczepienia.info, run by the Polish National Institute of Public Health. The site is a member of the WHO Vaccine Safety Net.