From the beginning of September to March 3, nearly 14 million outpatient consultations were recorded in Poland due to acute respiratory infections, including influenza. The most effective method of preventing illness is vaccination. However, the vaccination rate in Poland has been declining for two seasons and is currently only 5.5 percent. Doctors are calling for simplified and expedited procedures. Nevertheless, patient education is crucial.
“When the respiratory infection season began, it initially dominated infections caused by the RSV virus, which is the typical pattern of such seasonal occurrence. Then our community and illness departments were dominated by infections caused by the SARS-CoV-2 virus, or COVID-19. At the moment flu is in charge,” says Professor Aneta Nitsch-Osuch, paediatrician and epidemiologist from the Medical University of Warsaw.
According to data collected by the e-Health Center, nearly 14 million outpatient consultations for acute respiratory tract infections, including influenza, were recorded from the beginning of the infectious disease season (since September) to early March 2024.
The weekly report from the WHO indicates that the occurrence of flu-like diseases exceeds baseline levels in 12 European countries. Across the region, the percentage of samples from patients reporting to centers in the integrated SENTINEL epidemiological surveillance system testing positive for influenza remains above the 10 percent epidemic threshold (11 percent). For comparison, the percentage is 4 percent for RSV and roughly 2 percent for SARS-CoV-2.
“Global and Polish data suggest that among persons aged 65 and over, the main cause of hospitalization due to respiratory infections was COVID-19, followed closely by influenza,” the expert adds.
Vaccination is the primary preventative method, offering the highest chance of a mild illness progression. However, the vaccination rate in Poland is much lower than in Western Europe, currently standing at 5.5 percent. Although vaccines are mostly reimbursed in Poland, less than 2.1 million vaccines have been administered.
“We observed slightly higher interest at the beginning of the pandemic, then a nearly 20 percent drop in vaccination rate, and currently we continue to observe a decrease, not as drastic, but about 2 percent,” notes the WUM epidemiologist.
Nonetheless, seniors, with a 20-percent vaccination rate, continue to be the largest group getting vaccinated in Poland. This rate reaches 70 percent in some EU countries due to easier access to vaccines. For instance, flu shots can be received at any pharmacy in France, and Czech patients have fast access to innovative vaccines.
The myth that flu is a severe cold contributes to the low number of pediatric vaccinations (2 percent in the 0-4 age range and 1.9 percent in the 5-14 age range). It’s known that children are the main source and transmitter of the flu. They are more susceptible to infection than adults, and can excrete the virus in larger quantities. If the vaccination rate for children were increased to 20 percent, the risk of flu in the entire population would be halved.
“Still as patients and perhaps even medical staff, we downplay the flu. We consider it a rare disease or, in most cases, mild and self-limiting. Let’s be frank, it doesn’t help that access to epidemiological data has been restricted this season. We do not know how many flu patients were hospitalized or died from flu. This data is needed to build awareness about the disease and the risks associated with it,” argues Professor Nitsch-Osuch.
In rapidly aging societies, like Poland, the WHO suggests a community vaccination rate of 75 percent. Influenza is one of the top ten causes of death for those over 65, affecting about 80 percent. Statistically, seniors have at least two co-existing diseases (heart and lung disease, cancer, or diabetes), and this rate increases with age. Experts from the Polish Program for the Control of Infectious Diseases consider it necessary to implement a Health Prevention Program, enabling free flu vaccinations for seniors over 60 with a new, high-dose influenza vaccine.
“Viruses do not recognise the PESEL [Polish national identification number] and can cause illnesses regardless of age. Vaccinations do not end with adulthood. However, older people, due to the fact that the immune system ages, become more susceptible to diseases caused by respiratory viruses. But on the other hand, we also know that as we age, the chance increases that we will suffer from at least one, and often many chronic diseases, which are a risk factor for severe illness, such as flu,” explains the expert.
Improvements in the number of vaccinations could be made by simplifying and shortening the procedures. Currently, the flu vaccine is free for children from six months to 18 years old, pregnant women, and people aged 65+. For adults from 18 to 64 and adults in risk groups, the vaccine is available with a 50-percent refund. However, to obtain a 50-percent refund or a free flu vaccine, a prescription by a doctor is required. A pharmacist can also prescribe a full-price (non-refunded) vaccine. Vaccinations can only be administered in public pharmacies to adults.
“A lot is changing for the better, for example, the fact that flu vaccinations are fully refunded and therefore free of charge. This is a vital factor to eliminate, especially when considering it as a barrier in groups such as pregnant women, children, or seniors. However, this is not enough. We need to continue to raise social awareness and educate society, but also simplify the entire vaccine administration process. Therefore, we are still promoting vaccination in pharmacies and making the process from deciding to get vaccinated to getting vaccinated as short as possible,” assures Professor Aneta Nitsch-Osuch.
