Lower vaccine uptake among Polish schoolchildren in Scotland
In November 2018, two published investigations described a low vaccination uptake against human papilloma virus (HPV) and against influenza among children of Polish immigrants in Scotland. Both vaccines were offered free-of-charge by school nurses to all eligible schoolchildren. During 2014-2017, the HPV vaccine uptake among Polish girls aged 12-13 years was 73%, as compared with 89% vaccine uptake among UK girls. In the 2016/2017 season, the seasonal influenza vaccine uptake among children of Polish immigrants aged 5-12 years was 25%, compared with 71% average uptake among UK-born children.
The Polish immigrants are the largest ethnical minority in Scotland. Certain municipalities have large communities of immigrants, and Polish borne children can constitute up to 30% of all schoolchildren. The above mentioned investigations were initiated following an observation that vaccination programmes achieve suboptimal coverage in communities with large Polish communities. The investigation of ethnical determinants of diseases or interventions have to be carried out with caution, to not stigmatise minorities. On the other hand, they are necessary to determine the reasons for lower vaccine uptake.
The decision to vaccinate a child is taken by a parent, and is not mandated by law in Scotland. The HPV vaccine was introduced to the childhood immunization schedule in 2008, following a large-scale social information campaign. Vaccines are offered by school nurses to all 12-13 year old girls. In 2013, Scotland introduced vaccination against seasonal influenza of all schoolchildren aged 5-12 years. The vaccine is administered by school nurses in nasal spray to all children whose parents gave written consent.
Globalization creates many new opportunities, and people travel more for work and leisure. The situation encountered in Scotland indicates that the increased migration creates new challenges for the vaccination programmes. Parents bring their attitudes and beliefs from their home countries, and they often have more links with their relatives and friends in their country of origin, than in the host country. Also in Poland, the HPV and influenza vaccines are not reimbursed by the government and have to be purchased by parents of schoolchildren. The demand for influenza seasonal vaccine is very low in Poland. During the season 2017/2018, only 3% Poles were vaccinated.
Public Health Scotland tries to reach out to the immigrant communities and transmit Public Health messages more efficiently, for example by using materials in different languages.
- Pollock KG et al. Evidence of decreased HPV vaccine acceptance in Polish communities within Scotland. Vaccine, 2018, 37, 690-692.
- Bielecki, A. Kirolos, L. J. Willocks et al., Low uptake of nasal influenza vaccine in Polish and other ethnic minority children in Edinburgh, Scotland, Vaccine, 2018, 37, 693-697.