Mandatory vaccinations in Poland - history and rationale
In Poland vaccinations included in the immunization schedule are mandatory. This means that every child residing in Poland can receive vaccines refunded by the state, but it also means that parents are obliged to show up on vaccination visits. Refusal to vaccinate usually means triggering an administrative procedure, which typically involves a monetary fine.
Mandatory vaccinations are set by Polish law and pertain to all children which are residing in Poland for longer than 3 months. Each child at birth receives an immunisation card which is stored at the general practitioner (GP) office and used to monitor the immunization schedule progress. Based on this card, the GP is calling parents for well-baby visits and administers scheduled vaccines as part of developmental monitoring. The current immunization schedule (2017) includes 11 mandatory vaccines, against tuberculosis, hepatitis B, diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae type b, pneumococci, measles, mumps and rubella. The immunization schedule includes also a separate section describing which vaccines are recommended, but their cost has to be paid by parents.
The introduction of mandatory vaccinations was part of the former Soviet Union guided public health system implemented in all countries associated with the Soviet Union. Even after the democratic reforms starting in 1989, the mandatory vaccinations were maintained and were widely accepted by Poles, assuring a very high vaccine uptake. During the recent years, an increasing number of parents was challenging this legal requirement and was refusing vaccination of their children against one or more diseases, or delayed the scheduled vaccinations. The increasing number of anti-vaccination activists started a debate on resigning from mandatory vaccinations and leaving the choice to parents. It was argumented that since the vaccinations are mandated by law, the state should pay compensations to parents of children suffering from adverse events following immunization. To date, the governmental representatives are strongly opposing changing the law. The Minister of Health declared “Resignation from mandatory vaccinations is impossible. Thanks to mandatory vaccination we maintain high immunization coverage and protect the weakest who cannot be immunized.”