Teresa Jackowska: HPV vaccination program is not working as we would like it to

How do you assess the functioning of the vaccination program for 12- and 13-year-olds against HPV?

The HPV vaccination program for both girls and boys was implemented on June 1 and applies to children who are either 12- or 13-year-olds. Thus, it covered two year groups. However, it is absolutely necessary to emphasize that this is a program that is an optional vaccination program, that is, a recommended vaccination, voluntary, but free of charge. Two vaccines were purchased for this program, both a bivalent vaccine and a state-of-the-art 9-valent vaccine, which gives a decidedly broader coverage. The latter is a vaccine recommended by one of the most competent societies: the Polish Society of Cervical Colposcopy and Pathophysiology. There are doctors out there who deal with the clinical picture of cervical cancer in women on a daily basis, a disease that we prevent through vaccination with HPV vaccines.

According to data that are published, about 13 percent of children have been vaccinated. Certainly, you have to take credit for this. The best example of this is my granddaughters. I live in Warsaw and I was very careful to make sure that the very next day after their birth the girls were vaccinated by the program, which is in Warsaw. There were quite a few local government programs in Poland, and we don't have a register that will tell us how many children benefited from such programs. Some also financed the vaccine out of their own pockets. Certainly, some children no longer join this program, for the reason that their parents took care of the vaccination earlier. But let's remember that, after all, local government programs are not available in every city, or especially in every village. It certainly doesn't all function as we expect it to, and I wondered why this is so. Is it just this anti-vaccine propaganda? The answer came only from my conversations with primary care physicians, and especially from an initiative by one of the board members of the Polish Pediatric Society, of which I am now president. I was not aware of the fact that at the moment it is very difficult to implement this program, for the reason that according to the recommendations under the May 19, 2023 universal vaccination program for HPV, this vaccination must be preceded by registration in the central system. For the provider, this means creating special schedules just for this vaccination, the need to register patients before the qualification and vaccination is performed. The provider must therefore create vaccination schedules, booking the work of the vaccination team, regardless of any interest in vaccination. Doctors who very much want to vaccinate say that this is a very big difficulty, so they believe that the vaccine should always be available at the vaccination center with use for vaccination at any opportunity. Hence the Polish Pediatric Society's demand to simplify the HPV vaccination system.

The second thing is to standardize the availability of vaccines. Since September 1, we have available a vaccine that until now was in reimbursement and could be purchased at a 50 percent discount. At the moment, this vaccine is available for children over the age of nine, and there is practically no upper limit. It is very good that it is available, it is just that it causes, as doctors tell me, information noise. Parents don't understand why one vaccine can be immediately available after a prescription is written, while the other has to be scheduled, using a central registration system.

And how is the issue of vaccine promotion and inter-ministerial cooperation in this regard?

According to my information, there was a message on the website of the Ministry of Education and Science, but it mixes the terms I just mentioned: vaccination program and free vaccines for under-18s. This information, which is on the website of the Ministry of Education and Science, is supposed to reach schools, but I don't know in what form it reaches there and to what extent it is transmitted in schools. As far as I know, in Warsaw, there have been difficulties even with the message regarding local government programs. My postulate on vaccination in general is to encourage vaccination at school. Contact between 12- and 13-year-olds and the primary health care facility is less frequent, and health balances are not done at this age. I also don't know why there can't be SMS campaigns for these vaccinations, such as there were for the COVID-19 vaccination. Are there any obstacles? I leave this question open.