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Article

Parents’ Attitudes towards Vaccinations Regarding the Ukrainian Migration to Poland in 2022

by
Martyna Cholewik
1,
Maciej Stępień
1,
Carlo Bieńkowski
2,3,4,* and
Maria Pokorska-Śpiewak
3,4
1
Student Scientific Circle at the Department of Children’s Infectious Diseases, Medical University of Warsaw, Wolska 37, 01-201 Warsaw, Poland
2
Doctoral School, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
3
Department of Children’s Infectious Diseases, Medical University of Warsaw, Wolska 37, 02-091 Warsaw, Poland
4
Hospital of Infectious Diseases, 01-201 Warsaw, Poland
*
Author to whom correspondence should be addressed.
Vaccines 2023, 11(8), 1306; https://doi.org/10.3390/vaccines11081306
Submission received: 7 July 2023 / Revised: 28 July 2023 / Accepted: 29 July 2023 / Published: 31 July 2023
(This article belongs to the Special Issue HBV and HCV Infection in Children and Adolescents)
Versions Notes

Abstract

:
Background: Russia’s aggression against Ukraine in early 2022 resulted in a large migration of refugees to many countries, including Poland. Vaccination coverage for some infectious diseases in Ukraine is lower than in Poland; consequently, the incidence of infectious diseases—including measles, poliomyelitis, tuberculosis, and COVID-19—is higher. We aimed to investigate whether the migration of Ukrainians had influenced decisions of Polish parents on having their children vaccinated and to examine their attitudes towards vaccinations. Material and methods: A cross-sectional online survey study was designed. Data on parents’ demographics, attitudes toward vaccination, and knowledge of the current epidemiological situation in Poland were collected. Parents participating in the study were divided into two subgroups for further analysis according to their decisions to have their children vaccinated. Results: A total of 568 questionnaires were collected, of which 21 did not meet the inclusion criteria for the analysis (respondents were not parents). The Ukrainian immigrants’ influx affected 54 (9.87%) participants in their decision of having their children vaccinated. Respondents in this group were more likely to have a positive attitude toward recommended vaccinations (p = 0.0428); in addition, they more often had their children vaccinated with recommended vaccinations (p = 0.0063), believed the vaccination coverage with mandatory vaccinations was higher in Poland than in Ukraine (p = 0.0014), and believed the incidence of diseases covered by mandatory (p = 0.0472) and recommended (p = 0.0097) vaccinations was higher in Ukraine. In addition, parents who declared that the migration had affected their decision regarding their children’s vaccinations had more often been vaccinated due to the influx of Ukrainian immigrants (p < 0.00001) and were more likely to be aware of how migration had impacted the current epidemiological situation in Poland (p = 0.0021). Moreover, the survey more often made these participants think about getting additional vaccinations for themselves (p < 0.0001) and their children (p < 0.0001). Conclusions: The Ukrainian immigrants’ influx affected nearly one tenth of surveyed parents in their decision of having their children vaccinated. This group was more aware of the differences between infectious diseases’ epidemiology in Poland and Ukraine. In addition, they also had a more positive attitude toward vaccinations.

1. Introduction

Russia’s aggression against Ukraine in February 2022 resulted in a large migration of refugees to many countries. As of January 2023, an estimated 9.5 million people have crossed the Polish border since the war began [1]. Among them, many have settled in Poland. The level of vaccination and incidence rate of certain infectious diseases in Ukraine is described by the World Health Organization (WHO) as alarming. In particular, these include measles, polio, tuberculosis, and COVID-19 [2]. Since the beginning of the COVID-19 pandemic, there has been a lot of misinformation in Ukraine, leading to a low vaccination rate against the SARS-CoV-2 virus [3]. On the day the war broke out, only 34% of the population was vaccinated [4]. Measles outbreaks were also reported in Ukraine in the second decade of the 21st century due to a sharp decline in public confidence in vaccinations after the crisis and war in 2010. In 2018, the number of cases exceeded 54,000 [5]. In 2002, the European region was declared a polio-free area. However, in 2015, two unrelated cases of children being paralyzed by the wild poliovirus were reported in Ukraine [6]. In addition, tuberculosis is becoming a growing problem, making Ukraine the fifth country in the world with the highest number of extensively drug-resistant confirmed cases [7]. Factors that compound the risk of an epidemic include poor sanitation and overcrowding in refugee asylums [8]. In March 2022, the WHO identified the most needed vaccinations for refugees, which included vaccinations against COVID-19; measles, mumps, and rubella (MMR); diphtheria, tetanus, and pertussis (DTP); poliomyelitis; and Hemophilus Influenzae type B (Hib). Hepatitis B, meningococcus, pneumococcus, chickenpox, influenza, and tuberculosis should also be considered depending on the season, epidemiological situation, and living conditions [2]. The above might pose a major public health challenge in Poland [9]. This is the reason why vaccination should be especially promoted among both Polish citizens and migrants from Ukraine. Mandatory and recommended vaccinations in Poland are regulated by the immunization program and are shown in Table 1. We aimed to investigate whether the migration of Ukrainians had influenced parents’ decisions on having their children vaccinated and to examine their attitudes towards vaccinations. We focused on comparing the population that declared the impact of Ukrainian migration on their children’s vaccination decisions with the group that did not.

2. Materials and Methods

2.1. Study Design and Participants

A cross-sectional survey study was designed. The questionnaire included 25 single-choice and 4 multiple-choice questions on demographics (gender, age, place of residence, and education), whether respondents were parents of a child/children under 18, their attitudes toward vaccination, and their knowledge of the current epidemiological situation in Poland. The division into mandatory and recommended vaccinations was carried out on the basis of the law regulating the program of immunization in Poland in 2023.
Data were collected through an online survey, which was created using the “Google Forms” application between 15 November 2022 and 4 January 2023 and distributed via social media (Facebook and Instagram) on forums and social media groups/accounts related to parenting issues. Each participant was asked to complete the survey only once. There was no time limit to access the form. After completing the survey, participants received feedback on the epidemiological situation in Ukraine and Poland for education purposes.
After collecting responses, the study group was divided into two subgroups for further analysis. Stratification was performed according to the declared impact of Ukrainian migration on participants’ decisions as to whether they would vaccinate their children or not.

2.2. Inclusion Criteria

Inclusion criteria were completing the form and being a parent of at least one child under the age of 18.
By completing the questionnaire, each respondent agreed to anonymously participate in the study and gave consent for publication of the results of this study.

2.3. Exclusion Criteria

The exclusion criterion considered the indication that one is not a parent of a child/children under 18 years of age. Twenty-one surveys were rejected because respondents answered that they were not parents.

2.4. Statistical Analysis

The Mann–Whitney U test was performed to compare continuous variables and the chi2 or Fisher exact test were used to evaluate categorical variables. A p-value of <0.05 was considered significant. Statistical analysis was performed using Quick Statistics Calculators (available at https://www.socscistatistics.com, accessed on 20 January 2023).

3. Results

In total, 568 questionnaires were collected, of which 21 were excluded due to not meeting the inclusion criteria. The median age of the study participants was 34 (interquartile range (IQR): 31–39 years). The majority were females (503/547 (91.96%). Cities with over 500,000 inhabitants were the place of residence for 179/547 (32.72%) respondents, and a college degree was obtained by 472/547 (82.29%).
A positive attitude toward vaccination was declared by 497/547 (90.86%) study participants. According to the surveyed population, the Ukrainian immigrants’ influx had affected 54/547 (9.87%) people in their decision of having their children vaccinated. No influence on this decision was declared by 493/547 (90.12%) participants.
Respondents whose vaccination decisions were influenced by the migration of Ukrainians were more likely to have a positive attitude toward the use of recommended vaccinations (49/54, 90.74% vs. 433/497, 87.23%; p = 0.0428), have their children vaccinated with recommended vaccinations (47/54, 87.04% vs. 401/493, 81.34%; p = 0.0063), were more likely to believe the vaccination rate with mandatory vaccinations was higher in Poland than in Ukraine (49/54, 90.74% vs. 384/493, 77.89%; p = 0. 0014), believed that the incidence rate of diseases covered by mandatory vaccinations was higher in Ukraine than in Poland (48/54, 88.89% vs. 364/493, 73.83%; p = 0.0472), believed the incidence rate of diseases covered by recommended vaccinations was higher in Ukraine than in Poland (49/54, 90.74% vs. 353/493, 71.60%; p = 0.0097), were more likely to have been vaccinated due to the influx of Ukrainian immigrants (17/54, 31.48% vs. 9/493, 1.83%; p < 0.00001), and were more likely to be aware of how the influx of migrants from Ukraine had affected the epidemiological situation in Poland (40/54, 74.07% vs. 271/493, 54.97%; p = 0.0021). More often than not, the survey made participants whose vaccination decisions were influenced by the migration of Ukrainians think about getting additional vaccinations (41/54, 75.93% vs. 164/493, 33.27%; p < 0.0001) and having their children vaccinated with additional vaccines (44/54, 81/48% vs. 162/493, 32.86%; p < 0.0001) (See Table 2 and Table 3).
There was no significant difference in vaccines chosen by parents between the two groups. Participants most often chose for themselves to be vaccinated against pertussis (19, 3.47%), SARS-CoV-2 (18, 3.29%), and influenza (16, 2.93%), while they intended to be vaccinated against influenza (16, 2.93%), SARS-CoV-2 (10, 1.83%), meningococcal disease (8,1.46%), and pertussis (8, 1.46%). In an analogous question about the participants’ children, most children had already been vaccinated against meningococcal disease (18, 3.29%), influenza (18, 3.29%), and varicella (16, 2.93%). Likewise, their parents most often intended to have them vaccinated against varicella (14, 2.56%), meningococcal disease (14, 2.56%), and influenza (13.2.38%).

4. Discussion

The problem of evading mandatory vaccinations is growing worldwide, including Poland. It poses a huge threat to the public health in this country. In 2015, in Poland, infectious diseases caused about 1900 deaths, of which 300 deaths were due to hepatitis B and more than 500 due to pulmonary tuberculosis. Both diseases may be effectively prevented with mandatory vaccinations implemented within the first year of life [11]. Between 2015 and 2019, the percentage of children in Poland who were not vaccinated as a result of their parents’ conscious decision tripled. The rate of refusal to vaccinate children and adolescents per 1000 people was 2.3 in 2015, 6.6 in 2019, and 8.3 in 2021 [12,13]. A particularly visible effect of such a trend was the sharp increase in measles cases in 2018 and 2019 [14,15]. According to Szalonek A., fear of complications after vaccination is the most common reason for parents to avoid vaccinating their children [16]. In addition, strong anti-vaccine beliefs are related to respondents’ deep religiosity and living in a city with a small or medium population [17]. In reference to a study conducted by Kraśnicka J. et al., Poles’ attitudes toward mandatory vaccinations vary widely by age. There is a big difference between 41–50-year-olds and 18–30-year-olds, with a much smaller proportion of younger parents supporting mandatory immunization (OR = 0.352) [18]. In our survey, there were no significant differences in vaccinating children according to the guidelines among respondents whose vaccination decisions were influenced by the influx of Ukrainian immigrants and those who were not (53/54, 98.15% vs. 484/497, 98.17%; p = 0.9891).
The following Polish studies examined parents’ feelings about recommended vaccines: according to Janosz J. et al., a positive attitude towards the recommended vaccinations was recorded in 60% of the parents who had children under 3 years of age [19]; according to Lipska E. et al., 44% of surveyed parents had their children vaccinated with at least one recommended vaccine [20]; according to Pisaniak P. et al., 66.41% of the parents would reach for the recommended vaccinations for their children if they were free of charge. Nevertheless, in that study, respondents who refused to have their children vaccinated would not like to receive the vaccines, even if they were free [21]. A Polish large survey study revealed that the majority of women wanted to be vaccinated and have their children vaccinated, and considered vaccines to be safe and effective against infectious diseases [22]. According to Świątoniowska N.A. et al., 60.8% of mothers declared that it is worth vaccinating their children with recommended vaccinations [23]. In our survey, 482/547 (88.12%) participants specified that they were in favor of the implementation of recommended vaccines. In addition, respondents whose decisions regarding vaccinations were influenced by the migration of Ukrainians more frequently had their children vaccinated with recommended vaccinations (47/54, 87.04% vs. 401/493, 81.34%; p = 0.0063).
Male parents, parents who had a university education, and parents who had not been exposed to adverse reactions after vaccination in the past were more likely to report that their children have received the recommended vaccinations [18]. Moreover, parents who vaccinated their children with recommended vaccines showed significantly higher levels of health practices (daily habits regarding sleep and rest) compared with those who did not have their children vaccinated with these vaccines [24]. A study conducted by Ganczak M. et al. on factors influencing parents’ willingness to vaccinate their children against Human Papilloma Virus (HPV), which is one of the recommended vaccinations, showed that mothers were more likely to have their children vaccinated than fathers (90.8% vs. 82.8%, p = 0.03). The study also showed that working parents were more likely to report willingness to have their children vaccinated compared with unemployed parents (87.0% vs. 79.0%, p = 0.05). In contrast, no differences were found in terms of age, place of residence, education level, marital status, number of children in the family, or religiosity [25]. Dąbek J. et al. showed an association between the use of recommended vaccination and age (p = 0.002) or education level (p = 0.004). Among respondents using recommended vaccinations, those aged 18–30 years and those with tertiary education had the highest proportion [26]. In our survey, respondents whose vaccination decisions were influenced by the migration of Ukrainians were more likely to have a positive attitude toward the use of recommended vaccinations (49/54, 90.74% vs. 433/497, 87.23%; p = 0. 0428).
The influx of many refugees from Ukraine may pose a potential epidemiological threat. It is associated with infectious diseases including, e.g., COVID-19, measles, and poliomyelitis [27]. Rzymski P. et al. showed that by February 24, 2022, only 35% of the Ukrainian population had been vaccinated with the complete initial COVID-19 schedule and only 1.7% had received a booster dose. By comparison, in the European Economic Area countries during the same period, 72% of people were fully vaccinated against COVID-19 while as many as 51% had received a booster dose [4]. Such a low percentage of vaccinated people in the Ukrainian population may be primarily due to the delayed introduction of vaccines; massive misinformation in the media, probably resulting from the ongoing hybrid war there; online campaigns deprecating vaccines; and incitement by Russian propaganda against health care institutions [3]. Referring to Wadman M. in 2018, the number of measles cases in Europe tripled. Of the 83,000 measles cases across Europe, more than 54,000 were detected in Ukraine. Such a huge increase was the result of political and armed conflicts, delays in the vaccines’ delivery to health institutions, and the growing reluctance to be vaccinated [5]. In Ukraine, the vaccination rate for poliomyelitis with the three-dose vaccine dropped from 91% in 2008 to barely 15% in mid-2015. In 2010, Ukraine was recognized by the WHO as a high-risk country for poliomyelitis. After two unvaccinated children with vaccine-derived polio virus paralysis were identified in August 2015, it was decided to launch three rounds of a nationwide vaccination campaign among children. Ukrainian children are at a higher risk of contracting the polio virus due to lower vaccination rates than in other countries. In 2017, only 48% of children in Ukraine received all three vaccine doses against polio [28]. A nationwide vaccination campaign targeting nearly 140,000 children in Ukraine was scheduled to begin in February 2022 but had to be halted due to the Russian invasion. Because of this situation, some children have not been vaccinated at all or have been vaccinated incompletely [4]. Tuberculosis is prevalent throughout Ukraine; according to a study by Cojocaru et al., the incidence of tuberculosis in the pediatric population is rising [29]. Compared with 2014, there was an 8% increase in new cases among children in 2015. It is estimated that the actual incidence of tuberculosis in Ukraine is 94 cases per 100,000 population. About 25% of cases remain undiagnosed. Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) account for an increasing percentage of all tuberculosis cases. Therefore, due to the influx of a large number of refugees and immigrants, TB must not be forgotten, despite the fact that in the WHO European region the rates of this infectious disease are low [29]. In our survey, those whose vaccination decisions regarding their children were influenced by the influx of Ukrainian immigrants were more frequently aware of how the influx of emigrants from Ukraine affected the epidemiological situation in Poland (40/54, 74.07% vs. 346/493, 54.97%; p = 0.0021) and were more likely to have been vaccinated due to these circumstances (17/54, 31.48% vs. 9/493, 1.83%; p < 0.00001).
Lack of awareness regarding the need for vaccination is one of the main factors contributing to vaccine hesitancy and avoiding mandatory vaccines [30]. Greater knowledge of the disease and its potential consequences is associated with a greater willingness to be vaccinated. This is confirmed by studies regarding influenza [31], meningococcal disease [32], and human papillomavirus [33]. In our survey, respondents whose vaccination decision-making was influenced by the migration of Ukrainians were more likely to believe the vaccination rate with mandatory vaccinations was higher in Poland than in Ukraine (49/54, 90.74% vs. 384/493, 77.89%; p = 0. 0014), believed that the incidence rate of diseases covered by mandatory vaccinations was higher in Ukraine than in Poland (48/54, 88.89% vs. 364/493, 73.83%; p = 0.0472). This indicates that they were more aware of the current epidemiological situation regarding infectious diseases in both countries.
According to the survey study conducted by Zaprutko T. et al., Poles were significantly more likely to be vaccinated against influenza and COVID-19 than Ukrainians. In addition, Ukrainians were less likely to oppose making these vaccinations mandatory [34]. In our study, participants whose vaccination decisions were influenced by the migration of Ukrainians were more likely to believe the incidence rate of diseases covered by recommended vaccinations was higher in Ukraine than in Poland (49/54, 90.74% vs. 353/493, 71.60%; p = 0.0097). There was no significant difference between the two subgroups regarding awareness of the vaccination rate with recommended vaccinations, vaccination rate with SARS-CoV-2 vaccine, and COVID-19 incidence in Poland and Ukraine.
According to Jarret C. et al., dealing with vaccine hesitancy includes increasing vaccination knowledge and awareness [35]. In a study by Lewandowska A. et al., more than half of the parents expressed concern about the supposedly harmful effects of vaccination on their children’s health. Parents reported adverse vaccine reactions (22%), autism (7%), and child’s death (6%) as their main concerns [36]. Negative attitudes towards vaccination are mainly due to lack of knowledge. According to a study by Tang et al., parents are more likely to have their children vaccinated than themselves, especially when the risks of not vaccinating are higher [37]. Referring to Tump et al., people who are confident in their private decisions pay less attention to information coming from the outside [38]. This may explain why the opinion of those who did not express a desire to have their children vaccinated due to the influx of immigrants at the beginning of filling out the questionnaire did not change, while among those who did, the questionnaire was more likely to make them think about having additional vaccinations (41/54, 75. 93% vs. 164/493, 33.27%; p < 0.001) and having their children vaccinated with an additional vaccine (44/54, 81.48% vs. 162/493, 32.86%; p < 0.0001).

Limitations

This study has limitations. The questionnaire did not contain restrictions that prevented one person from completing it more than once. The survey was conducted more than six months after the beginning of the influx of migrants from Ukraine. Over time, respondents may have become accustomed to the situation by paying less attention to it. In addition, data were collected through an online survey. The opinions of parents who were very busy and had less access to the internet might have been excluded from this study. However, there are also a few strengths worth mentioning. A large population of people was surveyed and the questions were straightforward and easy to fill (no additional comments from respondents were obtained). In addition, the questionnaire was completely anonymous; therefore, study participants were encouraged and willing to give honest answers.

5. Conclusions

The Ukrainian immigrants’ influx affected 9.87% of surveyed parents in their decision to have their children vaccinated. This group was more aware of the differences in infectious diseases’ epidemiologies in Poland and Ukraine. In addition, they had a more positive attitude toward vaccinations and, more often, the survey made them think about getting additional vaccinations for themselves and their children.

Author Contributions

M.C.: conceptualization, methodology, investigation, and writing—original draft; M.S.: conceptualization, methodology, investigation, and writing—original draft; C.B.: conceptualization, methodology, writing—review and editing, project administration, supervision; M.P.-Ś.: conceptualization, methodology, writing—review and editing, supervision. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Medical University of Warsaw’s Bioethics Committee. Approval number: AKBE/6/2023.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data sets used and/or analyzed during the current study can be made available by the corresponding author upon reasonable request.

Acknowledgments

We would like to thank Krzysztof J. Filipiak, Anna Wasiewicz, Agnieszka Barchnicka, Magda Krygier, Dagmara Adamska-Tomaszewska, Zuzanna Lipiec-Rzepecka, Joanna Leśnik, and Olga Kryvonos for sharing the survey on their Instagram profiles, mental support, and constructive criticism.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Checks at Border Crossings from Ukraine to Poland. 2023. Available online: https://twitter.com/Straz_Graniczna/status/1619588627234971648?cxt=HHwWgIDTidHR9_ksAAAA (accessed on 20 January 2023).
  2. European Centre for Disease Prevention and Control. Operational public health considerations for the prevention and control of infectious diseases in the context of Russia’s aggression towards Ukraine. Stockholm, 8 March 2022. [Google Scholar]
  3. Patel, S.S.; Moncayo, O.E.; Conroy, K.M.; Jordan, D.; Erickson, T.B. The Landscape of Disinformation on Health Crisis Communication during the COVID-19 Pandemic in Ukraine: Hybrid Warfare Tactics, Fake Media News and Review of Evidence. JCOM J. Sci. Commun. 2020, 19, A02. [Google Scholar] [CrossRef] [PubMed]
  4. Rzymski, P.; Fulfushynska, H.; Fal, A. Vaccination of Ukrainian Refugees: Need for Urgent Action. Clin. Infect. Dis. 2022, 75, 1103–1108. [Google Scholar] [CrossRef] [PubMed]
  5. Wadman, M. Measles epidemic in Ukraine drove troubling European year. Science 2019, 363, 677–678. [Google Scholar] [CrossRef] [PubMed]
  6. Khetsuriani, N.; Perehinets, I.; Nitzan, D.; Popovic, D.; Moran, T.; Allahverdiyeva, V.; Huseynov, S.; Gavrilin, E.; Slobodianyk, L.; Izhyk, O.; et al. Responding to a cVDPV1 outbreak in Ukraine: Implications, challenges and opportunities. Vaccine 2017, 35, 4769–4776. [Google Scholar] [CrossRef]
  7. Holt, E. Tuberculosis services disrupted by war in Ukraine. Lancet Infect. Dis. 2022, 22, e129. [Google Scholar] [CrossRef]
  8. Castelli, F.; Sulis, G. Migration and infectious diseases. Clin. Microbiol. Infect. 2017, 23, 283–289. [Google Scholar] [CrossRef] [Green Version]
  9. Lewtak, K.; Kanecki, K.; Tyszko, P.; Goryński, P.; Bogdan, M.; Nitsch-Osuch, A. Ukraine war refugees—Threats and new challenges for healthcare in Poland. J. Hosp. Infect. 2022, 125, 37–43. [Google Scholar] [CrossRef]
  10. Saczka, K. Communiction from the Chief Sanitary Inspector of 28th October 2022 on the Immunization Programme for 2023; Official Journal of the Minister for Health: Warsaw, Poland, 2022. [Google Scholar]
  11. Paplicki, M.; Susło, R.; Benedikt, A.; Drobnik, J. Effectively enforcing mandatory vaccination in Poland and worldwide. Fam. Med. Prim. Care Rev. 2020, 22, 252–256. [Google Scholar] [CrossRef]
  12. National Institute of Public Health NIH. National Research Institute Department of Epidemiology and Surveillance of Infectious Diseases Chief Sanitary Inspectorate—Department of Epidemic Prevention and Border Sanitary Protection. Vaccinations in Poland in 2021. 2021. Available online: http://wwwold.pzh.gov.pl/oldpage/epimeld/2021/Sz_2021.pdf (accessed on 15 February 2023).
  13. Reczulska, A.; Tomaszewska, A.; Raciborski, F. Level of Acceptance of Mandatory Vaccination and Legal Sanctions for Refusing Mandatory Vaccination of Children. Vaccines 2022, 10, 811. [Google Scholar] [CrossRef]
  14. National Institute of Public Health NIH. National Research Institute Department of Epidemiology and Surveillance of Infectious Diseases Inspectorate—Department of Epidemic Prevention and Border Sanitary Protection Infectious diseases and poisonings in Poland in 2018. 2018. Available online: http://wwwold.pzh.gov.pl/oldpage/epimeld/2018/Ch_2018.pdf (accessed on 15 February 2023).
  15. National Institute of Public Health NIH. National Research Institute Department of Epidemiology and Surveillance of Infectious Diseases Inspectorate—Department of Epidemic Prevention and Border Sanitary Protection Infectious diseases and poisonings in Poland in 2019. Available online: http://wwwold.pzh.gov.pl/oldpage/epimeld/2019/Ch_2019.pdf (accessed on 15 February 2023).
  16. Szalonka, A. Antagonistyczne Postawy Wobec Szczepień Zagrożeniem dla Cywilizacji; Nowak, W.R., Szalonka, K.R., Waniowski, P.R., Niemczyk, A.R., Eds.; E-Wydawnictwo. Prawnicza i Ekonomiczna Biblioteka Cyfrowa. Wydział Prawa, Administracji i Ekonomii Uniwersytetu Wrocławskiego: Wrocław, Poland, 2019. [Google Scholar]
  17. Włodarska, A.; Gujski, M.; Pinkas, J.; Raciborski, F. The influence of socio-demographic characteristics on attitudes towards prophylactic vaccination in Poland. Int. J. Occup. Med. Environ. Health 2021, 34, 121–132. [Google Scholar] [CrossRef]
  18. Kraśnicka, J.; Krajewska-Kułak, E.; Klimaszewska, K.; Cybulski, M.; Guzowski, A.; Kowalewska, B.; Jankowiak, B.; Rolka, H.; Doroszkiewicz, H.; Kułak, W. Mandatory and recommended vaccinations in Poland in the views of parents. Hum. Vaccin. Immunother. 2018, 14, 2884–2893. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  19. Janosz, J.L.; Łukasik, R.J. Parents’ knowledge and attitudes towards the use of recommended and combined vaccinations in children under 3 years of age in the malopolskie voivodship. Pol. Nurs. 2020, 1, 24–32. [Google Scholar]
  20. Lipska, E.; Lewińska, M.; Górnicka, G. Recommended vaccinations among children and parents’ opinions on vaccinations. Nowa Medycyna 2013, 2, 64–69. [Google Scholar]
  21. Pisaniak, P.; Tarczon, A.; Konarska, M.; Ozga, D. Parents’ Opinions and Knowledge About Vaccination in Poland—A Cross-Sectional Observational Study. Int. J. Gen. Med. 2021, 14, 3235–3242. [Google Scholar] [CrossRef] [PubMed]
  22. Bienkowski, C.; Kowalczyk, M.; Golik, A.; Kacperczyk-Bartnik, J.; Bartnik, P.; Dobrowolska-Redo, A.; Romejko-Wolniewicz, E.; Pokorska-Spiewak, M. The attitude of Polish women planning pregnancy and/or having children towards vaccinations: A cross-sectional survey study. Ginekol. Pol. 2022, 93, 655–661. [Google Scholar] [CrossRef]
  23. Świątoniowska, N.A.; Rozensztrauch, A. Vaccinations through the mother’s eyes. J. Educ. Health Sport 2017, 7, 11–19. [Google Scholar]
  24. Kraśnicka, J.; Krajewska-Kułak, E.; Klimaszewska, K.; Cybulski, M.; Guzowski, A.; Lewko, J.; Łukaszuk, C.; Kowalczuk, K.; Doroszkiewicz, H.; Baranowska, A.; et al. The impact of parents’ health behaviours on their preferences regarding vaccinations in Bialystok, Poland. BMC Pediatr. 2020, 20, 354. [Google Scholar] [CrossRef]
  25. Ganczak, M.; Owsianka, B.; Korzeń, M. Factors that Predict Parental Willingness to Have Their Children Vaccinated against HPV in a Country with Low HPV Vaccination Coverage. Int. J. Environ. Res. Public Health 2018, 15, 645. [Google Scholar] [CrossRef] [Green Version]
  26. Dąbek, J.; Sierka, O.; Gąsior, Z. Protective vaccinations in the control and prevention of infectious diseases—Knowledge of adult Poles in this field. Preliminary results. BMC Public Health 2022, 22, 2342. [Google Scholar] [CrossRef]
  27. Roberts, L. Surge of HIV, tuberculosis and COVID feared amid war in Ukraine. Nature 2022, 603, 557–558. [Google Scholar] [CrossRef]
  28. Loboda, A.; Smiyan, O.; Popov, S.; Petrashenko, V.; Zaitsev, I.; Redko, O.; Zahorodnii, M.; Kasyan, S. Child health care system in Ukraine. Turk. Arch. Pediatr./Türk Pediatri Arşivi 2020, 55 (Suppl. S1), 98–104. [Google Scholar]
  29. Cojocaru, E.; Cojocaru, C.; Cojocaru, E.; Oancea, C.I. Health Risks During Ukrainian Humanitarian Crisis. Risk Manag. Healthc. Policy 2022, 15, 1775–1781. [Google Scholar] [CrossRef]
  30. Dubé, E.; Laberge, C.; Guay, M.; Bramadat, P.; Roy, R.; Bettinger, J. Vaccine hesitancy: An overview. Hum. Vaccin. Immunother. 2013, 9, 1763–1773. [Google Scholar] [CrossRef] [Green Version]
  31. Abu-Rish, E.Y.; Elayeh, E.R.; Mousa, L.A.; Butanji, Y.K.; Albsoul-Younes, A.M. Knowledge, awareness and practices towards seasonal influenza and its vaccine: Implications for future vaccination campaigns in Jordan. Fam. Pract. 2016, 33, 690–697. [Google Scholar] [CrossRef] [Green Version]
  32. Richardson, E.; Ryan, K.A.; Lawrence, R.M.; Harle, C.A.; Desai, S.M.; Livingston, M.D.; Rawal, A.; Staras, S.A.S. Increasing awareness and uptake of the MenB vaccine on a large university campus. Hum. Vaccin. Immunother. 2021, 17, 3239–3246. [Google Scholar] [CrossRef]
  33. Samkange-Zeeb, F.; Spallek, L.; Klug, S.J.; Zeeb, H. HPV infection awareness and self-reported HPV vaccination coverage in female adolescent students in two German cities. J. Community Health 2012, 37, 1151–1156. [Google Scholar] [CrossRef] [Green Version]
  34. Zaprutko, T.; Kremin, Y.; Michalak, M.; Bernatoniene, J.; Zaprutko, L.; Hudz, N.; Stolecka, A.; Cynar, J.; Niewczas, K.; Sprawka, J.; et al. Social Attitude to COVID-19 and Influenza Vaccinations after the Influenza Vaccination Season and between the Second and Third COVID-19 Wave in Poland, Lithuania, and Ukraine. Int. J. Environ. Res. Public Health 2022, 19, 2042. [Google Scholar] [CrossRef]
  35. Jarrett, C.; Wilson, R.; O’Leary, M.; Eckersberger, E.; Larson, H.J. Strategies for addressing vaccine hesitancy—A systematic review. Vaccine 2015, 33, 4180–4190. [Google Scholar] [CrossRef] [Green Version]
  36. Lewandowska, A.; Lewandowski, T.; Rudzki, G.; Rudzki, S.; Laskowska, B. Opinions and Knowledge of Parents Regarding Preventive Vaccinations of Children and Causes of Reluctance toward Preventive Vaccinations. Int. J. Environ. Res. Public Health 2020, 17, 3694. [Google Scholar] [CrossRef]
  37. Tang, M.Y.; Shahab, L.; Robb, K.A.; Gardner, B. Are parents more willing to vaccinate their children than themselves? J. Health Psychol. 2016, 21, 781–787. [Google Scholar] [CrossRef] [Green Version]
  38. Tump, A.N.; Pleskac, T.J.; Kurvers, R. Wise or mad crowds? The cognitive mechanisms underlying information cascades. Sci. Adv. 2020, 6, eabb0266. [Google Scholar] [CrossRef]
Table
Table 1. Mandatory and recommended vaccinations in Poland [10].
Table 1. Mandatory and recommended vaccinations in Poland [10].
Mandatory VaccinationsRecommended AgeRecommended VaccinationsRecommended Age
BCG—tuberculosis 1 day Meningococcal diseaseAfter 2 mths
Hepatitis B 1 day, 2 and 7 mthsVaricella After 13 mths
Rotavirus 2–6 mthsHuman Papillomavirus InfectionAfter 12 yrs
Diphtheria2, 3–4, 5–6, 16–18 mths, 6, 14, 19 yrsTick-borne encephalitis After 13 mths
Tetanus 2, 3–4, 5–6, 16–18 mths, 6, 14, 19 yrsHepatitis AAfter 13 mths
Pertussis2, 3–4, 5–6, 16–18 mths, 6 and 14 yrsInfluenza After 6 mths or after 2 yrs *
Inactivated Poliovirus Vaccine3–4, 5–6, 16–18 mthsCoronavirus disease
(COVID-19)		After 6 mths
Haemophilus influenzae type B infection2, 3–4, 5–6, 16–18 mths, 6 yrs
Pneumococcal disease 2, 4, 13–15 mths
Measles, Mumps, Rubella 13–15 mths, 6 yrs
mths—months, yrs—years; * depends on the type of the vaccine.
Table
Table 2. Baseline characteristics of parents participating in the study stratified by the influence of Ukrainian immigrants’ influx to Poland in 2022.
Table 2. Baseline characteristics of parents participating in the study stratified by the influence of Ukrainian immigrants’ influx to Poland in 2022.
CharacteristicTotal N = 547Influenced N = 54Not Influenced N = 493p-Value
Age in years, median [IQR]34 [31,39]33 [29–37.75]34 [31,39]0.0293
Female sex, n (%)503 (91.96)50 (92.59)453 (91.89)0.9309
Place of residence, n (%)
Rural areas137 (25.05)12 (22.22)125 (25.35)0.7461
City < 50,00081 (14.81)9 (16.67)72 (14.60)
City 50,000–100,000 67 (12.25)9 (16.67)58 (11.76)
City 100,000–500,00083 (15.17)6 (11.11)77 (15.62)
City > 500,000179 (32.72)18 (33.33)161 (32.66)
Education, n (%)
Primary1 (0.18)0 (0.0)1 (0.20)
Vocational5 (0.91)1 (1.85)4 (0.81)0.7993
Secondary55 (10.05)6 (11.11)49 (9.94)
Currently studying 14 (2.56)2 (3.70)12 (2.43)
Higher472 (82.29)45 (83.33)427 (86.61)
Attitude toward vaccination, n (%)
Positive497 (90.86)50 (92.59)447 (90.67)0.7489
Negative7 (1.28)1 (1.85)6 (1.22)
Neutral43 (7.86)3 (5.56)40 (8.11)
Opinion on usage of recommended vaccination, n (%)
In favor482 (88.12)49 (90.74)433 (87.83)0.0428
Against15 (2.74)1 (1.85)14 (2.84)
No opinion 50 (9.14)4 (7.41)46 (9.33)
Were vaccinated against SARS-CoV-2, n (%)
4 doses99 (18.10)10 (18.52)89 (18.05)0.8466
3 doses266 (48.63)24 (44.44)242 (49.09)
2 doses115 (21.02)14 (25.93)101 (20.49)
1 dose15 (2.74)2 (3.70)13 (2.64)
None 52 (9.51)4 (7.41)48 (9.74)
Child vaccinated according to the guidelines, n (%)537 (98.17)53 (98.15)484 (98.17)0.9891
Child vaccinated with recommended vaccines, n (%)
Yes448 (81.90)47 (87.04)401 (81.34)0.0063
No91 (16.64)4 (7.41)87 (17.65)
Unknown 8 (1.46)3 (5.56)5 (1.01)
Child vaccinated against SARS-CoV-2, n (%)416 (76.05)45 (83.33) 371 (75.25)0.1857
Believed there is a difference in vaccination schedules in Poland and Ukraine, n (%)507 (92.69)53 (98.15)454 (92.09)0.1045
Impact of migration on vaccination decisions, n (%)
Already vaccinated26 (4.75)17 (31.48)9 (1.83)<0.00001
Wanted to get vaccinated29 (5.30)15 (27.78)14 (2.84)
No impact492 (89.95)22 (40.74)470 (95.33)
Opinion about statistics concerning vaccination and incidence rate presented in the study, n (%)
The differences were greater73 (13.35)6 (11.11)67 (13.59)0.6743
The differences were lesser141 (25.78)16 (29.63)125 (25.35)
The statistics presented the opposite11 (2.01)2 (3.70)9 (1.83)
Presented statistics were not surprising322 (58.87)30 (55.56)292 (59.23)
Awareness of the impact of the influx of immigrants on the epidemiological situation in Poland, n (%)
Declared awareness311 (56.86)40 (74.07)271 (54.97)0.0021
Declared knowledge about the situation but no concern85 (15.54)10 (18.52)75 (15.21)
Lack of awareness151 (27.61)4 (7.41)147 (29.82)
Our study prompted them to think about getting additional vaccinations, n (%)205 (37.48)41 (75.93)164 (33.27)<0.0001
Our study prompted them to think about getting additional vaccinations for their children, n (%)206 (37.66)44 (81.48)162 (32.86)<0.0001
IQR—interquartile range.
Table
Table 3. Parent’s knowledge of the current epidemiological situation in Poland and Ukraine.
Table 3. Parent’s knowledge of the current epidemiological situation in Poland and Ukraine.
Vaccination Rate with Mandatory Vaccinations in Poland and Ukraine, n (%)
CharacteristicTotal N = 547Influenced N = 54Not Influenced N = 493p-Value
Believed vaccination rate is higher in Poland433 (79.16)49 (90.74)384 (77.89)0.0014
Believed vaccination rate is higher in Ukraine14 (2.56)1 (1.85)13 (2.64)
Believed there are no differences100 (18.28)4 (7.41)96 (19.47)
Level of incidence of diseases that are covered by mandatory vaccinations in Poland and Ukraine, n (%)
Incidence rate is higher in Poland13 (2.38)1 (1.85)12 (2.43)0.0472
Incidence rate is higher in Ukraine412 (75.50)48 (88.89)364 (73.83)
There are no differences122 (22.12)5 (9.26)117 (23.73)
Vaccination rate with recommended vaccinations in Poland and Ukraine, n (%)
Vaccination rate is higher in Poland417 (76.23)46 (85.19)371 (75.25)0.2093
Vaccination rate is higher in Ukraine19 (3.74)2 (3.70)17 (3.45)
There are no differences111 (20.29)6 (11.11)105 (21.30)
Level of incidence of diseases covered by recommended vaccinations in Poland and Ukraine, n (%)
Incidence rate is higher in Poland17 (3.11)1 (1.85)16 (3.25)0.0097
Incidence rate is higher in Ukraine402 (73.49)49 (90.74)353 (71.60)
There are no differences128 (23.40)4 (7.41)124 (25.15)
Vaccination rate with SARS-CoV-2 vaccine in Poland and Ukraine, n (%)
Vaccination rate is higher in Poland386 (70.57)36 (66.67)350 (70.99)0.7036
Vaccination rate is higher in Ukraine24 (4.39)3 (5.56)21 (4.26)
There are no differences130 (23.77)15 (27.78)115 (23.33)
No answer7 (1.28)07 (1.42)
Level of COVID-19 incidence in Poland and Ukraine, n (%)
Incidence rate is higher in Poland29 (5.30)2 (3.70)27 (5.48)0.6239
Incidence rate is higher in Ukraine297 (54.30)33 (61.11)264 (53.55)
There are no differences211 (38.57)19 (35.19)192 (38.95)
No answer10 (1.83)010 (2.03)
Impact of influx of migrants from Ukraine on the incidence rate of the infectious diseases mentioned earlier in Poland, n (%)
Incidence rate is higher396 (72.39)48 (88.89)348 (70.59)0.0043
Incidence rate is lower000
There are no differences151 (27.61)6 (11.11)145 (29.41)
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Cholewik, M.; Stępień, M.; Bieńkowski, C.; Pokorska-Śpiewak, M. Parents’ Attitudes towards Vaccinations Regarding the Ukrainian Migration to Poland in 2022. Vaccines 2023, 11, 1306. https://doi.org/10.3390/vaccines11081306

AMA Style

Cholewik M, Stępień M, Bieńkowski C, Pokorska-Śpiewak M. Parents’ Attitudes towards Vaccinations Regarding the Ukrainian Migration to Poland in 2022. Vaccines. 2023; 11(8):1306. https://doi.org/10.3390/vaccines11081306

Chicago/Turabian Style

Cholewik, Martyna, Maciej Stępień, Carlo Bieńkowski, and Maria Pokorska-Śpiewak. 2023. "Parents’ Attitudes towards Vaccinations Regarding the Ukrainian Migration to Poland in 2022" Vaccines 11, no. 8: 1306. https://doi.org/10.3390/vaccines11081306

APA Style

Cholewik, M., Stępień, M., Bieńkowski, C., & Pokorska-Śpiewak, M. (2023). Parents’ Attitudes towards Vaccinations Regarding the Ukrainian Migration to Poland in 2022. Vaccines, 11(8), 1306. https://doi.org/10.3390/vaccines11081306

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