For medical personnel, vaccination also has a moral dimension

Registration has begun for the COVID-19 booster vaccination for health care workers, university and medical school students, and people 50 years and older. In your opinion, is this a good and timely decision?

We have seen the immunological basis for this for many months, and there were studies last year showing that a third dose would be needed. Even more so now that we are dealing with the Delta variant, a virus that breaks down the immune barrier more easily and spreads much faster. Initial data showed the effectiveness of Pfizer's vaccine at 95 percent, but now we can see that this effectiveness has been decreasing with time, to about 75 percent. Therefore, another dose is very much needed. I think that, in the future, COVID-19 vaccination will be entered into the vaccination calendar and we will have new versions of the vaccine for its future variants every few years.

A recent survey conducted by ARC in co-operation with WUM showed that the number of people who strongly oppose COVID-19 vaccination remains unchanged, at about 27-30%. Are there a large number of health care workers among them? Are those already vaccinated willing to receive a third dose?

We have witnessed successive waves in hospitals, nursing homes and dispensaries, and we have seen or experienced this dramatic struggle ourselves. I am therefore surprised that some people who choose the medical profession still haven’t decided to get vaccinated. I wish it were different, but unfortunately there are some doctors and medical staff some who are sceptical about the vaccine or think that COVID-19 is not that dangerous a disease. However, I still believe in my colleagues’ good sense and responsibility. Certainly, most of those who work with COVID-19 patients will be given the third dose.

What about medical school students who are about to show up for classes at hospitals and clinics? Do you check to see if they are vaccinated?

There is some debate about this at different universities, not just ours, but from a legal perspective we are not supposed to be allowed to do this. Though personally I don't know why, since at airports travellers are required to either show a Covid passport or have an up-to-date examination. Why can't this be introduced in the classroom? Are we not violating a patient's right to protect their health when dealing with young medics who may be asymptomatic carriers? This is why I believe that all people who come into contact with patients, including students, should confirm that they are vaccinated or have a certificate of recovery. After all, many young people may have no symptoms of infection but they still spread the virus. In other countries, there have been no great problems with the introduction of compulsory vaccination. In France, the order applies to healthcare workers, and in Italy, it applies to all workers. I would like to stress that in the case of doctors, this issue also has an ethical dimension. Are our students ready to bear the responsibility for someone's life resulting from the risk of infecting a patient during classes? You may recall a case from a few months ago when one of the doctors risked his life when it turned out that he had infected his patients. The responsibility overwhelmed him. This is why I think that the message for students and health care workers, apart from the rational argument, should also have a moral dimension. Those who are not vaccinated expose their patients to serious consequences.

There are parents in the pediatric hospital with their children. Do you check to see if they are vaccinated?

We cannot screen all parents on the ward. We rely on their voluntary declarations and isolation. We only test parents if the child is suspected of being infected with COVID-19, unless they show proof of vaccination or a recovery test, which is valid for six months.

Are younger children expected to be vaccinated for COVID-19?

Studies of Pfizer's vaccine for childten aged 5 to 11 have been successful, and the company has already filed registration documents in this age group. So soon we can expect the possibility of vaccinating children from 5 to 11 years old. However, it seems to me that the vaccination of younger children will not succeed in Poland. For people over 12 years of age vaccination rates reach 30%. But looking at the strength of the anti-vaccination campaign on the Internet, this is not a bad result anyway. Unfortunately, the main debate about vaccination took place on the Internet. That's where a lot of information appeared which raised doubts, fuelled fears and spread irrational arguments. I regret to say that nobody tried to counteract it. I’d like to point out that if I persuaded my patient not to be vaccinated and the patient died as a result of this, I could be held civilly liable by his family. So how is it that spreading false information about vaccines on the Internet goes unpunished?

What percentage of children get COVID-19 and how many of them have complications afterwards?

It is difficult to say how many adults or children are infected. Our earlier studies show that the actual number of people infected is about four times higher than the number of people reported in official statistics. Therefore, we estimate that there are already at least several thousand infections a day in Poland. Of these, almost 30% affect children, at least according to American figures. In turn, as many as 35% of children show no symptoms of infection.  Some of them will develop the so-called multisystemic inflammatory syndrome associated with COVID-19, that is PIMS or MIS-C. Interestingly, the parents of most of the children we have treated for polyinflammatory inflammatory syndrome, or PIMS, did not even know that their children were infected with COVID-19. Only when we had a patient in a clinic in a serious condition did serological tests show that the child had antibodies, proving that they had come into contact with the virus.

A group of infectious disease physicians created a Polish registry of children with PIMS syndrome. A map showing PIMS cases registered in Poland has also been created. A white spot on this map are the provinces of eastern Poland, e.g. Lubelskie, Podlaskie. Here, almost no PIMS cases have been detected. I ask myself a question: was there really so few cases, or were they just not recognised. In Poland, it seems as if there’s still a lot of ignorance about the complications resulting from COVID-19. Science and reality have shown that it is a dangerous virus, which kills, leaves traces for a long time, with thousands of people, including children, suffering from neurological complaints. In the face of this, it is hard to understand why there are people who still believe that you shouldn’t get vaccinated.
 

Interviewer: Agnieszka Wlazłowska-Pietrzak