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The aim of the study was to survey the needs for HIV/AIDS educational interventions and attitudes and beliefs concerning HIV infection, including sexual relationships, among 17-year-old Polish adolescents. A total of 761 students who attended schools located in urban and rural areas was surveyed. The study, based on the voluntary, self-completed, anonymous questionnaire designed by World Health Organization (WHO), was also aimed at identifying their sources of information about HIV and AIDS. The findings suggest that the main sources of such information were television, newspapers and doctors/nurses (in that order), with the preferred sources being medical personnel, television, school and newspapers (in that order). The great majority of respondents felt they required more information. Responses indicated that previous information on HIV/AIDS had not been integrated into students' plans for situations involving relationships and sexual activity. About 60% of girls and 44% of boys stated that sex without love is not satisfying. About 40% of girls and 20% of boys stated that for the rest of their life they intended to have only one partner. Only about 10% of boys and girls believed that they should avoid sexual relationships because of AIDS. Adolescents declared that their attitudes towards HIV-infected persons were ones of acceptance. The mechanisms through which young people in Poland are not getting enough HIV/AIDS information and are not changing their sexual behaviour in order to avoid HIV infection are discussed. Areas that require future educational intervention are addressed. (Contains 1 table and 2 figures.)

Background: Face masks have been employed in the COVID-19 pandemic plans as a public and personal health control measure against the spread of SARS-CoV-2. In Poland, obligatory wearing of masks in public spaces was introduced on April 10th, 2020; a relaxation of previous universal measures was announced on May 29th, 2020, limiting use to indoor public places. Objective: To assess use of masks or other protective devices in public spaces in Poland during the SARS-Cov-2 epidemic. Methods: A non-participatory covert observational study was conducted on three dates, (10.05/18.05/25.05.2020) at public spaces in 13 regions with different risks. Ten consecutive individuals were observed by each of 82 medical students (n = 2460 observations), using a structured checklist. Results: Among 2353 observed persons, the female/male ratios were 1.0, 1.1, and 1.0 on the three dates. Almost three quarters - 73.6% (n = 552/750) were using masks on date 1, 66.5% (544/818) on date 2; and 65.7% (516/785) on date 3. Cloth masks predominated on all dates (64.7–62.3%-62.6%), followed by medical (23.4–28.5%-26.9%). Being female (OR = 1.77–1.47-1.53 respectively) and location in a closed space (OR = 2.60–2.59-2.32) were each associated with higher usage. Participants in sports were about two times less likely to use masks (OR = 0.64–0.53-0.53) as compared to other activities. The proportion using masks correctly decreased gradually over time (364/552; 65.9%; 339/544; 62.3% and 304/516; 58.9%). More females wore masks correctly (date 1: 205/294; 69.7% vs 159/258; 61.6%, and date 3: 186/284; 65.5% vs 118/232; 50.9%; p = 0.045; p = 0.0008 respectively). Uncovered noses (47.3–52.7%) and masks around the neck (39.2–42.6%) were the most frequent incorrect practices. Conclusions: Practices were not in line with official recommendations, especially among males, and deteriorated over time. Cloth masks were predominantly used in public spaces. Health promotion, through utilizing all available communication channels, would be helpful to increase compliance. [ABSTRACT FROM AUTHOR]

Background: Ukrainians numbering approximately 1.2 million are the largest migrant group in Poland. Data on vaccination coverage among migrants are not collected in EU, including Poland. Therefore, this qualitative study aimed to identify vaccination practices in this migrant group, to explore facilitators and barriers to vaccination and related access to Polish healthcare services.Methods: In September 2019, a qualitative study of Ukrainian migrants (UMs) living in Szczecin, Poland, and recruited through a snowball sampling method, was conducted. Using a semi-structured topic guide, four focus groups were held with 22 UMs aged 18-45. Participants were asked about their attitudes towards vaccination in general with comparison between services in Poland and Ukraine. Following transcription and translation, a thematic analysis was conducted.Results: Respondents were distrustful of Ukrainian vaccination policy, medical personnel and individual vaccines, however, they often returned to Ukraine for dental and gynaecological appoint-ments. While critical with regards to registering with Polish GPs practices, UMs were confident in health professionals, as well as vaccine delivery. Vaccines were perceived as safer and of better quality than in Ukraine. Difficulties in translating vaccination records were rarely reported, verbal communi-cation was not problematic due to language similarities. All UM parents reported vaccinating their children according to the Polish schedule. However, a significant number of adult UMs have not completed mandatory vaccinations, although they may have obtained false immunization certificates; according to UMs those can be obtained by bribing. Participants reported lower acceptance of the influenza vaccine, mainly due to perceptions around its importance; none had been vaccinated against influenza. None of UMs had heard of the HPV vaccine. UMs experienced challenges in accessing credible online vaccination information in Ukrainian, no official local health authority vaccination material existed either, except for information about measles.Conclusions: This study pinpointed positive UM attitudes and practices regarding child vaccination in the Polish healthcare system and identified issues for improvement, such as adult vaccination. Health communication should be more tailored within UMs information delivery systems to enable migrants to make informed choices about vaccination. Further research is needed to better assess factors affecting vaccine uptake identified in this study. [ABSTRACT FROM AUTHOR]

The general public influenza vaccination coverage in Poland is one of the lowest in the EU (3.7% in 2017/2018). Teachers have the potential to be a target group for immunization programs against influenza infection, however, there is yet to be a study in Poland, or even in the EU that has assessed influenza vaccine uptake among this group. The study objective was to evaluate influenza vaccination coverage and to assess influencing determinants amongst Polish teachers. A cross-sectional questionnaire-based study was conducted among 277 teachers from 9 primary schools of two regional capitals of two Polish regions: Szczecin and Lublin. A quarter of teachers have ever received influenza vaccine; 4.5% reported receiving vaccination in the 2018/2019 season. The main reasons for not being vaccinated were a lack of confidence in its effectiveness (56.9%) and concerns related to adverse effects (30.6%). Forty four percent (43.8%) of teachers believed that they are at risk of influenza infection, only 62.5% indicated vaccination as an effective method of preventing influenza. Previous information about influenza (OR = 15.70), high knowledge level about influenza (OR = 2.56), family physician recommendation (OR = 2.39), belief that influenza vaccination should be mandatory for teachers (OR = 3.29), and having a vaccinated family member (OR = 2.68) were each associated with higher odds of immunization. Willingness to be vaccinated against influenza in the next season was strongly associated with current vaccination status (OR = 7.16). Influenza vaccination coverage among Polish teachers is alarmingly low; vaccine receipt was associated with teacher attitudes and beliefs. Future interventions related to maximizing vaccination coverage in this group should take advantage of the involvement of family physicians and specifically focus on teachers who have never been vaccinated before. As knowledge about influenza positively influences vaccination decisions, education strategies should focus on reducing knowledge gaps to alter attitudes and increase uptake. [ABSTRACT FROM AUTHOR]

Background: A two-dose preoperative vaccination schedule against HBV has been the widely accepted policy in Poland. However, its effectiveness has not yet been assessed.Objective: To evaluate a two-dose preoperative HBV vaccination policy by an assessment of the proportion of patients who don't present a protective level of anti-HBs (<10.0 mIU/ml).Methods: Consecutive patients from surgical/gynecologic wards of 12 randomly selected hospitals in West Pomerania, Poland, hospitalized between 2010 and 2013, vaccinated against HBV with a two-dose regimen, were asked to complete an anonymous questionnaire. Serum samples were assayed for anti-HBs with the use of third-generation testing methods. To compare sensitivity versus specificity across a range of values for the ability to predict a dichotomous outcome (a protection against HBV infection) a Receiver operating characteristic (ROC) curve was determined.Results: There were 193 patients, 58.5% women, median age 52 years. Almost a half (46.0%) of the patients were operated on within 0-60 days of taking the second vaccine dose, 16.2% - 61-180 days after, 37.8% >180 days after. Anti-HBs titer was below a protective level in 49.2% of participants (0.0 mIU/ml in 17.8%, 0.1-9.9 mIU/ml in 31.4%); none of them were aware of this fact. Age ≤ 52 years (OR = 1.89) and having surgery more than 37.5 days after HBV vaccination (OR = 2.70) were associated with greater odds of being protected against HBV infection through vaccination. For the time frame between the second dose implementation and surgery 23 days, a sensitivity of 84% and specificity of 22% for obtaining protection against HBV infection was found, for the time frame >37.5 days - sensitivity remained high (80%), while specificity increased (41%); there was an apparent peek on the ROC curve between 38 and 60 day. In the group vaccinated 0-37.5 days before surgery, less patients had the protective level of anti-HBs titer than in vaccinated 38-60 days before surgery (32.3% vs 60.0%; p = 0.03).Conclusions: The success rate in achieving adequate immune protection with two dose HBV vaccination schedule in preoperatively vaccinated patients is relatively low, especially among those vaccinated less than five weeks prior to surgery. In more than a third of cases the standard three-dose regimen could have been implemented, as participants had time to complete a third dose. Current recommendations regarding a preoperative policy with a 2-dose vaccination schedule in Poland should be revised; the best time to perform surgery after the implementation of the second dose of vaccine in the context of patient protection against HBV infection would be between 38 and 60 days. [ABSTRACT FROM AUTHOR]

It is well known that community awareness of hepatitis B (HB) can lead to vaccination and testing. The study objectives were to assess the prevalence of HBV infection and knowledge of HB among adult patients attending randomly selected primary care clinics. A cross-sectional sero-survey was conducted in March 2013 in the Zgorzelec region, Poland, with the use of an investigator-developed questionnaire containing 22 questions regarding HB knowledge. Serum samples were assayed for anti-HBc total and anti-HBs with enzyme immunoassay. The prevalence of anti-HBc total among 410 participants (median age 56 years) was 10.3 % (95 % CI 7.6-13.8 %), nobody was aware of an infection. The main sources of HB knowledge were the media and medical staff. The mean knowledge score was 14.8 ± 4.9; 76.7 % of the respondents had scores >50 %. Particular gaps were detected relating to knowledge of unprotected sexual intercourse and MTCT; 45.6 % patients were not aware of the potential asymptomatic course of HBV infection, 41.2 % about chronic HB treatment. A patient's low educational level was negatively associated with a high knowledge level; the willingness for further education on HB and HBV vaccination in the past were independently associated with good knowledge. In conclusion, the HBV infection remains a public health threat in Poland, since the prevalence of infection markers in asymptomatic adult patients was high. Knowledge gaps call for awareness campaigns which may increase testing and diagnosis, audiences representing lower education level should be targeted first. Knowledge on HB might serve as an effective tool in decision making regarding vaccination. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B is a significant health burden in Poland with nosocomial transmission being the main source of infection. Therefore, HBV vaccination is widely recommended for those not covered by the national immunisation program.Objective: To assess the coverage and influencing determinants of HBV vaccination among adult patients attending GP clinics as well as to establish serological status in terms of HBV infection.Methods: Patients who were seen consecutively in March 2013 at four randomly selected GP practices located in Zgorzelec county, in south-western part of Poland, were invited to participate and complete questionnaires on socio-demographic data and other factors related to vaccination. A pilot study was done in one urban GP practice in the city of Gryfino (Gryfino county), the results have been included in the study. Patients' immunisation status was assessed basing on vaccination cards and anti-HBs titer with the use of third-generation testing methods. In addition, serum samples were assayed for anti-HBc total.Results: Response rate: 99.3 %. Of 410 participants (66.1 % females, median age 56 years), 55.4 % (95%CI:50.5-60.1 %) were previously vaccinated; in those 11.5 % took 2 doses, 66.1 % - 3 doses,18.1 % - 4 doses. Elective surgery was the main reason (57.7 %) for HBV immunization, 4.8 % - were vaccinated due to recommendations by GPs. The multivariable logistic regression model revealed that living in a city (OR 2.11), and having a surgery in the past (OR 2.73) were each associated with greater odds of being vaccinated. Anti-HBc total prevalence among those unvaccinated was 13.6 % (95%CI:9.3 %-19,5 %), and 7.2 % (95%CI:4.4-11.8 %) among those vaccinated.Conclusions: Low HBV immunization coverage among adult patients from GP clinics and the presence of serological markers of HBV infection among both - those unvaccinated and vaccinated call for comprehensive preventative measures against infection, including greater involvement of family doctors. Although interventions should cover the whole population, inhabitants living in the rural areas should be a group of special interest. Preoperative immunization for HBV seems to be an efficient public health tool to increase the vaccination uptake. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B vaccination, recommended for medical staff, has a non-response rate of 5% to 32%. In Poland, there is no standardized postvaccination protocol to verify immunity. Objectives: To determine the fraction of those who have been vaccinated against HBV (with a complete course followed/not followed by a booster) but not checked for serological evidence of hepatitis B immunity and to detect anti-HBs levels in this group by anonymous cross-sectional sero-survey. Patients and Methods: Surgical/gynecological staff from 16 randomly selected hospitals in West Pomerania, Poland, were surveyed between July 2010-January 2011. EIA system version 3.0 was used to detect anti-HBs. Results: Of 488 participants (439 females, median age 42 years) who were previously vaccinated (1-21 years ago), anti-HBs status was not determined after HBV vaccination in 361 individuals (74.0%; 95% CI: 69.9-77.7%), 5% (18/361) of whom had an anti-HBs titer of 0.0 mIU/ml (12/18 who were given booster doses developed anti-HBs > 10 mIU/ml) and 7.2% (26/361) of whom had an anti-HBs titer of 0.1-10 mIU/ml. The multivariate logistic regression model revealed that working in a teaching hospital was associated with lower odds of not being checked for anti-HBs after HBV vaccination (OR 0.22, 95% CI: 0.14-0.35; P = 0.0001). Conclusions: The lack of a strict post-HBV vaccination policy to confirm immunity results in the majority of surgical/gynecological staff not checking their anti-HBs levels after HBV immunization. It is unknown whether the absence of current serological evidence of hepatitis B immunity can be attributed to non-response, the waning of vaccine-induced immunity, or preserved anamnestic response. The lack of a booster vaccination response in a fraction of subjects suggests that they are non-responders. Strict post-vaccination testing to document immunity remains the key practice to detect nonresponders among medical staff. [ABSTRACT FROM AUTHOR]

Abstract: To determine the immunisation coverage for HBV and the prevalence of HBsAg an anonymous serosurvey of consecutive adult surgical/gynaecologic patients presenting to 16 randomly selected hospitals in West Pomerania, Poland, was conducted. Immunisation rate was 60.4%, of these 69.7% had received the complete course of three doses; 65.2% were immunised at the request of referring surgeons. The multivariable regression model revealed that age <40 years, low educational status, not having a surgery in the past, tattoo application, and emergency procedure were each associated with a greater odds of not being vaccinated. HBsAg prevalence was 0.6%. Authors conclude that the preoperative vaccination policy might be an effective public health tool to limit the spread of the epidemic. [Copyright &y& Elsevier]

Background: Due to numerous blood exposures hospital staff are at risk of acquiring hepatitis B virus (HBV) infections. This study aimed at estimating prevalence of HBV, associated risk factors and HBV vaccination among Polish health care workers (HCWs).Methods: A cross-sectional sero-survey was conducted (October 2016-January 2018) in 10 randomly selected hospitals from two provinces: of low and high incidence of HBV, with the use of an anonymous, self- administered questionnaire. Blood samples were screened for hepatitis B core antibodies (anti-HBc) with enzyme immunoassay.Results: Of the 306 participating HCWs, 88.6% were females, 69.9% nurses (mean age 47.8 ± 9.0 years). HBV vaccination was reported by 94.2%, participants (4.7% with 2 doses, 58.1% with 3 doses, 37.2% took a booster), but of these 75.1% reported no post-immunization serology. The sero-prevalence of anti-HBc was 12.1% (95%CI 8.4-15.7%); only 11.1% had ever screened themselves for HBV infection. Out of 37 anti-HBc positive HCWs, 29 reported being vaccinated for HBV; 10.5% vaccinated HCWs were anti-HBc positive. Regarding other occupational risk factors, 27.8% had experienced a sharp injury (SI) in the last year, 80.0% of incidents were not reported. The use of safety devices (SD) was 86.3%; 35.9% participants used to recap a needle. Older age (OR = 4.24), lack of HBV vaccination (OR = 7.42), working at the province of high HBV incidence in the general population (OR = 2.69) were each predictors of participant's HBV infection.Conclusions: High anti-HBc seroprevalence was found in hospital staff with older generation particularly constituting a risk group. Unsatisfactory vaccination coverage and the use of SDs, needle recapping and under-reporting of SIs were main modifiable risk factors regarding HBV infection. The study provides evidence of the protective role of HBV vaccine, as well as the possible effect of HBV incidence in the general population on HCW's anti-HBc seropositivity. Universal vaccination, followed by strict policies to confirm immunity, better compliance with infection-control practices and widespread implementation of SDs should be enforced to protect hospital staff from occupationally acquired HBV infections. [ABSTRACT FROM AUTHOR]

Background: Ukraine has one of the lowest COVID-19 vaccination rates in Europe. This may pose a significant epidemiological risk in the context of the refugee crisis and the fact that, since 2020, SARS-CoV-2 has been spreading and changing globally., Objective: To evaluate determinants of vaccination decision making among Ukrainian female migrants (UFMs)., Methods: A qualitative study with 45 UFMs was conducted between December 2021 and January 2022. UFMs, from 2 Polish provinces, differing in age, education and length of stay were invited with the use of the snowball technique. Using a semi-structured topic guide, eight focus groups were conducted in person, recorded and transcribed. Thematic, qualitative analysis was made; key themes which emerged from the data (with the help of the Working Group Determinants of Vaccine Hesitancy Matrix), were related to contextual, individual/group and contextual vaccine/vaccination-specific influences., Results: Mothers were found to be playing a crucial role in children and adolescent COVID-19 vaccine decision-making process. Universal trust in the Polish healthcare system and vaccination procedures, employer requirements and willingness to preserve jobs, desire to get back to normal and social influences were paramount prerequisites to let UFMs make a decision to get vaccinated. However, COVID-19 vaccines also faced backlash among UFMs. Negative experiences with vaccines provided in Ukraine, doubts about the rapid vaccine development, combined with lack of confidence in vaccine safety, specifically regarding child vaccination, might have a bearing on UFMs' decision about declining COVID-19 vaccine while on migration. Discrimination through HCWs during vaccination visits was also reported. Corrupted Ukrainian healthcare system, which facilitates proof forgery regarding vaccination certificates, could act as a negative influencer of UFMs' vaccine decision-making., Conclusion: The results provide the novel information, expressed in economic UFMs' own words. Findings show that influencers of the decision-making process regarding the COVID-19 vaccination are complex and polarized; elements of hesitancy may persist after migration. Any continuation of UFMs' vaccination with COVID-19 vaccine should be subject to designing accessible information to address modifiable demotivators of the vaccine decision-making process identified in this study., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ganczak, Kalinowski, Twardowski, Osicka, Pasek, Duda-Duma, Vervoort, Edelstein and Kowalska.)

Background Migrants' access to healthcare services is limited. This study aimed to identify health system barriers to vaccination, specifically HPV/MMR vaccination among children in Ukrainian economic migrants (UMs). Methods Between December 2021-March 2022, a qualitative study of UMs living in Poland was conducted. Six focus groups were held with 53 UMs aged 15-45; in-depth interviews with 12 healthcare workers (HCWs) were also performed. A thematic analysis was conducted based on the six WHO health system building blocks. Results HCWs described gaps in integrating migrant status in accessible healthcare data which impeded active management of vaccination procedures. UMs reported that the digitization of healthcare services, intensified during the COVID-19 pandemic, reduced their access to primary care. Inadequate health information systems caused problems with the provision of credible vaccine information in translated forms, and language difficulties, experienced by both UMs and HCWs; this was enhanced by a lack of professional interpreting services. Although most UMs reported vaccinating children according to the Polish schedule, the variations in schedules across countries caused concern among UMs and increased HCWs' uncertainty about how to interpret vaccination cards, particularly in the context of possible false certificates. UMs were affected by discrimination through HCWs. HPV was deprioritized by UMs due to misconceptions about non-mandatory vaccinations; the cost was also a barrier. Conclusions The study findings have implications for migrant vaccination delivery targeting children in Poland, and other UMs receiving countries. A concerted effort is required to improve UM's awareness of the significance of vaccinations. Barriers to healthcare access must be recognized by policymakers. Importantly, removing the cost barrier may increase the uptake of the HPV vaccine among Ukrainian migrant adolescents.

In February 2021, Polish teachers were offered the ChAdOx1-S vaccine as a priority group. However, there have been concerns among educators regarding the efficacy of this vaccine, as compared to the other types of vaccines (e.g., mRNA). The objective of this study was to investigate the reactogenicity and the immunogenicity of this vaccine. Participants, specifically teachers, were invited for serological testing ≥ 4 weeks post-vaccination. Antibodies against the receptor-binding domain (RBD) were measured. Of the 192 participants, the mean age was 50.5 ± 8.3 years and the mean (range) dosing interval was 69.6 ± (25−111) days. Adverse reactions included feeling feverish (44.8%), headache (41.7%), malaise/chills (38.0%), and injection-site tenderness (37.5%); these were reported more frequently after the first dose (84.9%). Fewer males than females (54.8% vs. 80.1%) and fewer older participants (65.7% vs. 90.4%) reported side effects (p < 0.002; p < 0.0001, respectively). All participants presented detectable anti-RBD IgG; the median (range) reading was 525.0 BAU/mL (20.6−5680.0); 1008.02 BAU/mL (115.3−5680.0) in those with prior SARS-CoV-2 infection; and 381.42 BAU/mL (20.6−3108.8) in those without (p = 0.001). In 27.6%, the anti-RBD IgG level was >500 BAU/mL. A multivariate logistic regression revealed that previous infection and longer dose intervals were predictors of higher immunologic responses (p < 0.0001; p = 0.01, respectively). The results demonstrated good tolerability and immunogenicity of the ChAdOx1-S vaccine. Our study justified the longer dose interval to enhance a higher antibody response. Our findings may also support the prioritization of uninfected individuals in regions where COVID-19 vaccine-sparing strategies are required.

To support high school students to develop knowledge they need to adhere to control measures during the pandemic, a peer-based educational intervention on SARS-CoV-2 was developed and its impact was evaluated. Multistage random sampling was used. The 50 min peer-based intervention was conducted by final year medical students. Baseline and post-intervention knowledge and attitudes were assessed. Significance was tested by McNemar's/Wilcoxon rank tests. Of 518 participants (mean age 17.8 years ± 0.43), 81.0% did not receive any school-based education on SARS-CoV-2. After intervention, the knowledge score improved from 65.2% to 81.6%, attitudes from 63.2% to 70.8% (both p < 0.0001). The effect size after the intervention compared to pre-intervention showed moderate improvement of knowledge, but not attitudes (d = 0.46 and d = 0.18, respectively). Pre- and post-intervention, females, students in non-science programs, living in cities < 250,000 inhabitants had lower knowledge, while fewer males, non-science program students, living in smaller cities presented positive attitudes. Before intervention, 67.0% students correctly named SARS-CoV-2 preventive methods and 73.6% were concerned COVID-19 is a serious disease; these improved after intervention (to 80.1% and 86.3%; p < 0.0001). The intervention was not very successful in increasing the intent to vaccinate for COVID-19 (pre-intervention 52.9%, post-intervention 56.4%; p < 0.007). Peer-based teaching for high school students can be effective in increasing SARS-CoV-2 knowledge and awareness. More efforts are needed to improve attitudes and enhance acceptance of vaccination against COVID-19.

To evaluate the prevalence of bloodborne infections (BBIs) and assess the incidence and selected risk factors for sharps injuries (SIs), a cross-sectional serosurvey was performed between December 2018 and October 2019 among 286 paramedics (76.5% males; mean age, 37 years) from 17 randomly selected ambulance stations in the West Pomeranian region of Poland. An ELISA system was used to detect anti-HBc, anti-HCV, and anti-HIV. HBV vaccination uptake was 95.6%; 7.3% (95% CI: 4.6-11.0%) paramedics were anti-HBc positive, and anti-HCV/anti-HIV seropositivity was not reported. Almost one-fourth of paramedics reported having had ≥1 SI during the preceding year (Me = 6.0, range 1-100). Most recent exposures primarily took place during an emergency procedure (76.7%), in an ambulance (45.2%), caused by hollow-bore needles (73.8%), and were not reported (50.0%). Additionally, 52.2% of paramedics reported needle recapping, and 52.6% did not use safety engineered devices (SEDs) at work. Mean knowledge score was low (2.6 ± 1.7); 3.4% had never participated in infection-control (IC) training, and those not trained were more likely to suffer a SI (odds ratio (OR) 4.64; p = 0.03). Due to frequent SIs, of which half are unreported, paramedics remain at risk of acquiring occupational BBIs. SI risk could be reduced by providing training on IC procedures, ensuring better compliance with safe work practices, and supplying more SEDs.

The effects of immunization with subunit inactivated quadrivalent influenza vaccine (QIV) are not generally well assessed in the elderly Polish population. Therefore, this study evaluated vaccine-induced antibody response and its determinants., Methods: Consecutive patients ≥ 55 years old, attending a Primary Care Clinic in Gryfino, Poland, received QIV (A/Michigan/ 45/2015(H1N1)pdm09, A/Singapore/INFIMH-16-0019/2016 (H3N2), B/Colorado/06/2017, B/Phuket/ 3073/2013) between October-December 2018. Hemagglutination inhibition assays measured antibody response to vaccine strains from pre/postvaccination serum samples. Geometric mean titer ratio (GMTR), protection rate (PR) and seroconversion rate (SR) were also calculated., Results: For 108 patients (54.6% males, mean age: 66.7 years) the highest GMTR (61.5-fold) was observed for A/H3N2/, then B/Colorado/06/2017 (10.3-fold), A/H1N1/pdm09 (8.4-fold) and B/Phuket/ 3073/2013 (3.0-fold). Most patients had post-vaccination protection for A/H3N2/ and B/Phuket/3073/ 2013 (64.8% and 70.4%, respectively); lower PRs were observed for A/H1N1/pdm09 (41.8%) and B/Colorado/06/ 2017 (57.4%). The SRs for A/H3N2/, A/H1N1/pdm09, B Victoria and B Yamagata were 64.8%, 38.0%, 46.8%, and 48.2%, respectively. Patients who received QIV vaccination in the previous season presented lower ( p < 0.001 and p = 0.03, respectively) response to B Victoria and B Yamagata., Conclusions: QIV was immunogenic against the additional B lineage strain (B Victoria) without significantly compromising the immunogenicity of the other three vaccine strains, therefore, adding a second B lineage strain in QIV could broaden protection against influenza B infection in this age group. As the QIV immunogenicity differed regarding the four antigens, formulation adjustments to increase the antigen concentration of the serotypes that have lower immunogenicity could increase effectiveness. Prior season vaccination was associated with lower antibody response to a new vaccine, although not consistent through the vaccine strains.

In Poland, in addition to mandatory, free of charge vaccines, listed in the national immunization schedule, numerous self-paid vaccinations are recommended, including meningococcal vaccination (MV). To assess MV uptake among ≤5-year-old children and to evaluate parental knowledge and attitudes regarding invasive meningococcal disease (IMD). A cross-sectional study was conducted in 2018 among 350 parents (mean age: 32.3 years), attending three randomly selected primary care clinics in Szczecin region, Poland. Anonymous questionnaires were administered to the parents by researchers, present at the time the survey was conducted, to self-complete on a voluntary basis. Chi-square or Fisher's exact for categorical and Mann⁻Whitney U test for continuous variables. Variables significantly ( p < 0.05) associated with 'good knowledge' in the bivariate analysis were used to build a logistic regression model. It was found that the response rate was 93.4%, and MV uptake among children was 29.5%. The main knowledge sources were medical staff and media; 72.5% had ever received information about IMD. Only 18.8% of parents self-assessed their knowledge regarding IMD as good; 61.8% scored >50% in the knowledge test 58.9% knew the mode of transmission, 58.7% recognized the severity of meningitis, and 79.7% knew that bacterial meningitis is a vaccine-preventive disease. Knowledge regarding IMD was higher among parents with higher educational level (OR = 3.37; p = 0.01), from urban facilities (OR = 2.20; p = 0.02), who received previous information about IMD (OR = 2.85; p = 0.01) and self-assessed their knowledge as good (OR = 2.59; p = 0.04). Low MV coverage among children up to five years old and knowledge gaps about IMD call for awareness campaigns which may increase the coverage. Although educational interventions should cover all parents, those from provincial facilities, representing lower education level need special attention.

Despite a number of studies on the risk factors of developmental delay (DD) in children conducted in developed countries, Polish data are scarce, which hinder an early diagnosis and initiation of prevention/control measures. Objective: To assess selected risk factors of DD in infants. A case-control survey was conducted in 2017⁻2018 on 50 infants (≤1 year old) with DD and 104 healthy controls from three outpatient clinics in Szczecin, Poland. Data were collected using an anonymous questionnaire distributed among mothers. The most common risk factors in infants with DD were: Caesarian section (68%), infections (46%), and chronic diseases during pregnancy (48%). DD was significantly correlated with maternal infections and chronic diseases during pregnancy (both: p < 0.001), caesarian section ( p < 0.001), preterm birth ( p = 0.004), birth weight <2500 g ( p = 0.03), Apgar score ≤7 ( p < 0.01), prolonged hyperbilirubinemia ( p < 0.001), and no breast-feeding ( p = 0.04). This study reinforces multiple etiologies of DD. Preventive strategies regarding DD in Polish infants should focus on the pre/peri/postnatal risk factors identified in this study. Strategies that prevent and control such risk factors and those on early detection and intervention in high-risk infants are highly recommended.

Background: Adolescent HPV (Human Papilloma Virus) vaccination is yet to be introduced as a mandatory program in Poland. Polish literature on factors associated with adolescent HPV vaccination is scant, despite the fact that uptake is one of the poorest in the European Union. Objectives: To assess HPV awareness and identify independent predictors for parental willingness to have their children vaccinated against HPV. Methods: All parents of first grade students from three selected high schools in Zgorzelec, Poland, who participated in parent-teacher meetings at the time the study was conducted, had their children unvaccinated regarding HPV, and who gave informed consent to participate were included. There were 600 first grade students; 9 were vaccinated against HPV. This left 591 parents who met the eligibility criteria; the response rate was 76.1%. Results: Awareness of HPV was reported by 55.3% of 450 parents (mean age 42 years, 70.9% females); 85.1% expressed their willingness to vaccinate their children against HPV; 31.3% identified HPV as a sexually transmitted pathogen, and 36.2% identified it as a risk factor of cervical cancer. Multivariable logistic regression analyses indicated that being employed (OR 2.09; 95% CI: 1.10-3.86), having positive attitudes toward vaccines (OR 3.02; 95% CI: 1.34-6.49), previous information about HPV (OR 2.02; 95% CI: 1.17-3.51), and concerns about the side effects of the HPV vaccine (OR 0.60; 95% CI: 0.35-0.99) were independent predictors of parents' willingness to vaccinate. Conclusions: Attitudes regarding their child being vaccinated against HPV were positive among Polish parents, even though awareness and knowledge of HPV in this group were low. Most of the significant factors that influenced their willingness were modifiable, such as being informed about HPV and having positive attitudes toward vaccines. Future interventions should focus specifically on vulnerable subgroups, such as unemployed parents., Competing Interests: The authors declare no conflict of interest.

Objectives: The consequences of hip fractures (HFs) in elderly persons include a deterioration in functional capacity to perform activities that enable independent living. Since prior research into this issue in Central Europe is rather scant, this study sought to assess the change in activities and instrumental activities of daily living (ADL/IADL) after HF surgery among Polish patients, to study predictors of regaining pre-fracture functional status three and six months later, and to evaluate the correlation between ADL and IADL limitations over time., Methods: A prospective study was conducted between 2011 and 2013 in a tertiary hospital in Western Poland. ADL/IADL were evaluated using the Katz index and Lawton scale, respectively., Results: About half (50.8%) of 120 patients (mean age 80.1 ± SD 7.59) had cognitive impairment (CI). Patients with CI were older ( p = 0.002) and had lower scores for pre-fracture ADL/IADL ( p = 0.001 and p < 0.001, respectively). Six months after HF, 33.3% of patients failed to return to their pre-fracture ADL and 62.5% failed to return to pre-fracture IADL; 20% of those who could walk before HF were unable to walk after six months. The pre-fracture Spearman correlation coefficient between ADL and IADL summary scores was 0.46; it increased to 0.70 at three months after HF surgery and 0.77 at six months ( p < 0.0001). Regaining ADL after six months was more likely in patients with pre-fracture intact intellectual function and independence in pre-fracture ADL; regaining IADL, in younger patients and those with higher pre-fracture IADL scores., Conclusions: Impairment in functional performance is common after HF surgery. ADL and IADL were strongly correlated in these patients, with this increasing over time. Functional outcomes after HF were more dependent on patient characteristics than treatment-related factors. Therefore, more emphasis should be directed towards the pre-fracture period and, in particular, maintaining cognitive function and preserving functional capacity in older persons at high risk of HF., Competing Interests: The authors declare no conflict of interest.