Vaccines are victims of their own success. Episode 13

Monika Rachtan
Good morning. I would like to welcome you very warmly to another episode of the programme. "First the Patient". And today my guest, but above all your guest, is Professor Jarosław Pinkas. Good morning, Professor.

Jarosław Pinkas
Good morning, and a warm welcome.

Monika Rachtan
The professor is a specialist in general surgery, family medicine and public health, and today we are going to talk about vaccination. A topic that is very important, very topical and probably relevant throughout a person's life, not just in childhood.

Jarosław Pinkas
Yes, throughout a person's life.

Monika Rachtan
Well. The pandemic showed us a little bit that vaccination is not only for children, that is, it is not in the parents' interest, but also at an older age we can vaccinate, we should vaccinate. Do you, Professor, also have this observation that it is this COVID pandemic that has built this greater awareness?

Jarosław Pinkas
Yes, undoubtedly. It has been shown how important vaccination is. We had forgotten about them as the most important tool in the fight for human health, the most important for health and life. Vaccines have been very successful. After all, thanks to them, we do not have many diseases. We have significantly reduced the incidence of many diseases. As a result, we have forgotten about them. But it is thanks to vaccines that we do not have smallpox, which was a real human drama for many, many centuries. We have also reduced polio. We don't have children with full-blown, symptomatic polio at the moment. This is a great success story. There are a whole bunch of successes, you could really multiply, But it is also true that we have not remembered them sometimes. Sometimes we benefited because there was a need, for example, not to vaccinate. When we went abroad, when specific vaccinations were needed, right? Yellow fever, and other types of vaccinations required in the countries concerned. And then without any discussion we would go and get vaccinated, we would get, we would get a document, we would have a sense of security during, during our trips. There were also, of course, and still are, various types of vaccination campaigns, the age of adults, particularly vulnerable groups, or those who may be at risk through their work, or for example for tick-borne encephalitis. Healthcare workers are, of course, hepatitis. It was perfectly rational, it was accepted without any emotion, it was not controversial. It seemed to everyone that they were getting something completely extraordinary, because it is extraordinary for us to have. I am going to repeat this like a mantra The sense of health security in this case was given by the state and continues to give. What we have at the moment is quite a worrying situation, because people have this attitude that something is being imposed on them, that they are not making their own decisions, even though they are, of course, actually making them. And, of course, the problem is also that vaccines are produced in such a way that their production cycle, but above all the actions of scientists. There is a lot of knowledge and there are a number of different other experiences, although when it comes to other vaccines, they are implemented quickly, so people have this sense of quickly untested and so on. Well that was a typical example, it was COVID vaccination. But also, please remember, and I will keep on pointing this out, that for such a vaccine to be developed, there are decades of work by scientists on different types of application of different types of antigens in different situations, and also, of course, research, of course, at a fast pace, but at the same time research which meets all the criteria so that such a vaccine can be implemented. And, of course, all medicines, all medical preparations and everything we do is subject to a certain amount of control, including analysis. On the timeline, we are wiser every day, certain things can be improved, but, as you can see, there is not really a desire to improve anything at the moment, because we know that the vaccines that are used are absolutely safe vaccines, absolutely in terms of public health, well, whenever there may be a case of some adverse reaction to a vaccination, we are different as people, but at the same time if as. If it is as a population, we know what needs to be done to make the whole population safe. That's what public health is about anyway, that we take care of the majority. And, of course, nothing ever happens 100 per cent of the time. There are no 100 per cent assumptions, there are always some. Which, in inverted commas, are out of control. But that's what medicine is all about. We absolutely have to choose the lesser of two evils, and in the context of the population this is absolutely to vaccinate as much of our population as possible. It's also a matter of a certain philosophy. We are, we are social beings, something we often forget. And this bond we have with society should be all the stronger the more we feel that we also care for others, not just ourselves.

Monika Rachtan
It is in the context of vaccination that this is very important. You talk about responsibility for the health of the whole population. That is to say, when we vaccinate, we take care not only of ourselves, but also of our grandmother, our aunt, our neighbour and the person in Poland who lives 500 kilometres away from us.

Jarosław Pinkas
About those who ride the bus with us. For example, they are going to hospital, have limited immunity or weakened immunity. We don't know that, do we? This is a noble duty, and we should be happy to do it. It is a shared responsibility not only for my health, but also for my choices. If they are inappropriate and pose a danger, they should be significantly restricted. At the moment it is the pre-election period and people want to hear about freedom. People think they have more and more knowledge and can choose.

Jarosław Pinkas
I digress, but relevant. People used to trust authorities, professionals. Information came from reliable sources. We read a newspaper that published reliable information. Now anyone can write anything and in a second. It costs us nothing to write a post or a comment. Especially if someone has a large following, they can do irreparable damage, sow uncertainty. People have emerged who are not authorities but call themselves influencers and influence our behaviour. Sometimes this is irrational, because they live on controversy rather than solidly documented knowledge.

Jarosław Pinkas
There are people who think they think something and write posts based on this, mobilising their followers on various social media. Some of these outreaches are huge. Why do they do this? They often do it unconsciously, with a sense of 'mission'. But over time, or even immediately, this is monetised. They make a living out of it, out of the number of likes, out of ads on YouTube or other media. It is very difficult for public health professionals because they have to be extremely principled. I know the situation will change, because bad human choices lead to fatal consequences. When we are young, we don't realise it. But if we choose badly, if we don't vaccinate, if we don't live a healthy lifestyle, at some point it accumulates and we will have to suffer the consequences.

Jarosław Pinkas
Everyone thinks they are immortal, that they are in no danger. But at some point this accumulates and we will have to suffer the consequences. If we don't care for others, our choices can cause many people to suffer. Our family suffers when we are sick, not to mention other consequences such as spreading the disease. It is also a social problem, related to supporting the family, to the emotions we generate. We must not forget that we are social beings and our choices affect others.


Monika Rachtan
I, too, think that the COVID-19 pandemic has shown the enormous misery that can result from a lack of vaccination. What do you think? Has the pandemic affected us positively in any way? Do we trust vaccination more now?

Jarosław Pinkas
The COVID-19 pandemic is a great misfortune that has caused people to doubt scientists and doctors. Doctors are now seen as people who could neither foresee the situation nor effectively deal with it. The consequences of this are numerous human tragedies, including the Long Covid cases. There is now a perception in society that it is all a 'plandemic', a conspiracy by those in power. This is problematic and affects current politics.

Monika Rachtan
Did you suffer from COVID-19?

Jarosław Pinkas
Yes, I did get sick and even despite being vaccinated. I went through the illness quite badly because I was working a lot at the time and was weakened. However, I think it would have been even worse without the vaccination.

Monika Rachtan
I have also been ill, and more than once. I heard recently that you can only get sick once and no more.

Jarosław Pinkas
Of course, it is possible to become ill more than once. Older people, people with other illnesses or those who are weakened and work a lot are particularly vulnerable. This is why vaccination is so important. I follow the recommendations and vaccinate when it is advisable. I have no doubt that I should listen to professionals: scientists, doctors and other medical experts. Vaccination is also the responsibility of other people who do a tremendous job, such as the health inspectorate, which did extraordinary things during the pandemic, but unfortunately is often...

Monika Rachtan
True, let me return to the subject of trust in vaccination. Has the pandemic made us trust vaccination more? Because you mentioned earlier that this is not necessarily the case.

Jarosław Pinkas
No, confidence in vaccination has not arrived. What is noticeable in the public space is the 'virus of denialism', a widespread rejection of reality. This spreads easily. People tend to forget and can be easily indoctrinated. In addition, it is not just about vaccination, but also about the various restrictions put in place during pandemics. People are looking for people to blame, although I firmly believe that many lives have been saved through these measures.

Jarosław Pinkas
If we behave rationally and wisely, we see the results. I think that the first year of the pandemic, especially up to November 2020, was a period of extraordinary prudence and reasonableness in Poland.

Monika Rachtan
This is true.

Jarosław Pinkas
I feel that all the decisions taken, even if some were excessive, were aimed at minimising losses. All this affected various spheres of our lives, including the health service, which we had to keep in good shape. From the very beginning, care was taken to keep health workers safe, because it is difficult to do anything without them.

Jarosław Pinkas
This is quite obvious. We also had examples of how the first SARS spread in Korea and in Asia through health care facilities. Action was therefore sensible. Now some people criticise this, but arguably a lot could have been done differently. I often talk about the 'owl of Minerva', a concept from Hegelian philosophy. It is a nocturnal bird that is wise by observing day and night. So post factum everyone is wise and would like to change decisions. We are still back to conspiracy theories. It is also important that we can compare ourselves with other countries.

Jarosław Pinkas
The first year was excellent, but then the pandemic began to be doubted, helped by social media. The rigours relaxed and a dramatic situation developed. I think it is too early to make a clear assessment. It is worth noting that many people died because they did not take care of themselves beforehand. For example, a lot of people don't know they have diabetes.

Monika Rachtan
This is true.

Jarosław Pinkas
They don't take care of themselves. If you add a virus to diabetes, the number of complications is huge. This is the SARS virus, which affects the endothelium, which is the lining of the blood vessel. This is crucial to our functioning. But going back, it is worth remembering 2020 and how we are learning about this virus. Learning is not about predictions, but about changing our decisions as we learn.

Jarosław Pinkas
And this is, of course, very complicated, because until now we thought that science, and especially medicine, was unchangeable. Nothing could be further from the truth. All medical technologies are changing. There are new diagnostic and therapeutic tools, doctors are learning new skills. We are dealing with a completely different world that is changing very rapidly. And the real acceleration, in my opinion, was brought by COVID. At the moment, we don't yet know about all the interesting developments, but I am sure we are better prepared for the next pandemic.

Monika Rachtan
Yes, this is true.

Jarosław Pinkas
We already have schemes in place, better functioning institutions that have been neglected over the years. I would like to return to the subject of sanitary inspection.

Monika Rachtan
Could you explain clearly what the health inspection even does? In our patient programme, many people may not know about it.

Jarosław Pinkas
Instead of asking what it does, it is better to ask what it does not do. The inspection has a very broad spectrum of tasks, which are of course described in the law. If we drink a glass of water in the morning and feel safe, if we eat breakfast and are sure that our food is of good quality, this is thanks to the sanitary inspection. It is responsible for the quality of the water that comes out of our tap and that the food in the shops is largely safe. The sanitary inspection is also in charge of sanitary and hygienic conditions in food production areas, hospitals and clinics. It is also responsible for our vaccinations and the entire immunization programme. It ensures that the cold chain is maintained and that what children get is safe.

Jarosław Pinkas
The inspection is also responsible for ensuring that we live in a safe home. We test, for example, radon, the different intensities of factors that can be dangerous for us. And I could go on and on. Many of you have no idea how much good the inspection does, mainly because you rarely come across it. Inspection also has an important educational character that is rarely talked about. For example, the sanitary inspection has been one of the key players in the anti-smoking project and has done so effectively. Thanks to the actions of various institutions, including the State Sanitary Inspection, the percentage of smokers has decreased from 52% a dozen years ago to 25% now.

Monika Rachtan
Well, that's because the data.

Jarosław Pinkas
These figures are worrying, but the inspectorate, although sometimes oppressive in a good way, deserves respect. It issues fines where the criteria are not met. And although I have not worked there for more than two and a half years now, my heart remains there. If a fryer gets a fine, it means it's done so that we don't get poisoned on holiday or in an ice cream parlour. This is extremely important for all of us. We have not had any big problems so far with infectious threats in our food, such as the toxic E. coli in Germany a dozen years ago. These "guardians" of ours, whom we should respect, are only 16,000 in the whole of Poland. And these are only a few aspects of their actions, there are many more.

Monika Rachtan
This is probably the most important thing.

Jarosław Pinkas
This most important feeling is our state of mind. When we get up in the morning, it is related to the fact that we live in a country where services are working and doing better and better. Speaking between us, COVID has resulted in the State Sanitary Inspectorate getting more resources, although it is still lacking. It has also become a more modern institution. It's a matter of digitalisation, and the introduction of a virtual station for the exchange of experiences between employees. Not everyone will like it, because the inspection can sometimes be oppressive, it demands something from us. But it does it so that we have a sense of health security. So let's think warmly of those who demand something of us. It's not irrational, it's not like someone is picking on the fact that a tap doesn't work or is badly fitted.

Jarosław Pinkas
This has a profound significance.

Monika Rachtan
Today we have talked a lot about COVID-19 and about health inspection. I would like to ask when and why should we vaccinate when we are adults? You said that there are groups that are particularly vulnerable to diseases and for them certain vaccinations are dedicated. What are these vaccinations and for whom?

Jarosław Pinkas
This is a very important question, thank you for asking it. I will not list all the vaccinations because everyone should ask their doctor what they should vaccinate for. Medicine is individual, so everyone should get the right knowledge or ask if vaccination is safe for them and if it makes sense. Now is a good time for concrete action, because the mushroom season is approaching and we will be going to the forest, which is a great passion for many Poles.

Monika Rachtan
Mine too.

Jarosław Pinkas
Well done. I wish you success.

Monika Rachtan
Thank you.

Jarosław Pinkas
Hopefully there will be great boletes this year. But how can you feel safe going into the forest? There are a huge number of ticks in Poland, which can transmit tick-borne encephalitis. The tick population in Poland is growing.

Monika Rachtan
Increasingly so.

Jarosław Pinkas
This is related to the climate we have. Tick-borne encephalitis is a really dangerous disease, but we can significantly reduce the risk of contracting it by simply vaccinating. The vaccine is available.

Monika Rachtan
And how often? Can everyone get vaccinated?

Jarosław Pinkas
It is worth seeking information from sources, checking that there are no restrictions for me, and simply asking your GP.

Monika Rachtan
Family.

Jarosław Pinkas
Yes, a general practitioner who, by the way, is well equipped to do this. I try not to give global health advice. Although I am a big proponent of flu vaccination and cannot imagine not being vaccinated every year, there are also sometimes contraindications.

Monika Rachtan
Of course.

Jarosław Pinkas
It would be a good idea to consult, or at least read up on, this vaccine and consider whether I might be at risk of a complication, for example related to an allergy to egg white. This is rare, but worth bearing in mind. Vaccinations are important throughout our lives. So let's talk about vaccination in adults and older people. I think 60-year-olds are still young people, but it's worth taking care of yourself. I've noticed that they often care more about their cars than themselves. We have all sorts of viruses in us, for example those that cause chickenpox, which can reactivate.

Jarosław Pinkas
If we have a weakened immune system, we can contract shingles, which is a severe disease that causes a lot of suffering. The nerve pains are very difficult to treat. However, you can protect yourself against this by getting vaccinated for shingles. The vaccine is very effective and it is worth thinking about, especially if you have other diseases. I suggest you ask your GP about this vaccination, but also about others, like for pneumococcus.

Monika Rachtan
Can we really die from pneumococcal disease?

Jarosław Pinkas
Yes, we can die from severe pneumonia, which is difficult to treat, especially in the context of antibiotic resistance. The older and sicker we get, the greater the risk. Fortunately, we have various vaccines, for example for respiratory diseases. The hope is that these will be available for all children, but they are already available for adults. They are worth looking into, especially those for pneumonia, which are really dangerous.

Jarosław Pinkas
It all depends on our awareness and the right choices.

Monika Rachtan
I think that before the COVID-19 pandemic, the prevailing belief in Poland was that respiratory illnesses were the result of colds, smog or cold weather. Many people didn't realise that the only effective defence against viruses or bacteria was vaccination. In the context of RSV - this is a virus known mainly to young parents. Older generations often do not know about it.

Jarosław Pinkas
Exactly, people often forget that even a simple cold can develop into pneumonia and end in death due to complications. These illnesses are caused by various pathogens, not by the cold. Although the cold can affect the immune system, the right problem is bacteria, viruses or fungi. We can defend ourselves against them, especially if vaccines are available.

Jarosław Pinkas
Vaccinations are crucial, especially for older people. In Poland, unfortunately, we have low levels of vaccination, for example against influenza.

Monika Rachtan
It is only 7%.

Jarosław Pinkas
Maybe even less than that. But still 7% is reasonably good, because a few years ago it was below 4%. Nowadays, more and more people are realising that influenza can be a fatal disease. Especially for people with cardiovascular or heart disease.

Monika Rachtan
In Poland, seniors are either very keen to go to the doctor with every pain, or they do not do it at all, saying they do not have the time or are afraid to do so. What is to be done when such a patient does not contact his/her primary care physician and ask about vaccination? Is there another place where he or she can get reliable knowledge about vaccination, not counting internet forums?

Jarosław Pinkas
I am not talking about forums, but websites such as the National Institute of Hygiene or other public institutions. These are always reliable. But let's remember that there can also be sites impersonating these institutions. However, there are many sites from reliable sources such as the Sanitary Inspection or the Ministry of Health. All these institutions promote rational knowledge, which helps us to make good health decisions.

Monika Rachtan
Professor, the internet is full of conspiracy theories about vaccination. How do you communicate about this issue? How to talk about vaccination?

Jarosław Pinkas
The conversation about vaccination should be clear. Based on current knowledge, we know which vaccine to use and when to repeat it. Science is an ongoing process. We should also remember that vaccines and pathogens change. That is why research is being done all the time to create something better and safer.

Monika Rachtan
So in communication we should focus on highlighting the learning process?

Jarosław Pinkas
Yes, on the learning process and on the progression of learning.

Monika Rachtan
Let me come back to vaccination and ask about the rational arguments. What are people afraid of in terms of vaccination? There are certainly people who have doubts. Is it because they do not have enough knowledge or do not understand the processes? For example, not everyone realises that we now have more researchers and the process of creating vaccines is faster.

Jarosław Pinkas
Lack of knowledge is one reason. Another is the information that comes to us, which is not necessarily knowledge. Sometimes they are so interestingly given that we start to trust them. Conspiracy theories emerge according to which vaccines are irrelevant and are sold to us by doctors. Meanwhile, once upon a time no one had such doubts; vaccination was the greatest good.

Monika Rachtan
And the doctor was a great authority.

Jarosław Pinkas
Yes, the doctor was a huge authority. I remember in my time there was a child with polio in every school. People saw it and knew that vaccination was the most important thing for their child. Nobody argued. Maybe it was because the knowledge was clearer. We seem to have forgotten the values and vaccines have fallen victim to their success.

Jarosław Pinkas
The idea is to keep the message positive, but we also need to be consistent. Whenever someone raises doubts, it is worth asking on what basis they are based - on research, myths, absurdities? In the context of vaccines, you have to be consistent in your questions.

Monika Rachtan
You have many years of experience as a doctor. Have you ever had a critical situation where a vaccine patient came to you because something bad was happening?

Jarosław Pinkas
Good question. I have been a doctor for 47 years and have also worked in primary care, which I have always valued. Personally, I don't have such experiences. Of course, there are doctors who have them. There can always be adverse vaccine reactions, but if you analyse the situation carefully, most often you find that the reality is different. Medicine is personalised and we know more and more about adverse reactions that are not falsified. They can also be reported by parents, but in Poland these reactions are generally harmless. For example, erythema can mean that the immune system has reacted appropriately.

Jarosław Pinkas
This means that the amount of antibodies will be higher. Has the body given a signal to defend itself, for example with fever or weakness? Such symptoms, which we sometimes call 'crashing', are not a cause for concern. Of course, you have to be vigilant and report it to your doctor, because our experiences influence medicine. New technologies, new adjuvants, and new approaches to what part of the pathogen will trigger the greatest immune response - everything is changing.

Monika Rachtan
When I ask you about your vaccination experience, I would also like to ask you if you remember a story that happened as a result of someone not being vaccinated? I know such a story and I can tell you about it. It is the story of a paediatrician's surgery to which a few-year-old boy came with a respiratory infection. It turned out that his parents had not vaccinated him on time or at all. The boy was ill with whooping cough, but was cured. Unfortunately, there was a small infant sitting in the waiting room at the same surgery who had contracted the infection from this boy and died.

Monika Rachtan
This is a terrible story. Both families lost in this situation.

Jarosław Pinkas
Yes, there are plenty of stories like this. One of my close friends was not vaccinated for COVID and is only alive thanks to new technologies. He is now a person who even promotes vaccination and says he made a fatal mistake. However, I do not want to talk about tragedies. Unfortunately, in medical work we often encounter them. They are largely the result of bad health decisions. For example, we don't use preventive programmes like the 40+ programme, or we have doubts about vaccinating children against HPV.

Monika Rachtan
Now this is what I want to ask, because there is this conspiracy theory circulating that the vaccine causes promiscuity.

Jarosław Pinkas
This is indeed a conspiracy theory. Everyone knows very well that this vaccine has completely nothing to do with it. Sexual initiation in children in Poland has increased, despite the fact that the vaccine is increasingly available. It is not that this vaccine affects promiscuity or the speed of sexual initiation. It is a vaccine that saves lives. If we look at it in a principled way, it will prevent at least 1,500 to 1,700 women a year from dying in Poland. These are mothers, wives, and it means a loss of a sense of stability for the whole family. Every year, several thousand people will become ill, will be saved by surgery, but will not be fully functional.

Monika Rachtan
Because we didn't say what it was about....

Jarosław Pinkas
I am sorry to interrupt you. We have a choice of two vaccines that also protect against head and neck cancers. HPV is the virus that causes cancers of the genital organs, but also of the anus and throat. In 70% cases of head and neck cancer in Sweden, this is caused by HPV. This is a dramatic story. You can also protect yourself in other ways, but this is not always successful. It is worth remembering that this virus can also be transmitted through kissing.

Jarosław Pinkas
We have hard data from many countries that have introduced mass vaccination. In Australia, for example, it is virtually impossible to meet a woman who has developed cervical cancer. This has been eliminated, which is a spectacular success of vaccination.

Monika Rachtan
At the beginning, when I asked about HPV, we did not say exactly what cancers this virus causes. It's about cervical cancer, but not everyone may know that. Is the public aware that the virus can cause cancer?

Jarosław Pinkas
It isn't. On my Twitter feed the other day, someone wrote that this is not true and that there is no research on the subject. He also claimed that a woman infected with this virus can eliminate it within two or three months. It is impossible to argue with this, but these opinions are in the public space. There are oncogenic viruses, this has been proven. One scientist even got a Nobel Prize for it.

Monika Rachtan
I still want to ask about the HPV vaccination, as it is new in Poland since the first of June. Can this vaccine be considered a kind of cure for cancer?

Jarosław Pinkas
The vaccine is free for children. I suggest that girls be vaccinated when the time comes. This vaccine has an age caesura, but you can be vaccinated at virtually any age. It is especially important before sexual initiation. It works from the age of 11-12, but if someone is 14, 15, 16 or older and hasn't been vaccinated, it's really worth doing. It brings extraordinary health effects and a sense of security.

Monika Rachtan
And from the point of view of parents who want to vaccinate their child, where should they apply?

Jarosław Pinkas
To the GP, to primary care.

Monika Rachtan
Does anything need to be pre-empted? What does it look like?

Jarosław Pinkas
As a rule, appointments are made by telephone. This works really well in Poland, although it varies in large cities. The GP is well informed and orders the vaccine.

Monika Rachtan
At the end of our conversation, I would like to ask what are the three most important things that people who watch or listen to us should remember?

Jarosław Pinkas
The most important thing is that we start taking care of ourselves in a smart way. Just as we take care of our cars by going for a check-up or a car wash, we should also do regular checkups. If we know that something might put us at risk, for example because of our specific interests like the forest, then let's get vaccinated. I have talked today about safe vaccines that can protect us from serious illness or death. The second important thing is to be critical of the information we are bombarded with. We need to learn to verify sources. I am running a big project with four universities on vaccine confidence. We even have a website medfejk.co.uk and a Twitter account. We are fighting myths and misinformation there. The third thing is trust in medical institutions and doctors. There is no such thing as 'alternative medicine', there is only one medicine.

Monika Rachtan
That is, let us take care of ourselves.

Jarosław Pinkas
Yes, let's take care of ourselves, verify the information that comes to us and be critical, but let's also trust our doctors and nurses. They are well educated and only have our best interests at heart.

Monika Rachtan
I think it is worth thinking not only about ourselves, but also about our loved ones and those we meet, for example, on the bus. In the context of vaccination, this is very important. We can't be selfish, we have to think more broadly. Professor, the partner of this podcast is the Institute for Patients' Rights and Health Education, which talks a lot about the humanisation of medicine. What does the humanisation of medicine mean to you?

Jarosław Pinkas
In medicine, humanisation is intrinsic. It is, above all, the ability to talk to the patient, to be empathetic and assertive. It is important to reach out to the other person. Of course, technology and new procedures are also important in medicine. But the most important thing is the patient. We treat the patient, not the test results. Often patients come to be listened to and helped to make a good choice. In medicine, we need to be deep humanists. Yes, engineers and biotechnologists develop medicine, but medical professionals implement it.

Monika Rachtan
Professor, I have three questions found on groups. I am not asking for diagnoses, but I would like to hear minute answers to give guidance on how to proceed. During the administration of the vaccine, the nurse damaged the syringe and the child was not given the whole dose. Is this vaccination effective?

Jarosław Pinkas
Vaccination is only effective if the entire dose is given. Further steps should be decided by the doctor in order for the vaccination to be effective.

Monika Rachtan
You are invited to listen to the podcast. "Patient First". Good morning, I welcome you very warmly to the next episode of the programme. "Firstly the Patient." And today my guest, but above all your guest, is Professor Jarosław Pinkas. Good morning, Professor.

Jarosław Pinkas
Good morning, and a warm welcome.

Monika Rachtan
The professor is a specialist in general surgery, family medicine and public health, and today we are going to talk about vaccination. A topic that is very important, very topical and probably relevant throughout a person's life, not just in childhood.

Jarosław Pinkas
Yes, throughout a person's life.

Monika Rachtan
Well. The pandemic showed us a little bit that vaccination is not only for children, that is, it is not in the parents' interest, but also at an older age we can vaccinate, we should vaccinate. Do you, Professor, also have this observation that it is this COVID pandemic that has built this greater awareness?

Jarosław Pinkas
Yes, undoubtedly. It has been shown how important vaccination is. We had forgotten about them as the most important tool in the fight for human health, the most important for health and life. Vaccines have been very successful. After all, thanks to them, we do not have many diseases. We have significantly reduced the incidence of many diseases. As a result, we have forgotten about them. But it is thanks to vaccines that we do not have smallpox, which was a real human drama for many, many centuries. We have also reduced polio. We don't have children with full-blown, symptomatic polio at the moment. This is a great success story. There are a whole bunch of successes, you could really multiply, But it is also true that we have not remembered them sometimes. Sometimes we benefited because there was a need, for example, not to vaccinate. When we went abroad, when specific vaccinations were needed, right? Yellow fever, and other types of vaccinations required in the countries concerned. And then without any discussion we would go and get vaccinated, we would get, we would get a document, we would have a sense of security during, during our trips. There were also, of course, and still are, various types of vaccination campaigns, the age of adults, particularly vulnerable groups, or those who may be at risk through their work, or for example for tick-borne encephalitis. Healthcare workers are, of course, hepatitis. It was perfectly rational, it was accepted without any emotion, it was not controversial. It seemed to everyone that they were getting something completely extraordinary, because it is extraordinary for us to have. I am going to repeat this like a mantra The sense of health security in this case was given by the state and continues to be given. What we have at the moment is quite a worrying situation, because people have this attitude that something is being imposed on them, that they are not making their own decisions, even though they are, of course, actually making them. And, of course, the problem is also that vaccines are produced in such a way that their production cycle, but above all the actions of scientists. There is a lot of knowledge and there are a number of different other experiences, although when it comes to other vaccines, they are implemented quickly, so people have this sense of quickly untested and so on. Well that was a typical example, it was COVID vaccination. But, also, please bear in mind, and I will keep on pointing this out, that for such a vaccine to be developed, there are decades of work by scientists on different types of application of different types of antigens in different situations, and also, of course, research, obviously at a fast pace, but at the same time research which meets all the criteria so that such a vaccine can be implemented.

Jarosław Pinkas
And, of course, all medicines, all medical preparations and everything we do is subject to a certain amount of scrutiny, including analysis. On the timeline, we are wiser every day, certain things can be improved, but as you can see, there is not really a desire to improve anything at the moment, because we know that the vaccines that are used are absolutely safe vaccines, absolutely in terms of public health, well, whenever there may be a case of some adverse reaction to a vaccination, we are different as people, but at the same time if as. If it is as a population, we know what needs to be done to make the whole population safe. That's what public health is about anyway, that we take care of the majority. And, of course, nothing ever happens 100 per cent of the time. There are no 100 per cent assumptions, there are always some. Which, in inverted commas, are out of control. But that's what medicine is all about. We absolutely have to choose the lesser of two evils, and in the context of the population this is absolutely to vaccinate as much of our population as possible. It's also a matter of a certain philosophy. We are, we are social beings, something we often forget. And this bond we have with society should be all the stronger the more we feel that we also care for others, not just ourselves.

Monika Rachtan
And it is precisely in the context of vaccination that it is very important, because you are talking about responsibility for the health of the whole population, that is, we vaccinate ourselves, we take care of our grandmother, our aunt in our neighbour's house and the resident of Poland who lives 500 kilometres away from us.

Jarosław Pinkas
About those who are travelling with us on the bus. They are going to hospital, for example, do they have limited immunity or do they have weakened immunity? We don't know that, do we? We have a duty and it is a noble duty. This word duty is nothing that should affect us. We should be happy to do this civic duty. This is what our role and life in society is all about. It is a shared responsibility, not only for my health, not only for my choices, but these choices of mine. If they are bad, if they cause danger, well, they should be significantly restricted. And, of course, we now have this sense that we should have this sense of freedom. Yes, it's a difficult time, it's a pre-election period, that's what's being peddled at the moment. And people want to listen to it. They feel that they have more and more knowledge, they can choose. This is also a digression here, but I think, unfortunately, a very important one, that it used to not be like this. And it used to be that people trusted authorities, they trusted professionals, and now this information comes from sources that are absolutely proven.

Jarosław Pinkas
That's how you took the newspaper. There was something written in that newspaper. As a rule, they were reliable things, because nobody allowed themselves to write, to write things that were not checked. If only because the author wrote it. That author had some affiliation, came from some scientific centre, then there were editors, there was proof-reading, and there was also an analysis of what social resonance it would have if it was controversial. Now everyone can write anything and literally in a second. It costs us nothing to write a post or a comment, and especially when those who write have large followings, they can do irreparable damage. To sow, to sow uncertainty, to sow hesitation. And that's what it's all about. Also, please remember that there have been the emergence of such individuals of such names, who are not authorities of any kind, they just call themselves influencers and they influence us, our behaviour. Sometimes it is completely irrational, because they live from controversy, they don't live from the fact that something is reliably documented by them, that they have their own knowledge or a workshop through which they have acquired this knowledge.

Jarosław Pinkas
These are the people who think they are doing something. And this is such a category. I think something, therefore I can write something, I can tear down my followers or those who follow me on all sorts of different social media. Some of those reaches are huge reaches. The next question is why do they do it? Often they do it, completely unconsciously, with a sense of mission quoting, a sense of mission. But over time, or maybe not, sometimes it is just simply monetised. It's what they do for a living. Yes, from the amount of likes from the ads that are, that are on YouTube or other media that reach people. At the moment, public health professionals have a very, very difficult life, because they have to be extremely principled. And of course I know full well that at some point the situation will change anyway. Why? That these bad human choices lead to fatal consequences? One. As long as we are young, we don't realise it. But the fact that we choose badly, that we don't vaccinate, that, that we don't lead a proper lifestyle, that's how everything is allowed now.

Jarosław Pinkas
Everyone thinks they are immortal, that there is virtually nothing, nothing threatening them. Well, that accumulates at some point and we have, we are going to suffer the consequences of that in the future, unfortunately. And another thing is that I will come back to this sense of, however, selfishness. If we don't care about others, then please remember that at. Elections. These are also the misfortunes of many people caused by the fact that we are sick. It is our family who suffer from our illness, it is our loved ones. Not to mention the other consequences, such as the fact that we can spread some disease, but also the fact that we are beings after all. Once again, I will repeat it socially, we cause suffering because of our illness, because we are leaving, not to mention the whole social aspect. Well, that is the problem of maintaining a family, isn't it? An appropriate standard and the kind of emotions that we generate that do not make people happy.

Monika Rachtan
I, too, think about the misery that a lack of vaccination can cause, the COVID-19 pandemic showed us. Because we saw these huge divisions of people. Well, what is your opinion? Did the COVID-19 pandemic have a positive impact on us? Have we learnt anything? We have seen this great misfortune and we trust vaccination more now, for example.

Jarosław Pinkas
The COVID-19 pandemic has brought something that is a great misfortune. What the pandemic has brought is that people, people have seen that perhaps things are not as they are shown by scientists or specialists, doctors. At the moment, doctors are seen as the ones who failed, firstly, to predict and, secondly, to be effective, because they end up with a huge amount of human misery, misfortune, human drama. Then the long Covid and suddenly it turned out that the doctors were to blame for that. Another thing is that somewhere in the space it appeared that there was no pandemic and now it is working at the moment. There was no pandemic, there was a plandemic, and it was all concocted. These are conspiracies, these are conspiracies of the rulers of the world, let's call it that. I don't want to name them, but it's worth seeing what's going on at the moment. Anyway, this is also how politics is being done at the moment.

Monika Rachtan
Can I ask one thing, did you suffer from COVID-19?

Jarosław Pinkas
I was ill and, despite being vaccinated, I passed, not particularly smoothly. I know how. I know how difficult this illness is. One of the reasons I was ill was because. That I was actually working beyond my capabilities at the time and was quite weakened. However, I think it would have been much worse if I had not been vaccinated.

Monika Rachtan
Well, that's right, because I've also been sick and I've been through it quite badly and I've been sick more than once, and I've also heard recently from the mouth of one person that you can only get sick once and you absolutely cannot get sick a second time.

Jarosław Pinkas
Of course it is possible to fall ill. Especially those who are older, who have a lot of illnesses or who have weakened immunity, who work very hard, get ill. So of course you should be vaccinated. If I vaccinate, I vaccinate when there are recommendations in relation to the railways, to specific vaccinations. I know that if it is intended for me and it will be good for me, then of course I will vaccinate, and I have no doubts here that I should, however, listen to those who deal professionally, that is, scientists, doctors and other medical professionals. After all, there are also other people responsible for vaccination who do an unbelievably hard job, such as the health inspectorate, which did extraordinary things during the pandemic, and unfortunately is often very

Monika Rachtan
Yes, it is true. I took the liberty of interjecting just now. Have you been ill and have I been ill? Because when someone has been ill, it seems to me that they cannot say at all that there was not this pandemic. Because if we know how, how this infection came hard, how we watched our relatives who also got infected so quickly at home, despite the fact that they were vaccinated, well it is difficult to doubt at all that this pandemic existed, but we talked about this confidence in vaccination and that is what I would like to come back to. Is it the pandemic that has made us trust these vaccinations more? Is the data maybe already there on that You have already said that we do not trust more.

Jarosław Pinkas
more we do not trust. Above all, because in the public space, the virus of denialism, let us call it that, that is, the rejection of reality, the rejection of truth, is quite widespread. It spreads easily. Yes, we have this tendency to forget. Yes. Someone can easily indoctrinate us. We see, after all, nothing has happened. Another issue is this. This is a question not only of vaccination, but also of what happened during the pandemic, which was extremely distressing. Yes, it was the introduction of all sorts of lock down restrictions. And it is a question of finding fault. Why has it been put in inverted commas? Because I firmly believe that hundreds, thousands of people, if not millions, were saved by these measures. Let alone how many lives have been saved in the world thanks to the fact that they have begun. It has begun to influence human behaviour in a significant way. I once said that a virus, apart from its biology, is also sociology, sociology, it is human behaviour. And, of course, I say this only in the context of behaviour that is supposed to be safe for others and safe for us.

Jarosław Pinkas
And that is what sociology is. Sociology is the science of behaviour. If we behave in a rational, wise way, well, we get results from that. And I think that this first year of the pandemic, especially up to November 2020, has been a year of extraordinary prudence and rationality, especially among Poles.

Monika Rachtan
This is true.

Jarosław Pinkas
And I have this impression that everything that was done, was done. Even though some people said that it was redundant, because there were probably elements somewhere, redundancy, and they were done purely out of concern for our survival, for the losses to be as small as possible. And here, in my opinion, a great deal of respect is due to those who were not afraid to take decisions that were very difficult, that affected the economy, that affected behaviour, that affected our young people, our schools, and so on and so forth. After all, it affected all areas of our, our lives. And besides, please also remember that we had to create a situation in which there would be an all-round efficient health service? Well, health care. That is to say, we had to create a situation in which the flow of patients to hospitals was not so small that the health service was efficient, and we also had to take care of it. And at the very outset, practically all of you know how to make sure that healthcare workers are safe, so that they have a sense of security, because without them, nothing can be done afterwards.

Jarosław Pinkas
This is completely, completely obvious. We also had examples of how the first, the first SARS spread in Korea and in Asia. Well, through healthcare facilities. And these actions were sensible actions by all means. Now it is being panned by some, by some who think that everything has been done right. Everything. Well probably not everything, because a number of things could probably be done differently. But there is this notion of the owl Minerva. I use it a lot. It is this. It comes from Hegelian philosophy. She is, as you know, a bird that is a nocturnal bird. She also observes the day and is thus wise at night. This is, of course, so literary or philosophical. A philosophical, interesting example. And, of course, post factum everyone is wise, everyone would like to change, modify or simply renew this decision, because some people think that there was no pandemic after all. That's how we keep coming back here, to these, to these theories, to these conspiracy theories, yes. And, of course, a major problem is that we are also already able to compare ourselves quite strongly with others, with other countries.

Jarosław Pinkas
As I said, that first year was excellent, then in an important way, however, I think this is where social media largely led to when the pandemic started to be doubted. We were heartily sick of it. We loosened up, the rigours loosened up, these internal rigours of ours as well. It came to a situation, a rather dramatic situation, because I do not want, I do not want to comment. I still believe that it is too early to say unequivocally what caused the excess deaths, but it is also worth saying unequivocally at this point that those who died were, firstly, those with multimorbidity, which means that at some point we probably stopped caring about them. It is not just a matter of lack of access to healthcare, but also, and above all, that a great many people died because they simply did not take care of themselves before. So bad things. If in the case of mums. If we have in. This example is perfect. It seems that between 800 000 and one million people do not know they have diabetes at all.

Monika Rachtan
This is true.

Jarosław Pinkas
Because.

Monika Rachtan
They do not ask.

Jarosław Pinkas
They just don't care. So, if we superimpose a virus on top of, on top of, on top of diabetes, the number of complications is obviously unbelievably high. This is the virus that causes SARS. This is the virus that affects the endothelium, which is, well, something extraordinarily important. It is that lining of the blood vessel. It's crucial to us in terms of functioning, right? So that's one example. I could go on and on, and after all, we've only met briefly, so I have to operate with some mental shortcuts. But it is also worth coming back to this, and especially for those of you who are listening to us today, to remind yourselves what it looked like in 2020, what the world looked like, how we learned this virus. Also, there is a different approach to science right now. No scientist is a cure-all, has no predictive skills. Science is something completely different. Science is the ability to change your decisions on a timeline. We learn, we change the decision, we give it, we learn, we change the decision, we modify it. This is often what a decision is about.

Jarosław Pinkas
And this is of course extremely complicated, because until now it has been the case that it seemed that science was carved in stone, especially medicine. So. Nothing changes, everyone knows everything, it's completely different. All medical technologies, after all, are practically changing. There are more and more new diagnostic tools, therapeutic tools. Doctors are acquiring other skills, so we are in a completely different world. This world is changing unbelievably fast, but such an acceleration was, in my opinion, also COVID at the moment, because it also brought, I think, many extremely interesting solutions that we do not know about yet, but I think we know how to prepare for the next Pandemic.

Monika Rachtan
Yes, that's right, we have.

Jarosław Pinkas
We have already developed patterns, we have better functioning institutions that we have, which, well, have been depressed quite a lot over the years. I come back here to the sanitary inspection, which.

Monika Rachtan
What does the Health Inspectorate even do, well, because we are in the patient programme. Patients may not know that such a thing exists, or if they do know that it exists, they may be completely clueless as to what the tasks of such a body are. That is, it is there to clearly explain what the inspection does.

Jarosław Pinkas
It would be better to ask the opposite question of what the job is not. The inspection has an extremely broad spectrum of its tasks. They are, of course, described in the law. But if we feel safe in the morning, if we drink a glass of water in the morning, if we make ourselves breakfast, if we have the knowledge that our food is excellent, because between you and me, we have some of the best food in the world, that is the responsibility for water. What is in our tap is checked by the health inspection. What we buy in the shop is largely safe, for the reason that all sorts of rigours are implemented. Also, of course, the food itself is the responsibility of its producers. Not the Sanitary Inspectorate, but the Sanitary Inspectorate is responsible for making sure that it is done in appropriate, properly described sanitary and hygienic conditions, right? And so on and so forth. The sanitary inspection is responsible for making sure that the hospital is clean and the clinic is clean. The sanitary inspection is responsible for our vaccinations. The sanitary inspection is responsible for the whole immunization programme. So that the cold chain is maintained, so that what the children get is safe.

Jarosław Pinkas
The inspection is also responsible for ensuring that we live in a safe dwelling. To a large extent, we inspect radom, we inspect the various intensities of factors that can be dangerous for us. And I could go on and on. And you, you have no idea how much good the inspection does, because you don't see it often enough. Inspection also has a very important educational character, which is also not talked about, right? I have, among other things. The State Sanitary Inspectorate was one of the important participants in the tobacco control project and did it in a very effective way. Well, in addition to various institutions, this State Sanitary Inspectorate has led to a situation where, from 52% smokers a dozen years ago, we now have 25% more people smoking at the moment, unfortunately.

Monika Rachtan
Well, that's because the data.

Jarosław Pinkas
These figures are worrying, well. But overall, this is an inspection that is also sometimes oppressive in a good way. It is. It should be respected for that. It's fines where you don't meet the criteria and even when you identify quite strongly with the institution. Although I have not worked there for more than two and a half years now, my heart remains there. It's this. If a fry-up gets a mandate, that is, it is a mandate that has definitely stayed. It's been done so that we have a sense of not poisoning ourselves on holiday or in the ice cream parlour or wherever. I am obviously implementing it. It's not nice for the owner, but I think.

Monika Rachtan
Important to us.

Jarosław Pinkas
But it is extremely, extremely important for us. We have not had, have not had, and I hope will not have any more, any great investment problems associated with the dangerous threat of infection of our food. Look at what happened a dozen years ago in Germany. Truth? Toxic ecoli, right, and the death of people. Anything can happen, of course. These caretakers of ours, whom we should really respect, are only 16,000 in the whole of Poland. I'm not just saying probably not many. And look, I have already discussed, I have only talked about a few, a few aspects of how they work or how they operate, but there are many more. If we were to go on for another four hours, I can tell you what the health inspectorate does. The fact that we have health security in the morning is.

Monika Rachtan
It is perhaps the most important, It.

Jarosław Pinkas
It is, and this is the most important feeling, it is our state of mind. When we get up in the morning, it is related to the fact that we live in a country where, however, these services work and work better and better. COVID, also between you and me, has led to a situation where the State Sanitary Inspectorate has been given a bit more resources all the time, that it has gone digital and from a coarse institution. It is an institution that is increasingly modern. It's a question of digitalisation, a question of bringing about something that could be called a virtual exchange station between, so between employees of course. Well, not everyone is going to like it, because, as I said in inverted commas, it is sometimes an oppressive inspection, that is, it demands something from us. OK, but why is it done? It is precisely to have this sense of health security. So let us think warmly of those who sometimes demand something of us. And it is not irrational. It's not that someone is picking on the fact that a tap isn't functional or that it's badly seated.

Jarosław Pinkas
This has a deep, deep meaning.

Monika Rachtan
We have said a lot of COVID today-19 We have said about the health inspection. And I would like to ask well what and why should we vaccinate when we are older, that is, when? This immunization programme, which is aimed at children, will it be finished already? And when we enter this adult age, you said that there are special groups which are particularly prone to disease, to certain illnesses, and specific vaccinations are dedicated to them. Well, exactly what kind of vaccinations are these and for whom?

Jarosław Pinkas
This is a very important question. Thank you very much for asking it. I am not going to list them all, because also remember that it is good to ask your doctor what I should or should not be vaccinated against. Medicine has a way of being personalised, so everyone should get the right knowledge or ask themselves whether it is safe for them or not and whether it really makes sense. So let's get to some specifics at the moment, because this is a very good time. Yes, it's about to be that I think, a great mushroom season, so we'll be going into the woods. Yes, and this is a great passion for many Poles.

Monika Rachtan
Mine too.

Jarosław Pinkas
Well done. I wish you success.

Monika Rachtan
Thank you.

Jarosław Pinkas
I hope there will be great boletes this year. But it's a good thing, too, because to make you feel safe going into the woods? There are a huge number of ticks. In Poland, the population is higher.

Monika Rachtan
Increasingly so.

Jarosław Pinkas
Related to the climate we have here. We have the virus that causes tick-borne encephalitis, which is a really dangerous disease, and we can make it so that we do not get the disease by simply vaccinating. A vaccine is available, a vaccine for this tick-borne encephalitis.

Monika Rachtan
And let me ask how often? Can anyone get vaccinated here?

Jarosław Pinkas
Here it is worth i. However, reach out to sources, see if I can, if there are any restrictions on my person and simply ask your primary care physician, ie.

Monika Rachtan
Family.

Jarosław Pinkas
That is to say, the family doctor, who is perfectly placed to provide us with such information. I try not to give global health advice because, as much as I am a great apologist for flu vaccination, I cannot imagine not being vaccinated every year. These are also sometimes contraindications.

Monika Rachtan
of course.

Jarosław Pinkas
So it would be a good idea to either consult this or actually read up on the vaccine and think about whether there is a real risk of a complication, even if I am not allergic to egg white, for example. This is not particularly common, but it is worth remembering. It is worth remembering. In addition, the introduction to our conversation is that vaccinations affect our entire life. That's right. Let us, then, talk about what should be done in adults, or even in older, elderly people, because here we have such a time line, 60 years, I think. These are still very young people, but sometimes it is good to take care of oneself, to take care of oneself, and it is precisely 60-year-olds who take care of their cars, between us, rather than themselves, and especially gentlemen. So please remember that there are diseases that we have inside us, or viruses that we have inside us. These are what are called viruses, which are lateral viruses we passed on to chickenpox. There are dormant, dormant viruses in our neural ganglia.

Jarosław Pinkas
We have a period where we have some kind of weakness in our body. We get sick with all sorts of diseases, a weakening of the immune system, and suddenly we have shingles. And shingles is a serious disease. Shingles is a disease that can give an incredible amount of suffering in the form of various neuralgia. These. These are nerve pains that are very difficult to treat even by eminent pain management specialists. These are the pains that can last for a very, very long time, limiting us already after the illness. Yes, already afterwards, after this acute phase. And it can persist for a very, very long time. It can be controlled by simply being vaccinated. We have, we have a new vaccine against hemiplegia and it is also extremely effective, so it is worth thinking about this, especially when we are also affected by other diseases. We know about them here too. Here, too, my suggestion is to ask your GP whether I should sometimes, whether I should be vaccinated for this. Well, of course, we have pneumococcus, several, several important vaccines that also make sure that we do not get seriously ill or simply die from pneumococcal bacteria this time.

Monika Rachtan
And we have a way we can die through this one.

Jarosław Pinkas
We are going to die from severe pneumonia, which can be very difficult to treat, which is also related to the fact that if we have weakened immunity, and this is also related to something that is a big Polish problem, which is antibiotic resistance, then we can actually have, have significant problems treating this. Well, and the sicker we are and the older we are, well, it will actually put us at great risk, so we are able to defend ourselves. Well, we also have other vaccines, Well, here it is probably worth saying that it is the RSV vaccine, This is the virus that causes respiratory disease. We also have this vaccine for children. It, I think, has a chance at some time, hopefully soon, to be a vaccine which will be available to all children, that is, it will enter the immunisation programme. But we also have such a vaccine for adults for respiratory diseases, infections of various types, well, especially those that end, end. Me pneumonia really is dangerous and we have a powerful weapon of form at the moment in the form of these very vaccines, so that we fight with this weapon.

Jarosław Pinkas
It is purely a question of our awareness, our good, good choices.

Monika Rachtan
I think that when it comes to respiratory diseases, it was in the minds of Poles even before COVID 19 in particular, that respiratory diseases are caused by colds. I got cold, smog, something like that happened to me. I have a cold, it turns into another illness, worse, more, more symptomatic. Whereas a lot of people didn't associate at all that actually vaccination is the only thing they can do, Because when they encounter a virus or bacteria, it doesn't matter if they're dressed warmly, it doesn't matter if they're wearing a scarf or a hat. They just might get sick. And here there is no other way. And when you talk about RSV, I think in the minds of young people who have children, this virus is a little bit popular. But my grandmother or my grandfather completely has no idea that there is such a thing as RSV. I think completely people don't know that.

Jarosław Pinkas
This is what people see. They don't remember that at least it's worth coming back to, that a simple cold like that can end up in pneumonia. Someone died because of complications. After all, he did not have to die from these complications if he had been vaccinated. These diseases are caused by different types of pathogens. Not from the cold. That's right. Of course, it is the cold that actually causes us to have a certain loss of immunity. It changes our mucous membranes, and it's dozens of different factors. It has a certain impact. But these diseases that we are talking about are linked to the fact that they are either bacteria, viruses or fungi, and we can deal with them to a large extent if we have a vaccine option. There are not, of course, vaccines for everything, but also the world is moving and advancing to the point where those major pathogens that are dangerous to us, and we know how many deaths RSV causes, are several tens of thousands of deaths in Europe. I am not talking about and deaths in the elderly related to pneumococci. There will probably be less of that, because we have unvaccinated child populations at the moment, so they will not bring the elderly that way, but they will, nevertheless.

Jarosław Pinkas
The elderly should definitely get vaccinated and remember that they are needed. influenza is a typical example here. In Poland, we actually vaccinate poorly compared to European countries.

Monika Rachtan
It has 7%.

Jarosław Pinkas
7%, maybe even less. If 7, then between you and me, it's not so bad, because we had two three years ago, if I remember, below 4%, around 4%. It's somewhere in the consciousness at the moment that influenza is a disease that is maybe a fatal disease. I think, if not in every family, among our friends there are those who have died from influenza. Yes, especially when they had cardiovascular disease, illness, heart disease. This is a significant problem. A vaccination that can be carried out instantly. After all, we have population-based programmes for the elderly at the moment, so that they are protected, and it's really, it's worth taking advantage of.

Monika Rachtan
I'm going to ask the population programmes about this, because it seems to me that in Poland it's the case that Poles, especially the elderly, the seniors let's call them that, or they really like going to the doctor and they go often. In fact, with any pain, or they see their family doctor regularly. But there are also those who don't go to the doctor at all, because they say I don't want to, I don't have the time. And that's it. And now, in a situation where such a patient doesn't communicate with this primary care doctor at all, or doesn't even know how to talk to him, because he's afraid of him, because before the visit he nervously writes down on a piece of paper everything he wants to say to him. And he runs out of questions about vaccinations. Is there any other place where he can gain such valuable knowledge about vaccinations? I am not talking here about forums, the Internet and such places.

Jarosław Pinkas
About the forums, no, but about the websites of, for example, the National Institute of Hygiene and Public Institutions, which are institutions. They are always reliable. Yes, but sometimes please be aware that someone is impersonating them. Sometimes it is. These are the websites of the Sanitary Inspection, the Ministry of Health, the National Health Fund, the Patients' Ombudsman. There are a whole bunch of them. All these institutions are involved in promoting rational knowledge, which results in us choosing well, because in fact our lives are connected with our choices, so either we choose well and live happily ever after, or unfortunately it is our choices that cause that. That it's our life that's not entirely happy, That's why we live with illness, which is not pleasant.

Monika Rachtan
Professor, we have been talking a lot about the internet today, and the internet is full of conspiracy theories about vaccination. Some of them are, we can say, from outer space, but some of them may have some grain of truth in them. We didn't know a lot either, for example about COVID 19 vaccines during the pandemic. Some things we were learning. We also talked about this learning process today, and now the anti-vaccinationists are using this ignorance of ours, this learning process to create different stories, and how to communicate in such a situation? How to talk about vaccination.

Jarosław Pinkas
In a very unambiguous way. The conversation about vaccination should be unambiguous. At this stage of knowledge, we know that we should administer such a vaccine at such a time, repeat it at some time. That is what science is all about. We are still learning. Please also bear in mind that vaccines also change, because viruses, pathogens change. We also have access to new technologies. Well, several hundred scientific institutions around the world are probably working on vaccines. It is an ongoing process, it is an analytical process, it is a process that results in something better, safer, safer every time. Maybe safe should always be, but safer is always some. And some chance to make something better improve, to give a vaccine that is more effective.

Monika Rachtan
OK, so in this communication we should focus on emphasising this learning process.

Jarosław Pinkas
Through the process of learning and the process of learning progression.

Monika Rachtan
I will still ask about vaccinations. I will still come back to these vaccinations and ask about the rational arguments. And what are people afraid of when it comes to vaccination? Is it actually the case that there are people who are afraid? Because there are. There are people who have doubts, because they have the right to have doubts, because, for example, they don't have enough knowledge, they don't understand all these processes. They just think in the way that once a vaccine was studied by one researcher and he did it for 20 years. Today we have 25 researchers in the lab and they are testing it. It's somehow going faster, but not everyone is able to understand it. Also, older people think that they have absolutely no idea what it is like to create this vaccine.

Jarosław Pinkas
Your editor did not answer in the first sentence lack of knowledge. Another issue is the question of what information comes to us. Information not knowledge. Sometimes they are so interestingly given that we start to trust them. We start to believe. Yes. Why? Why is there a whole conspiracy around vaccines? Yes, this conspiracy is that someone has invented something that is completely irrelevant to us. He has his canvassers, that is, those who sell it. These are the doctors, of course, these are the ones. Who talk about how it, how important it is. And it's not true. Why do we have to? Why should we do it when someone is going to make a good living through our choices? Yes, that someone, that mythical someone out there, the conspiracy, the truth etc etc etc etc. I for one wonder what it used to be like, because a few decades ago no one had such doubts. Vaccination was the greatest good

Monika Rachtan
And the doctor was a huge author.

Jarosław Pinkas
The doctor was a tremendous authority, but then I remember my own days when practically every school had a child with polio. That's how people saw this polio and knew that the greatest value they could give to their child was to vaccinate that child. Nobody, nobody argued, there was no such thing. Well, because as I said, the knowledge at that time was written down, it was quite hard. It was. However, it was all pretty much reduced. We had forgotten the values. Vaccines have unfortunately become a victim of their success. I know that the situation can change when we show, echo coffins and so on. See the unvaccinated dead do not do that.

Monika Rachtan
Well, that's exactly what it doesn't do.

Jarosław Pinkas
Or rather, we want the message to be positive, but we just have to be simply consistent. Whenever someone objects, it's worth asking yourself, where is this knowledge coming from? What is it based on some research, some myths, some absurdities, what is the truth in these vaccines, etc. etc.? Well you just have to be consistent in your questions.

Monika Rachtan
The Lord has worked as a doctor for many years. Many years of experience working with patients. Do you recall such a very critical situation where a patient got a vaccine and went to your professor because something terrible was happening or not?

Jarosław Pinkas
Well, that's a good question. I have been a doctor for 47 years and have also worked in primary care, unusually always. I have always, always valued and. Well I will say, I don't have that experience of my own. Of course there are probably doctors who have, there are always adverse vaccine reactions, or you can relate something. After all, there is always some time coincidence with the administration of the vaccine. But if one digs in very deeply, one suddenly finds out that it is completely different. Or if it is different. But as I said, there's always a certain amount of uncertainty that someone might not react the way we want them to. That's where personalised medicine comes in, but we know more and more about adverse reactions to vaccines and they really aren't falsified, because they come from two sources. Well, and the source of the National Institute of Hygiene. Very unequivocal. So we are talking ourselves here about parents in particular. They can report adverse reactions to vaccines, but they are what they are in Poland. One of my colleagues wrote that this should be. It should be called positive post-vaccination reactions, because if someone has an erythema it means that their immune system has reacted in the right, in the right way.

Jarosław Pinkas
And you know that the amount of antibodies will be higher. Has the body given a signal to defend itself with a fever, with some kind of weakness? Sometimes, right? What we call a breakdown. Isn't it easier with a medical term? But, but sometimes we can express it in that way. Well, even if these are it, let's stop worrying about it. Although, of course, you have to be vigilant and tell your doctor, because, after all, a number of things are changing. There are new technologies, new adjuvants, there are also new approaches to. To what part of the pathogen produces the greatest amount, will give us the chance to produce the greatest amount of immunity or whether cellular. It goes like this.

Monika Rachtan
When I ask about these experiences, I will also ask in the other direction do you remember a story, One from the clinic, that happened because it was a consequence of someone not being vaccinated? Because I know such a story. Maybe I'll tell mine first. Yes, yes. And it's not really a good story, because it's the story of a paediatrician's surgery where a boy of a few years old comes in with a respiratory infection. It turns out that the parents didn't vaccinate this boy for the time when he was little or didn't do the vaccinations at all. They abandoned them and, after some time, it turns out that this boy was ill with whooping cough, but was cured. The story ended very well for this boy, but in the same paediatrician's surgery, a tiny baby was sitting in the waiting room. An infant who had come for such his first visit. It wasn't even a check-up yet, because they are probably more careful not to have anyone in the corridor at that time, but it just somehow ended up in that clinic, in that surgery, and got infected from that boy and died.

Monika Rachtan
I. And it's a terrible story. Because, in fact, both parents lost. Yes.

Jarosław Pinkas
There are plenty of stories like this. One of my very close friends. One who went astray. Yours was not vaccinated for COVID. He is alive miraculously he managed to be saved, but he ended up like this. He is alive thanks to new technologies. He is in the moment. A person who even affirms immunisation. He is the person who said after I wandered off. I made a fatal mistake. I let myself be persuaded. I would never do it again in my life. And at the moment, he is indeed the person who is making a clear statement on this subject. But I don't want to talk about tragedies. Unfortunately, medical life causes one to encounter them very often. As I said, to a large extent they are the result of our poor health choices, of us not listening to each other, throwing in a problem or not doing what we should be doing at the right time. For example, getting tested, such as going to see your primary care doctor as part of the 40+ programme. This is still the case. Either we, or we don't at the moment, have doubts about whether our children should be vaccinated against HPV. Yes.

Monika Rachtan
Now, this is what I want to ask, because here there is this conspiracy theory that there is such a word promiscuity, that this vaccine causes promiscuity.

Jarosław Pinkas
is this really a conspiracy theory? Everyone knows perfectly well that it has nothing to do with anything. Anyway, sexual initiation in children in Poland, despite the fact that this vaccine is increasingly available. It used to be that a large number of local authorities also vaccinated for free. So it has increased. It is not that this vaccine has any effect on promiscuity or the speed of sexual initiation. A vaccine that saves lives in other ways. This is a vaccine that. If we are principled, 1700 women in Poland will not die in at least 1500 1700 people in each year. 1700 women are mothers, they are wives. That is the loss of a sense of stability for the whole family. Each year a few thousand will become ill, have an operation, be saved but not be fully functional. Yes they may be disabled, they will have to be treated. Also what has happened in the family is something that is very traumatic. Yes, the feeling that the mum, the wife might be gone. That's right.

Monika Rachtan
Because we didn't say, because it.

Jarosław Pinkas
Another point. Sorry to get into a word. It is still the vaccines. We have two vaccines to choose from, they also protect us against head and neck cancers, against other cancers. HPV is an androgenic virus, which causes cancers. Urogenital, which is genital, but also anal. These are the cancers that cause, which are also caused by cancers of the throat and neck. In 70 70% of head and neck cancers in Sweden. This has been precisely investigated, it is from HPV. This is a dramatic story. These are cancers of the larynx. They end up later with extremely disabling operations, human dramas. This is what awaits those in the near future. Of course, you can also protect yourself in other ways, but it doesn't always work. I do not want to. I don't want to tell you here how the transmission of this virus occurs, but it is also worth remembering that this virus can be spread by kissing, so we can get someone into a situation where they have a cancer that is difficult to heal. So it is something that is important. I'm not afraid to use it because the gift that children are getting at the moment to be protected for their lives.

Jarosław Pinkas
Here we have hard data in many countries that has led to population-based vaccination in Australia. Well that is us. You can't meet a person who is not with a woman who is, who has developed cervical cancer. That has been eliminated. The spectacular success of immunization and a principled approach.

Monika Rachtan
Because just at the beginning, when I asked about HPV, we didn't say so precisely what cancers, what cancer, what cancer in women, that it is cervical cancer that is responsible. HPV Virus Also not everyone may know about it so much. I don't know if this awareness of the public that the virus can cause cancer is present at all?

Jarosław Pinkas
It isn't. I came across this once, where on my Twitter feed someone was describing It's not true, it hasn't been researched, there's no such thing. And besides, a woman who is infected with this virus can eliminate it abroad within two or three months. It's impossible to argue with that, but it's in the public space somewhere. Yes. There are viruses that are oncogenic viruses. This has been proven. Even one scientist got a Nobel Prize for the fact that this virus is a virus. oncogenic code for other, that is, causing, causing cancer.

Monika Rachtan
That's another thing I'm going to ask about HPV and the HPV vaccination, because it's a new thing that came out in Poland from the first of June. And just as we've been looking for a cure for cancer for many years, I think this vaccine can probably be considered a bit of a cure for the general population for, well, cancer. And where, when?

Jarosław Pinkas
Who is this vaccine for? For children it is a free vaccine. I suggest that we vaccinate, we vaccinate girls when the time comes, because this vaccine has an age caesura, but also you can get it and vaccinate at virtually any, any age. It is especially important to vaccinate before sexual initiation. Yes, it does indeed apply to 11-12 year olds. But if someone is 14, 15, 16 or older and they haven't been vaccinated, it really is the best investment in their child. The best one that is possible. We have. We have a clear situation at the moment that it brings extraordinary health outcomes and a sense of security. It has nothing to do with promiscuity.

Monika Rachtan
This is yet to be asked from the point of view of mums of dads who want to go with their daughter, Where should they go to the doctor.

Jarosław Pinkas
Family, to primary care, to the GP?

Monika Rachtan
And this needs to be pre-empted somehow. Is this vaccine.

Jarosław Pinkas
This is generally by appointment? Telephone appointments mostly work really well in Poland outside the big cities. This is said because here it is a bit worse. You have your own doctor, it's a GP, he's very well informed and orders the vaccine. It's available in GP surgeries.

Monika Rachtan
I'm going to ask you one last question, because our conversation is coming to an end. The hour has flown by quickly. What are the three most important things from our conversation today that the people who are watching us should remember.

Jarosław Pinkas
The most important thing is that we start thinking about ourselves, that we start looking after ourselves in a smart way, not the cars. Just as we go to the car wash or go for a check-up, let's have a periodic check-up. If we have the knowledge that something might put us at risk, if only because we have, we have some interesting preferences of our own, for example this forest, well, let's get vaccinated and we have. I was talking today about these. vaccines which are safe for us and which mean that we will not get seriously ill or simply die from pathogens. Another thing is that we need to analyse where the information comes from. We are bombarded with all kinds of information. So let us check, let us learn to check. I am running a major project with four universities on increasing confidence in immunisation. We even have our own website, medfejk.co.uk We have a Twitter account, Med vs Fake. It's well worth a look. We debunk myths there. Anyway, there are a growing number of people who are debunking all sorts of myths or starting to fight against charlatanery because there is no alternative medicine.

Jarosław Pinkas
Medicine is one, just as there is no alternative law, because the law is so one, yes. Including alternative law is a crime too. And here you are also shmoozing such stories Alternative medicine what won't the doctor tell you? He has a vested interest in not telling you. This is something that is utterly dramatic and causes indeed a lot of human misery. Let's check, let's analyse, Let's ask ourselves who it serves. This is an important question who does it serve? Because if we go to the website of the National Institute of Hygiene of the National Health Fund, the Patients' Ombudsman of the Ministry of Health, it serves to keep the population healthy. There is no hidden intention, none, none. It is almost impossible to find the intention.

Monika Rachtan
That is, let us take care of ourselves.

Jarosław Pinkas
Let's go back, let's verify, let's be critical of the various pieces of information that come to us, those that are not in line with what the institutions that are there to offer, but also trust your doctors, trust your ladies, your nurses, your pious ladies. They are really well educated and want only our good.

Monika Rachtan
I think that another very important thing is for us to think about ourselves, but also to think about our loved ones, about the very people we meet on the bus, which you said earlier is very, very important in the context of vaccination. And here we can't be selfish, but it's worth thinking more broadly. Professor, a partner of this podcast, of this programme, is the Institute for Patient Rights and Health Education, which talks a lot about the humanisation of medicine. What is the humanisation of medicine for you?

Jarosław Pinkas
In the humanisation of medicine, there really is medicine. There is no medicine without humanisation. I think in this context that you are asking me, it is first of all the ability to talk to the patient. It is empathy, those are. It is the ability to convince one's self, a certain assertiveness and the ability to be able to reach out to another person. This is medicine. Of course, it is also technology. It is also new procedures. However, in medicine, the most important thing is the patient and the patient. That's right. 'Patient first' is like that. And it is the treatment of the patient, not the results of tests. Right? It's that deep insight into the problem, the ability to listen. After all, very often our patients come to be listened to, to. To give them a solution and a good choice. This is what I will repeat like a mantra. Do we choose well? Yes. In general, I can't imagine that someone who practises this profession is not a deep humanist. Medicine can sometimes be engineering. Sometimes. Engineers develop medicine bio technologists yes, biologists yes, but this implementation is nevertheless medical professionals, of which I also include them to a large extent.

Monika Rachtan
Professor, I am collecting questions from the groups and of course I am not asking you to make a diagnosis absolutely, but let me read these three such questions that I found on the groups and ask for literally minute answers to give a quick hint on how to act. During the administration of the vaccine, the nurse damaged the syringe that contained the preparation. The child was not given the whole dose. Is this vaccination effective?

Jarosław Pinkas
Vaccination is effective when the whole dose is given and the decision should be made by the doctor. What needs to be done for vaccination to be effective?

Monika Rachtan
OK, thank you. Another question. I am wondering if I should postpone the vaccination due to the fact that everyone in the house is sick except for the person who is supposed to be vaccinated 4 months. All in all, she could become infected at any time. I have heard that clinics still vaccinate.

Jarosław Pinkas
They vaccinate when the doctor decides that it is safe to vaccinate. Also, I won't answer that question, because that's for the doctor to decide whether a child can be vaccinated or not. Please remember that we still examine children before vaccination and part of the examination is the history.

Monika Rachtan
On a positive note. And one last question. We are going on our last holiday without the baby. And generally no additional vaccinations are required there, But because I am pregnant, should I be vaccinated for something?

Jarosław Pinkas
And that is a very good question. And it is a question for the person in charge of the pregnancy. Every pregnancy goes differently. Whether it is the length of the pregnancy is also very important. Sometimes it's also worth asking the doctor if she should go to this Zanzibar just pregnant, in what month, and get an idea of what the health care is like in that country.

Monika Rachtan
Well, that's what's important. I think insurance is too.

Jarosław Pinkas
Insurance is self-evident.

Monika Rachtan
Yes, one last question, may I?

Jarosław Pinkas
You are very welcome.

Monika Rachtan
Is it possible to be vaccinated during pregnancy? Because I think here.

Jarosław Pinkas
It is also already possible to be vaccinated during pregnancy.

Monika Rachtan
And what are we vaccinating against?

Jarosław Pinkas
We still vaccinate, including for covid we vaccinate for many different conditions and if there is a doctor's decision, we vaccinate then in pregnancy. When the doctor tells us that we should vaccinate in pregnancy. That's what the obstetrician, the gynaecologist is for. We have access. Also, the midwives can make suggestions to us. As I said, every case is different. Let us take medical advice.

Monika Rachtan
Professor, thank you very much for our conversation today, for a lot of valuable information. Some myths, I hope. We were able to dispel. Some facts about vaccination and health. We also presented in this programme thank you very much for accepting the invitation to this programme, Professor, and thank you for your attention.

Jarosław Pinkas
Thank you very much.