The importance of vaccination in the fight against viruses. Episode 28

Monika Rachtan:
As a child, when I was sick, or rather had a cold, I always left the doctor's surgery with a prescription for an antibiotic. This seemed to me to be the rule, but today it turns out that antibiotics are not the best way to fight a cold. They can do more harm to our body than help, destroying our bacterial flora and making it resistant to certain strains of bacteria that we can contract in unexpected situations. Fortunately, today we have tests to determine whether we have a viral infection, which does not require treatment with antibiotics, or a bacterial infection. Most importantly, these viral infections are as high as 90 per cent and the bacterial ones only 10 per cent. COVID-19 was also a viral infection and we did not need to be prescribed antibiotics at all. This is what I will be discussing today with Professor Adam Antczak, a specialist in pneumology, but above all the head of a temporary hospital during the pandemic. I'd like to invite you to the programme "Patient First". If we had met on air two years ago, I would probably have been sitting in a mask and talking to you. Fortunately, we're in a time now where it's safe, or at least we think it is. And we seem to have forgotten a bit about the COVID-19 pandemic, and are even laughing about it on the internet. Is that right?

Adam Antczak:
Good morning to you.

Monika Rachtan:
Professor, are there any COVID-19 patients in your department?

Adam Antczak:
Unfortunately, yes. There are patients who are ill with COVID-19. There are patients who have pneumonia because of this, and they get very ill. So, ladies and gentlemen, today I want to tell everyone that the pandemic is not over.

Monika Rachtan:
This is surprising, Professor, because it was announced in the media months ago that the pandemic was over. We have stopped disinfecting our hands. The retail chains of the big shops where we all shop, or at least most of us, still have hand disinfection stations everywhere, but every time I go in, I see that they are empty.

Adam Antczak:
Unfortunately, they are empty and that is not good. The concepts of pandemic and epidemic are, in short, administrative concepts. If we declare them, it involves different solutions on the part of the state and medical organisations. In this sense, a pandemic is not there, because the number of sick people is no longer so huge and the threat is definitely lower. But this does not mean that COVID-19 has packed its bags and moved somewhere into the skies. The virus has stayed. It occurs in cycles, which means we are talking about COVID-19 and waves. With other viruses, we talk about seasons. COVID-19 is such a seasonal virus too, or at least we think it will be. When is the season for COVID-19? When it's winter, when it's November. These are the two waves that we have usually seen since 2020, which is the autumn wave, which started and picked up very strongly end of October, November, December, reaching a peak just somewhere around November, sometimes January, and it subsided a little bit, and then there was a clear increase around February and March.

Adam Antczak:
We say scientifically that it was a bimodal distribution, in short, there were two waves in each year. Of course, this number of infections fell sharply around May, June and there were very few infections in the summer months, practically no deaths at all we observed. But I would remind you that, for example, in April this year, early April, now it is November, there were about a dozen deaths a day due to COVID-19. The number of deaths due to COVID-19 reached about 500 a month, which is very high. Later, of course, the number dropped sharply because there were no infections. But now comes autumn. As they say, autumn goes, there is no way around it. Therefore, from September onwards we always have an increase in viral infections. Viruses in the northern hemisphere, including Poland, attack us when the temperature drops sharply. In September, for example, we had very few infections because it was very warm. Viruses, for example, influenza type, COVID-19, merino, para influenza virus, RSV, these are very dangerous viruses.

Adam Antczak:
They like temperatures in the plus or minus 5 degrees range, that's when there are the most infections. That's when we congregate, we don't stay outdoors, we stay indoors. That's when humanity hides from the cold, and as it hides, it has more contact with each other. More contact means easier transmission. This is true for COVID-19 and other viruses endemic at this time. We had a time when COVID-19 swept up everything else and pushed out.

Monika Rachtan:
How we stopped getting the flu.
Adam Antczak
Influenza has taken over the whole virus market and all the rest have gone into hiding. At the moment they are competing with each other, and the number of RSV fungal infections is increasing. In Poland, we record around 1,000 cases of RSV every week. We are dealing with different versions of the virus, such as O and KRON, which are relatively infectious but not very pathogenic, cause primarily cold illness and are common. This prevalence means that many of us have probably already gone through another infection and had a simple cold, usually characterised by a nasty runny nose and thick secretions clogging the sinuses. However, with mass illnesses, there is always a proportion of people who get sick more severely, especially if they have a predisposition to it. This predisposition mainly affects older people. We often talk about the +50, +65 group, but in fact the change in response to microbial attack occurs around the age of 50, not in people considered older. Nowadays, a 50-year-old is a fully active person. Let us remember that life expectancy has increased significantly since the Second World War, and that the limit considered to be old age, 65, is a conventional number set by historical social agreements, not biology. In fact, the risk of infection and severe disease increases with age. Thus, people aged +65 are completely different biological groups - it is possible to meet a 65-year-old in perfect biological shape, while an 85-90-year-old is already a completely different organism, more prone to infection and severe courses of disease.

Adam Antczak
In the case of the current situation with COVID-19, when talking about the number of more than a thousand cases per day in Poland, it is worth pointing out that there are also deaths related to the disease. COVID-19 has not disappeared, it has not been lost. It is not something that could pack up in suitcases and disappear.

Monika Rachtan
I realise that the pandemic is still ongoing, and it is important that we remain vigilant. Could we now turn to the question of antibiotics? This is also a very important topic and I would like to ask about the situation in Poland with regard to the use of antibiotics.

Adam Antczak
Let us, of course, move on to this topic. Antibiotics are a different health issue, but equally important. Unfortunately, there is a problem of overuse of antibiotics in Poland, which leads to many negative consequences. As I mentioned earlier, antibiotics are only effective for bacterial infections and not for viral infections. Unfortunately, many patients expect doctors to prescribe antibiotics even for viral infections, which is not only ineffective but also harmful.

Monika Rachtan
Are doctors aware of this problem and what measures are they taking to reduce the overuse of antibiotics?

Adam Antczak
This is a complex issue. Many doctors are aware of the problem of antibiotic overuse, but unfortunately sometimes, under pressure from patients or for other reasons, they prescribe antibiotics without justification. However, many medical communities and health organisations are undertaking educational activities to raise awareness among patients and doctors about the responsible use of antibiotics. In Poland, there are also educational campaigns to counter antibiotic misuse.

Adam Antczak
It is worth stressing that the overuse of antibiotics has serious consequences, such as the development of bacterial resistance. This resistance is becoming an increasing global problem, especially in times of pandemics, where antibiotics are essential for the treatment of bacterial infections. Therefore, educating the public on the appropriate use of antibiotics is crucial.

Monika Rachtan
Has the COVID-19 pandemic somehow affected the antibiotic overuse situation?

Adam Antczak
Yes, the pandemic has had some impact on the antibiotic situation. On the one hand, the restrictions associated with the pandemic, such as social isolation and increased hygiene measures, have contributed to a reduction in the number of infections and therefore also a reduction in the number of antibiotics prescribed. This is a positive aspect. On the other hand, however, the pressure on the health system, especially during the intense period of the pandemic, may have led to overuse of antibiotics in some cases.

Adam Antczak
It is therefore important that we are aware of the consequences of antibiotic misuse and strive for responsible use of these drugs. This is not only a matter of individual health, but also of public health on a broader scale.

Monika Rachtan
Thank you, Professor, for this valuable information. I hope that this conversation will contribute to raising public awareness of antibiotic use. Could you summarise the main points we discussed?

Adam Antczak
Of course. The most important issues are to be aware that the COVID-19 pandemic is still ongoing, although to a lesser extent than before. It is therefore important to be cautious and follow hygiene and safety recommendations. When it comes to antibiotics, responsible use is key. Antibiotics are only effective in treating bacterial infections and their overuse leads to serious consequences such as bacterial resistance. The public and doctors should act together to prevent the misuse of antibiotics and safeguard public health.

Monika Rachtan
Could we speculate a little bit? The professor mentioned that we are talking in November, but our viewers will probably only watch the episode in December. So what is in store for us before Christmas in terms of COVID-19? Can we expect a peak in disease?

Adam Antczak
Currently, the number of cases is increasing and is likely to continue to do so. In December we can expect to see even more cases, perhaps even more than a thousand a day. This is quite significant. It is also important that microbial transmission occurs during gatherings and gatherings. This is why Christmas, New Year's Eve and around this time is the ideal time for virus transmission into the environment. Viruses simply 'like' this time.

Monika Rachtan
But before that, we all also meet in the shops.

Adam Antczak
Of course, before that we have a shopping frenzy where the shops are full of people. Now, after years of isolation and distance, it's hard to tell people to do the same things now as before, because it's not safe. Whereas what we can do as a society is to wear masks.

Monika Rachtan
That is, it is worth having a mask with you at all times.

Adam Antczak
You even have to. Nowadays in hospitals, for example, we are back to wearing masks. We used to not wear masks for a long time. I personally use them regularly at work, but I admit that over the years I have got used to not having to wear them all the time. Now that the need to wear masks at my work has returned, I have to get used to it again. I use them often and I have to say that that unpleasant feeling of wearing a mask has returned.

Adam Antczak
For a long time, I selected the masks myself because I was not used to wearing them for long hours, which caused skin irritation. It's not many people who realise what it looks like from the inside that we had head injuries and sores caused by wearing masks. It wasn't until later that we learned to use comfortable masks that are made in Poland and are both high quality and skin-friendly. These are minor details. But when a mask grows into someone's nose, it's not at all pleasant to work for several hours and wonder what exactly hurts on the face. Or if someone wears glasses.

Monika Rachtan
Yes, some of the masks were so steamy.

Adam Antczak
Indeed, some masks caused the glasses to steam up. Almost all of them had this effect, but it is only temporary. You can get used to it. Besides, the evaporation of the glasses itself goes away, and the mask itself protects us from infection. Even if we have slight symptoms of infection, it is worth wearing the mask, thinking of others. Especially about older people. We go to a shop where people of all ages are shopping. We can imagine a situation where someone who is carrying a milder form of the virus infects an older person who already has some medical conditions. By wearing a mask, we not only take care of ourselves, but also others.
Monika Rachtan
That is to say, the social responsibility that we talked so much about, shall we say, two years ago. It is worth returning to it again. I'd like to leave it at Covid-19 for a bit and talk about infections in general. Our grandmothers, when the autumn and winter season started, used to say: "Fasten your jacket up to your neck, put on your hat because you'll catch a cold." Are these illnesses, associated with coughs, runny noses, a result of the cold, of being out in the cold air? Does it have an impact, but should we go more back to these endemic things and think about this hygiene? And doesn't that only apply to the other diseases that the professor mentioned?

Adam Antczak
The human respiratory system is attacked by around 200 different viruses. That's a whole range of microorganisms that can threaten us. As I said earlier, they like temperatures of plus or minus 5 degrees. Essential question about the cold: What is the cold all about? In medicine we don't use such a term, although there is such a thing as the 'common cold'. It is a viral illness, mainly caused by so-called rhinoviruses, commonly occurring during the change from summer to autumn, i.e. in September. This usually manifests itself in a runny nose of a few days, feeling sick, but enough to work or study. Statistically, there are about one and a half infections per inhabitant per year in Poland. This is the norm from an epidemiological and physiological point of view, as we do not live in isolation and have a natural tendency to get infections. These infections do not usually pose a threat unless we have serious chronic diseases.

Adam Antczak
A cold can be dangerous in such cases. Let us also not confuse the phenomenon of cooling the body with a cold. A cold is a viral infection, whereas a body chill is when you are exposed to low temperatures and then experience cold symptoms. Such a cold can result from a weakened immune system due to chilling. It is a good idea to take care to protect yourself from low temperatures, especially your head and hands, in order to stay thermally comfortable. However, it is worth remembering common sense by avoiding overheating, which can also be unhealthy.

Monika Rachtan
In previous episodes of the programme, I hosted Valerian Romanowski. Do you know this person, Professor? He is a man who has an exceptional tolerance to low temperatures. He has survived more than 50 days on a frozen river in Lapland. He says the cold can improve immunity and have a beneficial effect on the body. What do you think of such people, Professor?

Adam Antczak
This is very individual. Walrus bathing in itself is not harmful, especially for healthy people. People with chronic respiratory diseases may experience negative effects. As for temperature tolerance, people are biologically different. Some feel comfortable in low temperatures, others in high temperatures. My experience of cold comes from years spent in a cold flat. Despite spending a long time in such conditions, I never got used to them. It is an individual issue whether one prefers low or high temperatures.
Monika Rachtan
Professor Antczak mentioned that each of us goes through about one and a half colds a year. When can we treat ourselves at home using home methods, and when should we go to the doctor? Sometimes people have abandoned visits to the doctor, perhaps through advice, prescriptions and home remedies. What are the symptoms that should worry us? Is there a line between self-medication and the need to visit the doctor?

Adam Antczak
Most illnesses, especially colds, do not require a compulsory medical visit. Isolation and rest at home are usually sufficient. It is important not to infect others by avoiding leaving the house during the infection. After a few days of rest and self-medication, the infection can usually be overcome. It is advisable to reach for home remedies such as the consumption of juices, raspberries, lemonade, and possibly anti-inflammatory medicines such as paracetamol, instead of aspirin, which is more dangerous. However, it is important to notice when symptoms are getting worse.

Monika Rachtan
Could there be situations where people delay seeing a doctor for too long?

Adam Antczak
Yes, there are situations that require a medical consultation. If the fever persists above 38 degrees Celsius for 2-3 days and additional symptoms such as coughing, breathlessness or chest pains appear, it is worth consulting a doctor. In some cases, an antibiotic may be necessary, but this decision should be made by your doctor, avoiding excessive use of antibiotics.

Monika Rachtan
You mentioned the antibiotic pandemic, where overuse of antibiotics leads to bacterial resistance. How do you assess the situation in Poland in terms of overuse of antibiotics?

Adam Antczak
Unfortunately, an excessive attitude towards antibiotics exists in Poland, which leads to many negative consequences, such as the development of bacterial resistance. There is a tendency in Poland to wait for strong antibiotics, and sometimes patients put pressure on doctors to prescribe them. This is an unhealthy practice that has serious consequences.

Monika Rachtan
Are doctors aware of this problem? Why are antibiotics still prescribed sometimes without justification?

Adam Antczak
This is a more complex issue. Some antibiotic prescriptions are justified, but there is also pressure from patients who expect a prescription for strong antibiotics even without necessity. Doctors should be aware of the consequences of overuse of antibiotics and try to avoid prescribing them without justification. There is also a culture of waiting for a prescription, which influences doctors' decisions.

Adam Antczak
It is worth remembering that antibiotics have side effects and their overuse contributes to bacterial resistance, which can lead to serious health consequences. The COVID-19 pandemic has had the effect of reducing the number of infections and therefore also less antibiotics prescribed. This can be a positive effect, but the public and doctors must continue to be educated about the responsible use of antibiotics.

Monika Rachtan
Has the COVID-19 pandemic also affected public awareness of the appropriate use of antibiotics?

Adam Antczak
The pandemic has influenced public awareness, reducing the number of infections and antibiotics prescribed. However, education about the responsible use of antibiotics should be continuous. It is worth understanding that antibiotics are only effective for bacterial infections and not for viral infections. Therefore, the use of antibiotics for viral infections is pointless and harmful.

Monika Rachtan
Thank you Professor for explaining the use of antibiotics and its consequences. I hope that this talk will help to raise public awareness of this topic. Could you summarise the main points we discussed?

Adam Antczak
Of course. The most important points are to be aware that most infections, especially viral infections, do not require antibiotics. Self-medication at home, isolation and rest are usually effective. If fever, shortness of breath or chest pain persists, it is worth consulting your doctor. Overuse of antibiotics leads to bacterial resistance, which is a serious health problem. The public and doctors should act responsibly, avoiding pressure to prescribe antibiotics without justification. Education on the responsible use of antibiotics is key to preventing negative consequences.
Monika Rachtan
I will ask this further on behalf of unbelievers. Let's assume that the clinical picture, i.e. those symptoms that the professor was talking about, point to a viral infection and my primary care doctor, to whom I went because I was very worried about my health, said: "No, no, no, Mrs Monica, please be calm. This is definitely a viral infection." However, I don't believe this doctor because I have a kind of feeling that it is a bacterial infection after all. Is there some kind of test, some kind of examination that allows us to verify whether we are dealing with a viral infection or whether we are dealing with a bacterial infection, so that we don't have to believe the doctor's words, but that we have confirmation through a test result?

Adam Antczak
Firstly, research shows that trust in the primary care physician is one of the most important trust phenomena in our society. If Poles already trust someone, it is the doctor, and pharmacists are well trained and well educated. I am a big fan of pharmacists.

Monika Rachtan
Me too, very much so. Absolutely.

Adam Antczak
Whereas now it is difficult to have a hunch that it is bacteria. Well, you can have a feeling that something is going to happen. OK. But to have a hunch about it being bacteria, I can't imagine. But let's say I have a thought, whether it's definitely right. Not everyone, of course. We are not in a position here and now to investigate immediately whether it is, whether it is a bacterium or not in the first place. Very many infections are. We do not distinguish between others clinically we say. So in short, if someone has a viral infection, I cannot tell by eye what kind of infection it is. Then we can use probabilities. Now, there are a lot of covid 19 infections, so we can say OK, because there are a lot of people sick with covid 19, well then the probability that this disease is just in is high when there is a lot of flu. This is roughly January, February and March. When someone comes in with a fever, they're going to have mainly a fever and they're going to have very few symptoms like runny nose, cough, because in flu it's mainly fever and nothing else. Almost.

Adam Antczak
Then I can be ok. It is a high probability of influenza. If we want to reach for tests, well, of course, in case. Viruses. We have so-called rapid tests available in pharmacies at the moment. Some of these tests either single tests or so-called triple tests have been widely introduced into pandemic medicine and they, after a proper nasopharyngeal swabbing, can tell us whether or not we have RSV, influenza or covid 19 infection. Of course, these tests must first of all be done properly, so if we have that back of the throat gently there, forget it. You really have to apply yourself to it. The second thing is that the result is not always false. There are false results and, above all, false negatives. They can also lead to wrong conclusions. That can also happen, so we have to take that into account. When it comes to other microorganisms, diagnosis is much more complicated. And so from the street, it can't really be done. So, in short.

Monika Rachtan
It was carried out in our hospital at the time.

Adam Antczak
It is mainly carried out in hospitals and primarily in situations of clinical doubt. And, of course, here this diagnostics can be very broad. We are talking about so-called multiplexes, which means that a single swab allows us to identify or examine such biological material for infections with, for example, up to several dozen microorganisms, both viruses and bacteria. In the sense of such hospital medicine, heavy medicine, this is used. Of course, as much as possible. Here, too, attention in many cases fails to confirm the pathogen. We have to be guided by intuition, we have to use so-called empirical treatment, i.e. we think that the probabilities that this is this and that are very high in the particular population where we are and therefore we will use this treatment and not another. This is important. Often we don't have a specific treatment against influenza, we have anti-influenza drugs, against covid 19 is an anti-viral treatment that is very effective and you can even buy it for yourself on prescription from the pharmacy, although it is very expensive. It even costs several thousand zloty per pack? It is actually unavailable because we do not have reimbursement in Poland for the drug, which is considered essential at the moment. But in hospitals this drug is present and we can use it for RSV, the special virus. There is no specific treatment. Here we are not able to give.

Monika Rachtan
Targeted.

Adam Antczak
Exactly against such a microorganism. We have antibodies being introduced at the moment, against such, against such microorganisms, but this is reserved for very severe inflammations when someone is already very seriously ill, because these are very sophisticated drugs and at the same time monstrously expensive. Also, this is all limited. In most cases, we have to follow our own intuition as far as the doctor is concerned and a certain amount of knowledge and experience. And this is what we call empirical therapy or blind therapy. It has a slightly uglier name.

Monika Rachtan
But empirical is much better.

Adam Antczak
Empirical because we have some experience, i.e. we have tested populations, we know what the probabilities of a given microorganism are, and can therefore apply empirically. The opposite of such empirical treatment is targeted treatment, that is, we have carefully examined biological samples in a person, some secretions and so on. It could be urine, it could be faeces, it could be secretions, bronchial, and it could be washings, bronchial, nasal swab and so on. And we have, first of all, the microorganisms identified, for example, in the case of bacteria, we also have what's called an antibiotic, which is a description, a kind of analysis in which the microorganisms. In the case of bacteria, it's a bacterium. We describe the sensitivities, and then it is targeted. We choose the antibiotic to which the bacterium is particularly sensitive. And this is targeted treatment, obviously reserved for specific situations of pneumonia or other infections.

Monika Rachtan
As we head into the autumn/winter season, and especially in these first few months of the season, everyone is thinking about what they can do to improve their immunity. Are all those things that are shown to us on TV, the internet and all the other places they are presented for improving, building immunity? Do they even work? Do we have any of these researched methods that are actually able to build us this immunity, improve us and improve it, for example, within 4 weeks?

Adam Antczak
To create immunity against microbes, you need vaccines. Vaccination is the most important thing, but before I talk about vaccination, I will talk about the various hacking ways, let's call it. So some of the preparations advertised in the media have nothing to do with any improvement. It is completely pointless. Or, for example, flu medicines, which are often advertised as, and I emphasise in inverted commas, against the flu, have nothing to do with treating the flu, so they are a kind of media manipulation, as well as a market manipulation, persuading consumers to buy something that in fact will not have the expected effect. Whereas of course when it comes to immunity, immunity is a very complex phenomenon and it can be stimulated by ourselves. I mean, imagine someone who drinks a lot of alcohol and yet walks around somewhere like that, doesn't take care of themselves, eats badly and yet smokes cigarettes, so they do any number of things that have a terrible effect on immunity. So such a person will have a higher risk of infection. Just cigarettes and alcohol. Two things that work fatally. The inverse of that is what's called healthy living, a healthy lifestyle.

Adam Antczak
We also say we have the concept of lifestyle medicine. This is something that is such a jigsaw puzzle to make us live longer and better and healthier. And as part of that jigsaw, of course, we have diet. We have. Let's remember to eat, for example, lots of vegetables and fruit, above all vegetables.

Monika Rachtan
And how to do it this winter season?

Adam Antczak
We have vegetables, let's choose quality vegetables. We have lots of different vegetables that are eco. It's very different to such mass-produced vegetables where there are lots of different enhancers and fertilisers. Definitely foods that have a lot of omega 3 fatty acids read fish. Yes. This is incredibly important. But for example, physical activity, intellectual activity? Well exactly, avoiding excess alcohol and not smoking. And not smoking cigarettes, just not smoking anything at all. Because e-cigarettes are here too. This is an example of the total capture of humanity's imagination by the manufacturers, unfortunately. They tell you that this is an alternative, there is no alternative. It's like there is an alternative to pregnancy, and there is no alternative to pregnancy. Either we are pregnant and we want to be, or we are not and that's it. Here there is no alternative, no alternative phenomenon to replace. And it is the same with smoking. Because if we smoke, we are harming ourselves. End of story, full stop. And now, as part of this lifestyle, there are also vaccinations and immunizations, which until recently were considered something that is reserved for children and young people.

Adam Antczak
Yes, this is the whole adult immunisation programme.

Monika Rachtan
And is it worth getting vaccinated for COVID?

Adam Antczak
In the case of COVID, absolutely yes. It is worth getting vaccinated if we are a person who is plus 60. If we have co-morbidities and we are also younger than that, it is worth it because covid 19 can cause a severe course just in people who are either older or have chronic diseases. So to the question of whether it's worth getting vaccinated against covid 19 Now vaccines in Poland for the vaccine are present. It can be done. Therefore, it's not only worth it, but you have to do it if you want to avoid covid 19 Because I stress this is not everyone. If we are young people, we vaccinate, then here this requirement is not so strong. On the other hand, if it's plus 60 and illness. And another thing if we are alone, because they are forcibly exposed to contact and disease. Let us remember that in the pandemic, about 1 000 medical personnel in Poland died because they contracted covid. I do not know whether this fact is being publicised at all. I think not. That is several, several hundred doctors and several hundred nurses died because of covid.

Adam Antczak
And these were not elderly people who were very seriously ill. They were at work and vaccinated, they mainly died when they were not vaccinated. Let's remember the death from covid and the severity is mainly related to the fact that we are not aware that there is still a large percentage of people who have not taken the vaccine. Admittedly, it is a great success of vaccination that these almost 60% Poles have taken at least these first two doses. The population of people 70-79 is over 80% of people who have taken it. Super, but let's remember that it's vaccination too. Do these doses of the vaccine? They stop working at some point. So if we have a risk of severe, severe course, then it's due.

Monika Rachtan
And what else has the professor been vaccinated against? At the beginning of this season.

Adam Antczak
Autumn is a typical time for flu vaccination, but there is a disadvantage here - we have to do it every year. The flu vaccine has a changing formulation every year due to the variability of the flu virus. In addition, receiving the vaccination makes the immunity to the flu grow quite rapidly, and the peak of this immunity is reached after a month, staying high for another 2-3 months. Therefore, it is best to get vaccinated in November and December, especially if you are in good shape. December is a great time to do this, as most cases of flu occur in January, February and March. For older people or those with co-morbidities, I suggest vaccination in September, which is a little earlier. Unfortunately, it is necessary to repeat the process every year, which is a disadvantage, but ultimately the vaccination is extremely effective. It protects against influenza, and the consequences of influenza are much more serious than one might think associated with infection alone.

Monika Rachtan
And what are these consequences?

Adam Antczak
We are talking here about cardiovascular sequelae. Although it sounds rather emotionless, it is worth pointing out that influenza can lead to serious cardiovascular problems. As a result of the flu, we can experience a stroke, which can result in disability for the rest of our lives, death, heart attack, heart failure or cardiac arrhythmias. These are really not trivial matters.

Monika Rachtan
This also applies to young people.

Adam Antczak
Yes, this applies to everyone, but especially to older people. I emphasise again that as we age, our body undergoes a certain amount of wear and tear, just like a car. While an old car can be reconditioned by replacing parts, it is unfortunately not so easy with people. This is why it is important to take care of our health, including through vaccinations. Let us remember that if we want to enjoy good health and avoid heart attacks, strokes and other complications, we must make the decision to be vaccinated, especially in winter, when the risk of strokes and heart attacks is much higher due to infections. In short, the effectiveness of the flu vaccine is much broader than many of us think. This is especially true for people over the age of 50 and even 65, for people with significant diseases such as diabetes, heart failure or chronic respiratory diseases. This affects a very large number of people.

Monika Rachtan
More than half of people aged 50.

Adam Antczak
Exactly right. In addition, there is a group that is particularly vulnerable to severe flu - pregnant women.

Monika Rachtan
That is, it is safe to be vaccinated during pregnancy.

Adam Antczak
Of course, it is safe to be vaccinated against influenza in every trimester of pregnancy. This protects the woman, above all, from the severity of the illness, which is extremely important, because we know that influenza is more severe in pregnant women, with fatal health consequences for the child as well. Neglecting such vaccination is medical malpractice, which is why I emphasise it as an important part of taking care of your health. And how do I know this? Well, flu vaccination has a 90-year history. The first vaccines appeared in the 1930s, and every year, two to three billion people worldwide are vaccinated against flu. In short, if someone says it's an experiment, so be it. Any experiment that lasts 90 years and includes at least the last 30-40 years of vaccination on this scale is certainly worthy of consideration.

Adam Antczak
Billions of people in the world. Well, let everyone have that experiment. What I want to emphasise is that there is a huge amount of knowledge about these vaccinations, their effectiveness and their safety, so it is worth using it. It is not only a health issue, but also a safety issue. There are vaccinations that we do not have to repeat every year, such as the Pneumococcal vaccination. Here we are entering the world of bacteria. Pneumococci are the bacteria that most often attack us, causing all sorts of infections. Of course, vaccination does not give full protection, but, as with the flu or pregnant women, it serves to make us mildly ill if we become infected. I would like us to focus for a moment on what I am saying, because vaccination does not eliminate the disease, but it does make the course of the disease milder. Many people, having been vaccinated, are now doing very well after being ill, thanks to the mild course of the disease.

Adam Antczak
This Pneumococcal vaccination is the right approach. It aims to mitigate severe cases of the disease.
Monika Rachtan
Can you vaccinate against this?

Adam Antczak
We associated it with children because there is a childhood vaccination programme in Poland where all children have access to free pneumococcal vaccine. This is crucial because children contribute to the spread of pneumococcus and vaccinated children do not. This is a win-win for everyone. As for the over 65s and those between 50 and 65, they are more likely to get infections, especially the more serious ones. However, if a 40- or 30-year-old wants to be vaccinated, they absolutely can do so. Yes. We can give the pneumococcal vaccine. These are vaccines that are taken once in a lifetime, at least according to today's medical knowledge. Perhaps this will change in the future when we reach the age of 40. As it will be.

Monika Rachtan
Live?

Adam Antczak
Perhaps another vaccination will be necessary in the future. Probably yes, but today's knowledge unequivocally says that we vaccinate once and that is enough. We also now have new vaccinations, for example against the RSV virus, which causes very severe infections in young children. This is problematic.

Monika Rachtan
This is a novelty.

Adam Antczak
Yes, the RSV vaccine that we are currently introducing is important because we do not have an effective treatment for RSV infections. If you get RSV infection, unfortunately there is no effective treatment.

Monika Rachtan
What is important now is to have resilience.

Adam Antczak
It is worth getting vaccinated, especially in the elderly, as children and the elderly are the most susceptible to disease. Children usually survive, although they pay a high price, and the elderly can suffer severe infections and even die. I would like to mention the consequences of illness in children, which are often ignored. Severe infections in children often lead to damage to the central nervous system, such as the brain and meninges. Even if a child survives a severe illness, his or her brain may be partially damaged, which is referred to as minimal brain damage.

Monika Rachtan
What are the consequences later in adult life?

Adam Antczak
The consequences are very serious, as such a person often performs worse in school, has problems passing the baccalaureate, getting into university or learning in general. This is a really low price to pay.

Monika Rachtan
Very high, dramatic price.

Adam Antczak
Older people get sick more spectacularly and often die. This is something that comes to us when we see someone get seriously ill and die. Illnesses in children, even when they are severe, disappear over time somewhere. But the price can be high, especially because of the mental and social health consequences. This is why it is so important to take care of children's health. I really don't understand why some people choose not to vaccinate their children against diseases covered by the compulsory vaccination programme, claiming that it is not eco or wise. This is extreme irresponsibility. I would like to stress that if an adult decides not to vaccinate, it is their conscious decision. I hope it is made with full awareness. However, when deciding to vaccinate a child, we should think ten times if we are sure we are making the right decision.

Monika Rachtan
Yes, because it is our responsibility. Professor, my programme partner is the Institute for Patients' Rights and Health Education, which focuses on the humanisation of medicine. How do you view humanisation, especially in the context of vaccination and social responsibility?

Adam Antczak
It is worth remembering that we do not live only for ourselves. Human beings live in contexts, and one of the most important is the family and social context. When looking at health from a social perspective, remember that health is never a private matter. When we go out into the world with an infection, we become potential carriers, putting others at risk. Viruses can endanger the lives of others, especially those who are sick with something we are not aware of. For example, cancer.

Monika Rachtan
Meeting them on the bus returning from therapy.

Adam Antczak
Exactly, such as those returning from chemotherapy. We often don't realise that we are putting others at risk of infection. By wearing a mask, even if we don't care about protecting ourselves, we care about others, about their health. This is social responsibility. Let us care not only for our own health, but also for the health of others.

Adam Antczak
We are not lonely islands. It's worth following the recommendations, wearing masks, taking care of hygiene, because it's not just about our health. It is about the health of society as a whole. Protecting the health of the individual is at the same time protecting the health of society.