Perspective| Volume 125, P37-43, July 2022

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Ukraine war refugees - threats and new challenges for healthcare in Poland

Published:April 20, 2022DOI:



      Between February 2022, when the war in Ukraine began, and April 1, 2022, the number of refugees to neighboring countries reached 4,137,842 people. The majority have fled to Poland. The main challenge for the health system in Poland in this situation is how to develop effective adaptation measures.


      The aim of this study is to describe threats and challenges to public health related in particular to infectious diseases and to identify the resources of the healthcare system that are necessary to meet the needs of the recent war refugees and the Polish population.


      Scientific publications, statistical data from national and international organizations, information obtained from public institutions in Poland and Ukraine, and reliable sources of up-to-date information on the Internet were used. Key data on threats and challenges to public health were collected and presented.


      Differences were observed between Poland and Ukraine in terms of immunization programmes and their implementation as well as in relation to the prevalence of selected infectious diseases. The increase in demand for healthcare resources in Poland was estimated on the basis of current indicators. Both the possibilities of counteracting epidemic threats related to the current situation and possible consequences for the availability of services and the health condition of all people currently staying in Poland were presented.


      European countries may experience public health threats due to the influx of war refugees. The data presented could be useful for European countries while developing effective strategies to mitigate public health issues.


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        • United Nations High Commissioner for Refugees
        Operational data portal: Ukraine refugee situation.
        • OECD Policy Responses to Coronavirus (COVID-19)
        What is the impact of the COVID-19 pandemic on immigrants and their children?.
        • Kondilis E.
        • Papamichail D.
        • McCann S.
        • Carruthers E.
        • Veizis A.
        • Orcutt M.
        • et al.
        The impact of the COVID-19 pandemic on refugees and asylum seekers in Greece: A retrospective analysis of national surveillance data from 2020.
        EClinicalMedicine. 2021; 37: 100958
        • Hargreaves S.
        • Hayward S.E.
        • Noori T.
        • McKee M.
        • Kumar B.
        COVID-19: counting migrants in.
        Lancet. 2021; 398: 211-212
        • European Centre for Disease Prevention and Control
        COVID-19 vaccine tracker.
        • WHO Regional Office for Europe
        Provision of immunization services to refugees: guidance for host countries in the context of mass population movement from Ukraine.
        • Roberts L.
        Surge of HIV, tuberculosis and COVID feared amid war in Ukraine.
        Nature. 2022; 603: 557-558
        • European Center for Disease Control and Prevention
        Infectious diseases of specific relevance to newly-Arrived migrants in the EU/EEA.
        • Pavli A.
        • Maltezou H.
        Health problems of newly arrived migrants and refugees in Europe.
        J Travel Med. 2017; 24
        • Global Polio Eradication Initiative
        GPEI deeply concerned for health of Ukrainian people amid escalating crisis.
        • Public Health Center of the Ministry of Health of Ukraine
        In 2021, Polio vaccination coverage was 80%.
        • World Health Organization
        Strengthening response to measles outbreak in Ukraine.
        • European Centre for Disease Prevention and Control
        Communicable Disease Threats Report.
        Week. 2022; 10 (March 2022): 6-12
        • World Health Organization
        Measles and rubella strategic framework 2021–2030.
        • World Health Organization
        Global measles and rubella strategic plan : 2012-2020.
        • World Health Organization
        WHO vaccine-preventable diseases: monitoring system.
        2020 (global summary)
      1. Knoema. Ukraine - pertussis reported cases. 2022
        • National Institute of Public Health NIH – National Research Institute
        Infectious diseases and poisonings in Poland in 2020.
        • Stefanoff P.
        • Paradowska-Stankiewicz I.A.
        • Lipke M.
        • Karasek K.
        • Rastawicki W.
        • Zasada A.
        • et al.
        Incidence of pertussis in patients of general practitioners in Poland.
        Epidemiol Infect. 2014; 142: 714-723
        • Strebel P.
        • Nordin J.
        • Edwards K.
        • Hunt J.
        • Besser J.
        • Burns S.
        • et al.
        Population-based incidence of pertussis among adolescents and adults, Minnesota, 1995-1996.
        J Infect Dis. 2001; 183: 1353-1359
        • Gay N.J.
        • Miller E.
        Pertussis transmission in England and Wales.
        Lancet. 2000; 355: 1553-1554
        • World Health Organization
        Report on the health of refugees and migrants in the WHO European Region.
        • Kimbrough W.
        • Saliba V.
        • Dahab M.
        • Haskew C.
        • Checchi F.
        The burden of tuberculosis in crisis-affected populations: a systematic review.
        Lancet Infect Dis. 2012; 12: 950-965
        • World Health Organization
        Treating tuberculosis in Ukraine.
        • World Health Organization
        Ukraine. Public health situation Analysis (PHSA) – short-form.
        • National Tuberculosis and Lung Diseases Research Institute
        Tuberculosis and lung diseases in Poland in 2020.
      2. Worldometer. 2022
        Date accessed: March 23, 2022
        • Maltezou H.C.
        Antibiotic resistance and the refugee crisis in Europe - Preemptive action is indicated.
        Travel Med Infect Dis. 2016; 14: 69-70
      3. Ukraine: WHO and UNICEF estimates of immunization coverage: 2019 revision. 2020
        • Rodyna R.
        Measles situation in Ukraine during the period 2017-2019.
        Eur J Public Health. 2019; 29 (ckz186): 496
        • National institute of Public Health NIH – National Research Institute
        Vaccinations in Poland in 2020.
        • World Health Organization
        Measles vaccination coverage.
        • World Health Organization
        Poliomyelitis vaccination coverage.
        • World Health Organization
        Global polio eradication initiative.
        • European Centre for Disease Prevention and Control
        Operational public health considerations for the prevention and control of infectious diseases in the context of Russia’s aggression towards Ukraine.
      4. (Live COVID-19 Vaccination Tracker)Our world in data. 2022
        Date accessed: March 28, 2022
        • World Health Organization
        Achieving 70% COVID-19 immunization coverage by mid-2022. Statement of the independent allocation of vaccines group (IAVG) of COVAX.
        • World Health Organization
        SAGE Working Group on Vaccination in Humanitarian Emergencies. Vaccination in acute humanitarian emergencies: a framework for decision making.
        • World Health Organization
        Reducing measles mortality in emergencies.
        WHO-UNICEF Joint Statement, 2004
        • World Health Organization. Global Polio Eradication Initiative
        Reducing risk of poliomyelitis outbreaks in emergencies (Interim update).
        • World Health Organization
        Leave no one behind: guidance for planning and implementing catch-up vaccination.
        • Ministry of Health of Poland
        Decree on methods of spreading infection or infectious diseases constituting a special threat for public health in relation to the ongoing armed conflict in Ukraine.
      5. Poland. Act on preventing and combating infection and infectious diseases of 5 December. 2008
        • Ministry of Health of Ukraine
        Recommended immunization schedule.
        Date accessed: March 13, 2022
        • Ministry of Health of Poland
        Routine immunization programme.
        • World Health Organization
        Access to vaccination for refugees from Ukraine needed to protect the most vulnerable among them from vaccine-preventable diseases.
        • Ministry of Health of Poland
        Guidelines on how to vaccinate children from Ukraine, in connection with the armed conflict in that country.
        • Centers for Disease Control and Prevention
        General best Practice Guidelines for immunization: best Practices guidance of the Advisory committee on immunization Practices (ACIP).
      6. Poland. Law of 12 March 2022 on assistance to citizens of Ukraine in connection with the armed conflict on the territory of that country. 2022
      7. Statistics Poland. Demographic yearbook of Poland 2021. 2021
        • Organization for Economic Cooperation and Development
        Health at a Glance 2021.
        Date: 2022
        Date accessed: March 28, 2022
        • National Institute of Public Health NIH – National Research Institute
        Mortality and deaths by causes in the first half of 2021 in Poland.
      8. Statistics Poland. The foreign population in Poland during the COVID-19 pandemic. 2020
        • World Health Organization
        ICD-10 : international statistical classification of diseases and related health problems : tenth revision.
        2nd ed. 2004