Intensive development of medicine offers great opportunities not only for diagnosis and treatment of many diseases, but also to prevent getting sick. The basic condition that determines the legality of medical action of a prophylactic or therapeutic agent is the patient’s consent. However, in certain statutorily defined cases, introduced legal solutions which might affect the autonomy of the patient. In these cases, the dilemma between the values of the protection of community health patient autonomy is resolved in favor of the first one (1). Examples of such solutions are the provisions of the law on the prevention and combating of infections and infectious diseases in humans (2), including those that relate to mandatory vaccinations. In art. 1 of this Act states that it specifies “the rules and procedures of preventing and combating infections and infectious diseases in humans” and “the rights and obligations of service providers and persons residing in the territory of the Polish Republic in the prevention and combating of infections and infectious diseases in humans”. The obligations referred to in that provision include undergo sanitary treatment, preventive vaccination, after-exposure prophylactic medicines, sanitary-epidemiological studies, disease surveillance, quarantine, treatment, hospitalization, isolation (art. 5, paragraph. 1, item 1 of the Act).

Vaccinations, both compulsory and recommended pursue one of the basic tasks of public health, which is the prevention of diseases (3). The current decline in the incidence of severe, often fatal infectious disease is the result of 200 years of work of researchers (4). It is worth to add some historical statistics of the epidemiology of some infectious diseases. In 1963, Wrocław there was an epidemic of smallpox (5). There have been 99 cases, including 7 deaths. In the twentieth century. Smallpox was responsible for 300-500 million deaths. The World Health Organization (WHO) estimated that in the 1967. 15 million people infected with the disease, of which 2 million died. Thanks to vaccinations, the disease was until 1980. Completely eliminated (4). WHO announced the eradication of smallpox. The germ is stored only in the laboratory WHO w Moscow and Atlanta (6). Another example is the diphtheria. In 1952, Poland had as many as 40 562 cases, including 782 deaths. After the introduction of vaccination in 1955 and the public vaccination program in 1960 there has been a rapid decline in incidence. Currently, since 2001 Poland was not a single disease (7). In 1973 it was recorded in Poland, 184 308 cases of measles and 109 deaths from the disease. Since the 90s. the number of cases is usually below 100 and they occur most frequently among unvaccinated. In Poland after 2000 deaths from measles are not present (4). Data from recent years show that measles fell ill in 2012 – 70 people, 2013 – 84 people and in 2014 – 110 people. In the case of rubella in 2009-2011 were recorded respectively 7856 cases, 4197 and 4292 cases of infection. In the last year of rubella fell ill 5891 people (7). These data indicate that the resignation of the immunization carries the risk of serious consequences not only for the individual non-vaccinated people, but above all for the whole population (8).

The effective implementation of vaccination, especially those with compulsory important role played by the legal provisions governing this issue. It is a clear indication of the list of infectious diseases, of persons obliged to fulfill the obligation of vaccination, as well as the means to enforce this obligation.

The Law on prevention and fighting infections and infectious diseases in humans in art. 5 paragraph. 1 point. 1 point b in the compound of the art. 17 paragraph. 1 imposes on the persons on the territory of the Polish obligation to subject to specific protective vaccinations. Regulation of the Minister of Health on compulsory immunization (9) defines: the list of communicable diseases covered by the obligation of vaccination, as well as persons or groups of persons obliged to undergo mandatory preventive vaccination, specifying their age and other circumstances which are prerequisite to the possible exercise vaccination defined in the Regulation of the Minister health on compulsory vaccinations. Additionally, pursuant to art. 17 paragraph. 11 above Act detailed list of vaccines for that year announces the Chief Sanitary Inspector, in the form of an announcement in the official gazette of the Ministry of Health. This is the Immunization Program for the year, with specific indications regarding the use of individual vaccines. The program for 2016 was published in the Communication Chief Sanitary Inspector of 16 October 2015 on Immunization Program for 2016 (10). In the previous year there were changes concerning, among others guidelines for vaccination against acute poliomyelitis (Polio) and pertussis, as well as changes in the group of persons to whom it is recommended that some vaccinations. Allowed to use 5-component vaccine (DTaP-IPV-Hib). Still does not include vaccination of all infants against pneumococcal or public vaccination formulations of acellular pertussis component (11). However, the vaccination kit intended for use in Poland does not differ significantly from those in force in other European Union countries. It is worth mentioning two different approaches to vaccination in EU countries. They may be exercised within the framework of the mandatory vaccination schedule and recommended. The differences arise, among others, used approaches the conditions of cultural, historical, the organization of health care, the level of economic development, and public awareness (12).

At this point it is worth noting that the nature issued by the Chief Sanitary Inspector statement, although it has its statutory authorization may raise doubts as to the compatibility with Article. 87 paragraph. 1 of the Constitution (13). Neither the law on the prevention and combating of infections and infectious diseases in humans or above. Regulation – i.e. the provisions of current law – do not define the requirements for vaccination in sufficient detail (14). This obligation concrete mentioned above message that is not a source of universally binding law. We are therefore faced with a reference to the legal regulation which is outside the constitutional catalog of sources of law (15). From a legal point of view, such a rule may be grounds to invoke subjecting the compulsory vaccination protective concretized in the document is not located in the directory of sources of law. And that may raise doubts as to the compatibility with the Constitution of the Republic of Poland. However, from a medical point of view, the legislative procedure is understandable and convenient because it allows relatively easy, from a regulatory point of view, the way to take into account the dynamically changing epidemiological situation (1).

It is worth noting that since 2017 change the rules of financing vaccines. The purchase of vaccines for the insured to finance the payer, currently the National Health Fund, and the vaccine for people not covered by insurance will pay the Ministry of Health (16).