Conflict of individual freedom and community health safety: legal conditions on mandatory vaccinations and changes in the judicial approach in the case of avoidance

Background
In Poland, the number of parents or caregivers, mainly declaring concern about the occurrence of vaccine injuries, refusing to subject people under the age of 19 to mandatory vaccinations has increased from 3,437 in 2010 to 30,089 in 2017.

Material and methods
Legal regulations concerning vaccinations and legal literature in Poland, as well as judicial decisions concerning cases of evasion of mandatory vaccinations were reviewed.

Results
The Constitution of the Republic of Poland obliges public authorities to fight epidemic diseases. In judicial decisions, a connection between preventive vaccinations and safety and public health protection is taken for granted – mass vaccinations allow for protection of all people, who would be exposed to infectious diseases without them. Statutory obligation to submit to mandatory vaccinations exists in the law and is directly enforceable; only in the case of refusal, the State Poviat Sanitary Inspectorate (PPIS), as creditor of the obligation, may demand its implementation and indicate an effective enforcement measure; however, it is the voivode who is authorized to conduct enforcement proceedings regarding the non-pecuniary obligation. The imposed fine is a measure leading to fulfilment of the obligation of vaccination, not a penalty for its non-performance.

Conclusions
A statutory obligation to submit to protective vaccinations does not constitute a violation of constitutionally guaranteed human freedoms. As a person authorized by a specific law in the form of the Act on Preventing and Combating Infections and Infectious Diseases in Humans, this obligation overcomes the individual’s freedom to exercise the right to refuse to undergo health benefits resulting from general regulations, such as the Act on Patients’ Rights and Patients’ Rights Ombudsman. Although the PPIS is the creditor of the statutory obligatory vaccinations, the voivode is the correct enforcement body.