Influenza in children is a significant clinical, epidemiological, and economical problem, but the present investigation shows that public awareness in this regard was not significant. The respondents regard the protection of children over 6 months of age as beneficial in 59 %, while only 13 % of them believed that vaccination of pregnant women is a good way to protect the mother and the child. The low percentage above outlined is rather surprising in view of the data of others showing that 24 % of all outpatient visits concerning sick children are due to influenza (Nitsch-Osuch et al. 2012). Thus, influenza in the pediatric population seems an underrated and under-evaluated issue. The reason for that may be non-specific symptoms and a relative difficult conclusive diagnosis.

Influenza virus infection is particularly dangerous for pregnant women and for new-borns and infants. The risk of birth defects increases if one catches influenza during pregnancy. On the other hand, influenza in neonates, although rare, is associated with a high risk of complications. Following the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC 2000), all women who are pregnant or are planning to be pregnant during the influenza season should be vaccinated. Observational research shows that antibodies produced against influenza by a woman during pregnancy also protect the infant during the first months of life.

Infections caused by the influenza virus cause a significant increase in mortality in high-risk groups, the increase in medical costs, and substantial economic losses. Influenza remains a serious public health problem that requires reaching for all available methods of control and prevention in order to minimize the annual effects. Currently, the recommendations for influenza vaccination are issued not only by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC 2000), but also by many Scientific Medical Societies. Recommended vaccines are safe and do not cause serious adverse reactions, and their effectiveness in preventing influenza illness and post-influenza complications is high. Vaccination of 80 % of the worldwide population would give savings of $2.1 billion per year. International studies have shown that the direct costs of influenza are four times higher than the cost of vaccination. This indicates the need of prophylaxis by vaccination (Lew 1996; Nichol et al. 1990).

Meanwhile, despite the best efforts of the World Health Organization to determine the actual composition of the vaccine and to increase its safety and efficiency, the influenza vaccines have not yet been widely used. The technology of production of influenza vaccines (chick embryo) does not allow obtaining the number of doses needed to vaccinate the entire populations. Thus, in the first place vaccination should be recommended for persons at increased risk of complications and mortality after influenza infection, and for epidemiological indications (major population centres, medical staff, large workplaces, etc.). The level of use of influenza vaccine in a given country is defined by providing a number of doses per 1,000 persons. For example, at the beginning of the twenty-first century the use of vaccine was 140 doses per 1,000 inhabitants in Iceland and France, 90–100 in Canada, USA, Australia, and the U.K., whereas in Sweden the indicator was 60–70 doses. In Poland, the use of vaccine in the epidemic season 2000/01 increased 178 times compared with the season 1992/93, from 0.52 doses to 92.4 doses per thousand inhabitants (Brydak 2001).

The obligation to report the cases of influenza was introduced in Poland in 1936. In the years 1946–2000, there were 65 million cases of influenza, ending up with 17,000 deaths, recorded in Poland. Since 1994, influenza vaccinations in Poland can be found in the calendar of recommended vaccinations. In recent years, several millions people became voluntarily vaccinated, which constitutes a substantial progress from the 1980s when influenza vaccinations had been almost never applied. The rarity of vaccination during that time caused the cessation of vaccine production and closure of a vaccine plant in Cracow. Vaccinations on a larger scale were resumed in the epidemic seasons 1990/91 and 1991/92 with the use of a subunit vaccine within the American Foundation ‘Project Hope’ (a total of 50,000 doses and 100,000 doses, respectively). Vaccinations were carried out in all voivodeships of Poland in proportion to the number of inhabitants. People from 6 months to 85 years of age were vaccinated. The results indicated the effectiveness of vaccine in terms of seroconversion and hence, the desirability of using this type of prophylaxis (Brydak 1998). In Poland, however, there is no tradition to vaccinate, although in recent years medical staff and the public at large are becoming interested in this form of prophylaxis (Brydak 2001). Scarce knowledge in the society about post-influenza complications is a major cause of the relatively low interest in such prevention. Research carried out among the staff of nursing care at Neonatal Departments and Intensive Care Units in Germany showed that only 15–17 % were vaccinated at least once during a lifetime, 9 % – twice, and 2 % thrice (Glathe and Langer 1995).