Timeline of S. pyogenes (GAS)—scarlet fever infections in Poland (2018–2025) the figure shows annual scarlet fever incidence in relation to the COVID-19 lockdown period (March 2020–May 2022). Reduced microbial exposure during lockdown is associated with a gap in trained immunity (2020–2022), a decline in incidence, and subsequent re-establishment of herd-trained immunity (HTI, green line) in 2023–2025, expressed relative to the pre-2020 baseline (100%). Scarlet fever incidence (new cases per year) is shown in bars. Data source: PZH, 30 March 2026. GAS, group A Streptococcal; HTI, herd-trained immunity; pre-2020, pre-pandemic.