Bulgaria sees 30% increase in HPV vaccination after fight against anti-vax propaganda

Bulgaria recorded a 30% increase in the number of girls vaccinated against human papillomavirus (HPV) in 2024 compared to last year - according to data released by the Ministry of Health. However, a change in pace is still needed.

Speaking to Euractiv, epidemiologist Dr Hristiana Batselova confirmed an increase in demand for vaccines due to a successful crackdown on anti-vaccine propaganda on social media.

"There has been an increase in interest among young people and parents. Anti-vaccine propaganda has not disappeared in Bulgaria; it is even increasing. The successes are due to the information campaign of the Ministry of Health and the activists of the HPV Coalition," Batselova said.

She added that one of the most common fake news stories is that the vaccine, which protects against various forms of cancer, can cause cancer in humans.

Campaign hits mark

The information campaign, carried out simultaneously by the state and activists, has succeeded in dispelling fears caused by mass propaganda in parts of the population. "Some of the training is also aimed at giving additional information to medical professionals," says Batselova.

Health Ministry numbers show that for the whole of 2023, 2,892 girls were vaccinated against HPV with the first dose of the vaccine, and in just eight months of 2024, the number rose to 3,661. This means an increase in annual vaccination coverage from 14% to nearly 18%. Even better results are expected by the end of the year.

"The population of girls to be immunised against HPV under the national programme is 20,000 per year," said Prof. Stefan Kovachev, head of the Clinic of General and Oncological Gynaecology at the Military Medical Academy.

Fake news

Since the HPV programme started in 2012, 23.83% of immunisation coverage was achieved, and 19.6% was completed in 2014. The following year, the rate dropped to 2.68% for 12-year-old girls, while for 13-year-olds, it was only 0.75%.

This sharp decline is related to a broad anti-vaccination campaign, as Euractiv reported in November 2023. The campaign alleged that HPV immunisation caused a 12-year-old girl to develop a severe autoimmune disease. Despite specialists concluding that there is no proven cause-and-effect relationship between HPV vaccination and the resulting disease, mistrust and refusal of immunisation persist in society.

Bulgaria also experienced serious problems with mass vaccination during the COVID-19 pandemic, when only 30% of the population asked to be vaccinated. Many of the nearly 40,000 deaths, which represented 0.65% of the country's population, ranking Bulgaria second in the world in Covid deaths per capita after Peru, could have been avoided through vaccination.

Cervical cancer

Increasing HPV vaccine coverage in Bulgaria is also key to reducing the country's high cervical cancer mortality.

Cervical cancer is also characterised as 'cancer of the young' as it has the second highest incidence among women aged 15 to 44.

According to the National Statistical Institute (NSI), the incidence of cervical cancer in Bulgaria has been increasing in recent years – 15,691 cases in 2017 and 16,006 cases in 2019. Every day, two women lose their lives from cervical cancer, the cause of death of 8-10 per 100,000 women annually in the country. This makes cervical cancer the second cause of death in young women after breast cancer.

However, HPV doesn't just affect women; it also affects men. The Ministry of Health has pledged to greenlight free vaccinations for boys starting in 2025.

To raise parents' awareness about HPV-related diseases, the pharmaceutical company that produces the government-funded vaccine is organising a mass awareness campaign with the slogan "You are a hero for your child, today and forever".

They want to remind parents of children aged 10-13 that they are the ones their children rely on to make the right and timely choices for their health. As part of the campaign, an information website has been created where people can learn more about HPV-related cancers, how they can protect themselves and where they can get vaccinated.

[Edited by Vasiliki Angouridi, Brian Maguire]