Bulgaria faces persistent parental hesitancy over HPV vaccination
Mandatory vaccination coverage among adolescents in Bulgaria is high, but significant hesitancy persists over immunization against human papillomavirus (HPV), according to two World Health Organization (WHO) surveys announced by the WHO Country Office in Bulgaria.
The parallel surveys were conducted at the request of the Bulgarian Health Ministry and commissioned by the WHO Country Office to Global Metrics. Fieldwork took place between December 2025 and June 2026. One survey examined mandatory childhood immunizations and barriers affecting vulnerable communities, while the other focused on parental decision-making regarding the recommended HPV vaccine, CE Report quotes BTA.
The survey on mandatory immunizations covered 1,000 parents and guardians of children aged 10 to 14. Nearly nine in ten respondents (88.4%) said their children had received all mandatory vaccines recommended for their age.
The HPV survey, which involved 156 parents and guardians, found that, according to respondents, vaccination had been completed for 13.8% of girls aged 10 to 18 and 8.6% of boys aged 10 to 14. Around half of the parents of girls and nearly three-fifths of the parents of boys had not yet decided whether to have their children vaccinated, the analysis said.
Among 373 general practitioners surveyed, 98% expressed full support for mandatory immunizations, while 54% said their practices included children who had missed doses of mandatory vaccines. The latter figure refers to medical practices reporting missed vaccinations, not to the proportion of children affected.
Reasons cited for delayed immunization included medical considerations, vaccine hesitancy, refusal and family mobility, including stays abroad.
Among parents, 38.3% were unfamiliar with the national immunization schedule, while 81.8% valued regular invitations and reminders. General practitioners and paediatricians were the leading sources of information about HPV vaccination. Of the parents who answered a question about their doctor's role, 61.3% said they had received a recommendation from their doctor, while 37.4% said they had received no information.
The surveys concluded that the main challenges to adolescent vaccination in Bulgaria involve delayed, incomplete or missed immunizations rather than widespread outright refusal.
Implementation of the national immunization schedule increasingly depends on improving the timeliness and completion of vaccinations and monitoring coverage, rather than solely addressing outright refusal, the analysis said.
Trust in medical professionals, particularly general practitioners, remains the most influential factor in vaccination decisions and the most effective channel for addressing parental concerns and supporting informed choices, it added.
The surveys were conducted under the ongoing EU4Health project, funded by the European Commission's Directorate-General for Health and Food Safety.
Photo: Chat GPT
