Europe’s Tomorrow: Vaccination and Prevention Summit, organised by the youth organisation ThinkYoung, took place on 28 June at the Natural History Museum of Brussels. Discussions focused on young people’s trust in vaccinations after the pandemic and how to combat misinformation and fake news at the expense of awareness and trust in the achievements of science and medicine.
As part of the PROTECT-EUROPE project and the Bulgarian HPV Coalition, Plamena Nikolova from the National Network for Children joined the conference to share the experiences and challenges we face in Bulgaria in vaccination policies. A special topic in the panel “United for Health: EU Member States exchange best practices on vaccination and prevention” was the panel dedicated to vaccination against human papillomavirus – a cause not only of the National Network for Children, but also of the Bulgarian Pediatric Association, the Bulgarian Family Planning and Sexual Health Association, the National Network of Health Mediators and many other organizations. We all advocate the priorities in children’s healthcare to be focused on prevention, not on treatment and medication, especially when it comes to preventable and eradicable diseases that can be completely forgotten within a generation – that of our children.
In Bulgaria, confidence in vaccines is inconsistent and only vaccines in the mandatory immunisation schedule have generally high coverage. Worryingly, in the first year after Covid-19, there was a drop of more than 5% in coverage for some vaccines such as those for measles, mumps and rubella. This vaccine has 91.2% coverage in 2022 and is the only vaccine to show an improvement from 2020, but there is also a significant drop from 2019 when coverage was 95.1%. This downward trend in childhood vaccination leads to concerns that outbreaks of long-forgotten diseases could erupt if coverage does not quickly return to its standard levels.
However, our society is highly suspicious of recommended vaccines such as those for rotavirus infections, hepatitis A, etc. These are considered non-critically important since the diseases do not lead to mass deaths. The financial barrier is also a problem, as even if patients are aware of the benefits and decide to vaccinate, they have to pay for the vaccine themselves. Only the rotavirus vaccine for infants and the HPV vaccine for girls aged between 11 and 14 are funded under national programmes. Outside of these, costs are borne by parents.
Unfortunately, there has also been no progress on the Human Papilloma Virus (HPV) vaccines. Coverage remains below 3%, parents are uninformed, doctors do not proactively provide information, and there is distrust of the vaccine, even though it has been given for more than a decade and has been proven worldwide to lead to almost complete eradication of cervical cancer in women – one of the main contributors to which is HPV.
And the statistics are startling.
According to the National Statistical Institute, 43 women are diagnosed with cervical cancer every day in Bulgaria. The incidence rate in Bulgaria is twice the European average and the country is second after Romania in mortality from diseases related to the female reproductive system (breast cancer is first in our country). One Bulgarian woman dies of cervical cancer every day.
The HPV virus is a major contributor to the development of cancer, but 99% of cases can be prevented by vaccination. Over 156 countries worldwide have working vaccination programmes and correspondingly high coverage, which corresponds with reduced rates of HPV-related diseases. For 2020, according to the European Cancer Organisation, Norway’s vaccination coverage is 90%, Portugal’s is 81% and Spain’s is 79%. In some countries around the world, cervical cancer has been completely forgotten, and countries in Europe already have generations of vaccinated children who in turn are now parents and will vaccinate their children.
In Bulgaria, the Ministry of Health launched the National Cervical Cancer Prevention Programme in 2012, which still provides free vaccines for girls aged 11-14. The vaccine has no age limit and is protective for women of any age and can be given to boys and men, but for these groups it is not covered by the state budget and needs to be paid for by the patient.
The HPV Coalition reminds that the cervical cancer vaccine contains no genetic material and results in building long-lasting protection against the most common types of HPV.
Anyone interested in cervical cancer and HPV vaccine data can look up information on the NMHM – National Network of Health Mediators website – http://www.zdravenmediator.net/, and on the HPV Coalition website – https://hpvcoalition.bg/.
