Most parents in Bulgaria say their children aged 10 to 14 have all the required vaccines, but many have yet to decide on the vaccine against the human papillomavirus (HPV). Two World Health Organization studies were presented on Wednesday, 4 November, at a round table held by the Ministry of Health and the WHO in Sofia.
In the national survey of 1,000 parents and guardians, 88.4% said their child has all the required vaccines.
The second study looked only at the HPV vaccine and covered 156 parents and guardians. Among girls aged 10 to 18, 13.8% are fully vaccinated, families of 50.5% have not decided, and families of 17.4% have chosen not to vaccinate them. Among boys aged 10 to 14, 8.6% are vaccinated, 59.3% are undecided and 22.2% will not be vaccinated. The figures come from what parents said and do not cover the whole country.
Parents hear about HPV mostly from their family doctor or paediatrician. Of those who answered the question about the doctor's role, 61.3% got a recommendation from the doctor, while 37.4% got no information. The report says doctors' consultations are not equally thorough. After being shown basic data on the national programme, 59% of parents said they want more information on the vaccine's safety.
"Parents trust their doctors and value it highly when doctors talk to them clearly and with understanding," said Nela Vamporova, head of the WHO office in Bulgaria. She believes this approach will leave every family informed, heard and confident in its choice.
The studies also questioned 373 GPs. Of these, 98% fully back the required vaccinations. Some 54% have children with missed doses in their practice, but this figure refers to practices, not to children. The doctors said vaccines are put off for medical reasons, from hesitation, after a refusal, or because families move around, including time spent abroad.
Some 38.3% of parents do not know the immunisation calendar, while 81.8% value regular invitations and reminders. The reminder system itself was not studied.
Parents can check their child's past and upcoming vaccines in the "eZdrave" app or with the family doctor. They can also talk to the doctor about missed doses, the HPV vaccine and vaccination under the national programme.
The researchers recommend that doctors regularly check children's vaccination status, send reminders, track missed doses and help children catch up. They say parents need to be told clearly that the HPV vaccine protects both girls and boys from cancer. Family doctors, regional health inspectorates, schools and health mediators who work with disadvantaged communities should act together. Support is also needed for problems such as language, transport, missing documents and a broken vaccination schedule.
The ministry said hesitancy matters especially for HPV vaccination. It said the data will be the basis for discussing next steps, so that more families make an informed choice.
The studies ran from December 2025 to June 2026, using surveys, interviews and discussions. WHO/Europe and the WHO office in Bulgaria commissioned them at the ministry's request. Global Metrics coordinated them, and the money came from the EU under the EU4Health programme. The data are self-reported by respondents and do not show trends or cause and effect. The full reports will be published in 2027.