Decline in HPV Vaccinations: Data and Concerns in Bulgaria

Over the past nine years, a concerning trend has been observed in immunization practices against the human papillomavirus (HPV) in the country. Dr. Kremena Parmakova, head of the "Surveillance of Infectious Diseases" department at the Ministry of Health, revealed to journalists that the percentage of immunized 15-year-old girls has suffered a dramatic decline – from 21% to a mere 3%.

This announcement was made during a seminar focused on vaccination programs for the prevention of various acute infectious diseases, including influenza viruses, RSV, COVID-19, pneumococci, and, of course, the prevention of cancers associated with viruses.

In light of these data, it is important to note that HPV vaccination is completely free within the framework of the National Program for Primary Prevention of Cancers Caused by Human Papillomavirus (HPV) for the period 2025-2030. Dr. Parmakova emphasized that from this year, the program also allows for the immunization of boys, with a total of 2638 vaccinated this year.

Dr. Parmakova expressed serious concern about the spread of HPV and its consequences. She explained that a large part of the infected people do not realize that they are carriers of the virus, as in many cases the body copes on its own. Unfortunately, however, approximately 5% of those infected find out about the presence of the virus in one of the most severe ways – through the development of cancer.

HPV is the most common sexually transmitted infection. The leading disease associated with the virus is cervical cancer in women. A disturbing statistic indicates that in 2022, the country ranked second in the European Union in terms of morbidity and mortality from this type of cancer.

Data for the period between 2018 and 2020 reveal an additional alarming picture. The total costs for the treatment of 3540 women affected by cervical cancer amount to nearly 37 million leva. In addition, nearly 20,446 years of life have been lost. Dr. Parmakova added that cervical cancer is the second leading cause of death from cancer among women aged between 15 and 45 in the country.