One in 10 children in Bulgaria has not had all the required vaccines, a joint survey of parents by the Health Ministry and the World Health Organization has found.

The results were presented at a round table in Sofia on Wednesday, 4 November.

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Children of 88% of the parents surveyed have had all the required vaccines. When a vaccine is missed, the most common reason is health: 34.3% of parents cited medical conditions and contraindications, and 21.8% cited a temporary delay because of illness. Parents also named a lack of information and advice (9%), clarity (8.5%) and time (8.4%).

Parents trust the required vaccines more than the recommended ones. Trust is lowest in the free vaccine against the human papillomavirus (HPV). It has been given to 13.8% of girls and 8.6% of boys in the target groups.

More than half of parents are unsure about it, and between one in five and one in four are against it. Some 58% of parents of boys and 50% of parents of girls have not decided. Another 22% of parents of boys and 17% of parents of girls have refused it.

More than two thirds of parents get their information mainly from their family doctor. Other parents, the media and social networks also influence their views.

If parents flatly refuse a vaccine, they sign a declaration and the doctor reports it to the health inspectorate. Fines have not reduced refusals.

Dr Kalina Bozhilova said patients of other doctors come to her practice because their own doctor refuses to vaccinate. She called this unacceptable. She and her colleagues answer parents' questions, but they cannot persuade everyone.

In her practice, too, some parents hesitate even over the required vaccines, while only a few have real medical grounds. Dr Bozhilova said a parent's feeling that a child has many allergies or tolerates vaccines badly is not enough reason to delay.

A mother of a 2-year-old girl and a 12-year-old boy said her older child has had all the required vaccines and the HPV vaccine. The family decided after talking at home and with the paediatrician about what the virus causes and what the consequences are. The parents concluded the vaccine is good for the child's health.

The ministry recommends that children with missed vaccines be followed up, and that parents get reminders and explanations of the benefits of immunisation.