Why Bulgarians Do Not Want to be Vaccinated?

Health | November 6, 2021, Saturday // 11:45|  views

The Atlantic

Due to insufficient communication and broken trust in institutions, people are not convinced of the benefits and safety of vaccines and share unfounded fears.

In the first months of the year, before the mass vaccination became a reality, several pan-European studies revealed that Bulgarians are most negative about vaccines in the EU and this was an early sign that immunizations in Bulgaria will not be quick or easy. The main reason for vaccine skepticism on a European scale was the fact that vaccines against COVID-19 are new and it is not clear how safe they are for health. However, many months have passed since then, billions of people around the world have been immunized, and it is now clear that these concerns are unfounded.

However, they are still the leading reason why Bulgarians do not want to be vaccinated - this is shown by the survey conducted by "Capital" (without claiming representation). And the fact that fears are not dispelled speaks of both an insufficient information campaign and a broken trust between institutions and people.


It's complicated

More than 30% of respondents to the Capital survey share unfounded fears of potential health damage that vaccines can cause. Another quarter of respondents said they did not need a vaccine because they had already had COVID-19.

One in five mentions reasons related to misinformation or conspiracy theories - that the vaccine can harm reproductive functions, that it is a manipulation of politicians and pharmaceutical companies or a global conspiracy to control the population through chipping. About 10% believe that the vaccine does not protect against infection, over 6% say they have a disease that prevents them from being vaccinated, and another 2.6% cite their GP as a reason not to be immunized.

These answers reveal a variety of problems:

  • Objective information on the safety, efficacy and benefits of vaccines - including those already in place - has clearly not reached people or has not been convincing.
  • Misinformation is widespread and affects at least 20% of the population.
  • GPs in some cases stumble instead of helping with immunizations. Although less than 3% indicated in the survey that they had been advised by their GP not to be vaccinated, the phenomenon seemed to be much more widespread. It is the subject of wide discussions in a number of groups on social networks, and is commented by experts as an unacceptable but widespread practice.
  • Too many people cite their illnesses as a reason not to get vaccinated, which also indicates a lack of information and medical inactivity. There are really very few conditions that are really contraindicated for immunization against covid - such as severe allergies and a very rare type of thrombosis.
  • More than 7% of respondents share the classic anti-vaccination postulate: better illness than vaccine.


And who is against vaccines?

According to a Eurobarometer survey from the end of August, the typical "anti-vaxxer" in Bulgaria is mostly a young woman between the ages of 25 and 39, with a high school education, two children and living in the city. However, other surveys by Bulgarian agencies in the last year show that young men from smaller settlements, with primary or secondary education and relatively low incomes, have the largest share among opponents of vaccines.

Both statements are probably true. A European study from the summer paints the typical profile of the vaccine skeptic in Europe on several indicators - education, age, income, occupation, information habits. According to him, the most negative about vaccines are the unemployed, housewives, people in small towns and especially people who are informed mainly by social networks.

All this clearly shows the relationship between vaccine skepticism and, generally speaking, low income.

Thus, the task of convincing Bulgarians to get vaccinated will be, to put it mildly, challenging. However, it has no alternative because it is the only sustainable solution to the health crisis. The other option is for the country to continue to enter from wave to wave and from crisis to crisis at the cost of tens of thousands more lives lost, a health system blocked for months and serious financial damage to business. And hopes that "this time we have already reached collective immunity" turn out to be deceptive after each wave, despite the high price.


How vulnerable will Bulgaria remain?

Regional data on vaccinated, sick and deceased in different areas of the country reveal significant differences between regions, but strongly suggest that no area is close to collective immunity (see graphs). There are no groups in society that can be considered protected, except perhaps to some extent for doctors.

Unsurprisingly, the highest share of vaccinated is in Sofia-city - already almost 32%, while in Montana it is only 14%. The highest share of those immunized is in the age group between 60 and 80 years (33-34%) - these are the most vulnerable to severe illness and the filling of hospitals. But this level is almost three times lower than the European average for these age groups. Vaccinations for young people under 18 are at the bottom by 1% compared to an average of over 16% in the EU. Only 40% of teachers are immunized, although schools are one of the biggest factors in the spread of the infection. Only doctors managed to achieve a 70% share of immunizations, and the rest of the medical staff - about 50%.

Survivor data also vary widely across regions. The highest percentage of infected is registered in Sofia - almost 12%, and the lowest is in Kardzhali - less than 4% (see map). It is clear that these differences are not objective. In large cities, where there are more laboratories, the population is more solvent and more educated, the proportion of cases is higher, while in poorer and economically more backward regions there is a significantly higher hidden morbidity. Thus, the percentage of patients in Sofia can certainly be considered more realistic than in Kardzhali.

Information about the dead of COVID-19 in each area completes the picture. In Sofia, where treatment options are best, victims account for about 2% of registered cases, the European average. At the other extreme is Smolyan - 7%, and on average for the country the victims of the disease are about 5% of those officially infected. Thus, judging by the high proportion of deaths, the number of cases in many areas has been reduced two to three times and in some places the proportion of survivors can reach 16-18%.

However, even so, those who have fallen ill and been vaccinated hardly exceed 50% in any area, and at least half of the population remains vulnerable to the disease - enough for a few more covid waves.


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Tags: anti-vaxxer, vaccines, Bulgaria, COVID-19


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