Between 3% and 18% of Bulgarian Children Miss Mandatory Vaccines, Authorities Warn

Health authorities in Bulgaria have reported a slight decline in the coverage of mandatory childhood vaccinations, with the percentage of unvaccinated children ranging between 3 and 18 percent depending on the region. The variation reflects differences in parental attitudes and local reporting, according to general practitioner Dr. Ina Detelinova, who spoke on the Nova TV. She noted that parental hesitancy and the influence of anti-vaccination messages are the main drivers behind the decline.

Dr. Detelinova stressed that while the drop in immunization is modest, it has remained consistent over time. “Most of the reasons in children stem from anti-vaccination campaigns that we encounter each year. Many parents express concern based on such claims,” she explained. She emphasized that medical specialists aim to improve preventive care and protection for children and the wider community rather than engage in confrontation with hesitant parents.

The data on immunization coverage is compiled through reports from general practitioners to regional health inspectorates (RHI), with each practice submitting statistics that are then aggregated at the regional level. This is why the reported percentage varies from 3 to 18 percent depending on the area. Efforts in Sofia-city have focused on keeping the decline minimal.

Despite the national trend, Dr. Detelinova highlighted that trust between doctors and families remains strong in her own practice. “About one in ten families might express hesitation, but last year we did not have a single refusal of a mandatory vaccine,” she said. In cases of refusal, parents are required to sign a declaration, and the law allows RHIs to impose sanctions.

On the positive side, immunization coverage is expanding in Bulgaria, with new inclusions in the mandatory vaccination calendar. This year, the chickenpox vaccine has been added, and the HPV vaccine has been extended to cover girls aged 15 to 18, as well as boys, marking a significant step forward in preventive care.

The MMR vaccine, protecting against measles, mumps, and rubella, continues to generate the most parental hesitancy. Concerns often revolve around an alleged link to autism or other neurological conditions, which Dr. Detelinova categorically denied. “These fears are completely unfounded. Clinical studies and confirmations from infectious disease specialists and child neurologists show there is no link,” she said. She noted that the timing of vaccinations coincides with critical periods of neurological development in children, which can sometimes mislead parents into drawing false conclusions.