European Immunization Week 2024

In Bulgaria, more than half of parents of children aged 0 to 4 support mandatory routine immunization, according to a survey by the Ministry of Health and UNICEF

Copenhagen, Geneva, Brussels, Sofia April 23, 2024 – Vaccines are one of humanity’s greatest achievements. In the last 50 years alone, they have saved 154 million lives – that’s more than 3 million lives a year or 6 people every minute for five decades. In the same period, vaccination reduced infant mortality by 40%. Today, more children live to see their first birthday and beyond than at any other time in human history.

The establishment of the Expanded Program on Immunization (EPP) 50 years ago was a pivotal moment in public health history and saves millions of lives worldwide every year. In 1974, only 5% of the world’s children were vaccinated against diphtheria, tetanus and pertussis. Today, this figure has risen to almost 85% of children worldwide and 94% in the WHO European Region.

Just five years after the European Immunization Program (EIP) was introduced, smallpox was eradicated. Since then, the geographic range of the wild strain of polio virus has been reduced to just two countries, and the threat of several serious childhood infectious diseases has declined dramatically.

Continued innovations in immunology have led to the development of vaccines that can protect against even more diseases, opening the possibility that hepatitis B and cervical cancer could be eliminated in the European region in the near future.

While we celebrate these significant achievements that have preserved the health of multiple generations, we remain in anticipation of the consequences of the unprecedented impact of the COVID-19 pandemic on our societies and economies, on health systems and the delivery of health care.

The decline in vaccination rates in some countries in the European region between 2020 and 2022 highlights the vulnerability of our success. In the last three years more than 1.8 million children in the WHO European Region missed their measles vaccination. The consequence of this is a 60-fold increase in the number of measles cases in 2023 compared to 2022, including in some of Bulgaria’s neighboring countries, making the country vulnerable to the side effects of migration, for example.

In recent days, nearly two hundred confirmed cases of whooping cough have been registered in Bulgaria, and the epidemiological forecasts are for their number to increase to a thousand in the next month.

In these circumstances, UNICEF Bulgaria emphasizes the need for a series of key activities and recommendations:

• For the past 10 years, UNICEF has been piloting a model of patronage care in the Sliven and Shumen regions, which has proven extremely successful for the best start in life for every child. Expanding universal home visiting services across the country will enable this to be used as a platform to raise awareness among pregnant women and parents of young children, especially in vulnerable communities, about the importance of immunizing their children, as well as providing more comprehensive care;
• UNICEF created and promotes the free Bebbo mobile app for parents. It should be available to as many families as possible in the country, as it also contains valuable information on childhood immunization, as well as providing comprehensive care for every aspect of the development and well-being of young children;
• UNICEF supports the information campaign of the Ministry of Health and the specialized +Men website. More media and professional organizations need to get involved in efforts to increase health literacy and combat vaccine misinformation;
• UNICEF and the Ministry of Health study the attitudes of parents and GPs towards the National Immunization Calendar. There is a need to increase efforts to build interpersonal capacity and vaccine confidence among medical students and young people preparing for parenthood.

The Ministry of Health and the United Nations Children’s Fund (UNICEF) jointly conducted a nationally representative survey on the attitudes of parents and general practitioners towards the National Immunization Calendar 2023. The survey was conducted by the sociological agency “Global Metrix” among 1002 parents of children up to 4 years of age and 350 GPs with children in their practice.

• The results show that 61% of parents support mandatory vaccines and would give all or even additional vaccines to their children.
• Over 77% of parents identify doctors as the main source of information on vaccine issues, a
• 95% of general practitioners (GPs) advise parents to vaccinate their children with all vaccines from the mandatory immunization schedule.

“Despite the positive trend in Bulgaria, there is inequality among vulnerable communities, which deserves special attention in children of Roma origin, children with disabilities, refugee children, who are often among the adolescents with zero or insufficient vaccination and need to catch up in order to prevent -further epidemiological explosions,” emphasized Christina de Broin, UNICEF representative in Bulgaria.

Almost half of GPs said they had difficulty communicating with parents. One of the main reasons, according to them, is the “lack of awareness” against which diseases are the vaccines from the immunization calendar and when they are administered, as well as fears and concerns about side effects from vaccines, lack of interest of parents regarding the immunization of children, the spread of negative opinions , misinformation and misconceptions about vaccines, problems with understanding and communication with people with a low level of education, incl. representatives of ethnic minorities.

“Trained community health workers, such as community nurses and health mediators, are needed to inform and support every family on how to take advantage of their right to health care so that every child can thrive. Valid, accessible information is also needed , accessible to every family and adapted to their needs”, added Christina de Bruyne, expressing the readiness of UNICEF Bulgaria to continue working with the state health authorities, families, media and professionals to ensure that Bulgarian children are safe and protected .

Attitudes towards the implementation of the Bulgarian immunization calendar in children

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