Health authorities discuss whether to include HPV vaccine in Bulgaria's mandatory vaccination calendar

The number of Bulgarians with cancer is increasing. The mortality rate in Bulgaria is higher than the EU average. Cancer is the second cause of death after cardiovascular diseases. According to data for 2022, the incidence rate in this country is 422 per 100,000 population, while in the EU it is 571 per 100 000 people on average.

Low interest in medical preventive examinations and screening and low vaccination coverage against the human papilloma virus, which is the cause of some cancers, cancer mortality in Bulgaria is high.

The European Cancer Organisation presented a "Manifesto against Cancer" for 2024 to MPs and institutions in Sofia. It also outlines the problems to be solved by the new European Parliament.

Around 95% of women have been exposed to the human papilloma virus. The infection is sexually transmitted and some people do not develop symptoms. 14 types of the virus cause various cancers.

"HPV types 16 and 18 are known to be responsible for 75% of cervical cancers," said Professor Radka Argirova, a virologist.

This, after breast cancer, is the second most common cancer in women.

"In Bulgaria, it has been proven that every year about 1,010 women get ill. The mortality rate is over 500, which means that 2 women die every day," said prof. Assen Nikolov - President of the Bulgarian Society of Obstetrics and Gynaecology.

There is a vaccine against human papilloma virus. In Bulgaria it is available free-of-charge and recommended for girls between 10 and 14 years of age. The immunized rate is about 2%

"We have a paradox - on one side we have imported vaccines and when we don't have girls to vaccinate we can't vaccinate boys who are willing to get the vaccine because the programme doesn't allow it," said Dr. Gergana Nikolova, a general practitioner.

Health authorities are discussing whether to include the HPV vaccine in the mandatory immunization calendar.

"The programme should be for both men and women, because we are not talking about cervical cancer only. Given that we are talking about cancer of the penis, the anus, the oropharynx - I don't see why the male gender should be left out."

The health ministry plans to include boys in the human papillomavirus immunisation programme from next year.

"They are carriers. It is about the fact that a very large part of the Bulgarian population is infected with the human papilloma virus. This new national programme is currently being developed. We have an assurance from the Ministry of Finance that the funds will be provided," said Assoc. Prof. Mihail Okoliyski - outgoing Deputy Minister of Health.

Vaccination has shown good results worldwide.

"Australia, for example, which for more than 10 years has set itself the goal of eradicating cervical cancer, has already reached incidence rate of of 4 cases per 100,000 people," said Prof. Radka Argirova.

The European Cancer Organisation's manifesto says early cancer detection programmes should be improved. In addition, a solution must be sought to the shortage of medical professionals which affects the whole of Europe.