The national program for primary prevention of cervical cancer in Bulgaria expired at the end of 2024, doctors now report a risk that the HPV vaccination campaign will not be continued due to expected budget restrictions.

The Bulgarian government promised that from 2025, the vaccination programme would expand to include not only girls up to the age of 13 but also boys.

In January, the new Bulgarian government announced that it must fight for a 6% reduction in the estimated budget deficit this year to guarantee the country’s admission to the eurozone, raising concerns about the future of the HPV programme.

“I am very worried that the vaccination program could be stopped. That would be scandalous,” immunologist Associate Professor Hristiana Batselova, a civil activist with the Coalition Against HPV, commented.

The health ministry’s refusal to answer Euractiv’s questions about continuing the campaign this year only fuels fears that the vaccination programme is at risk.

“The question is, where is the political will of those in power to ensure that our society is healthy and that two young girls do not die of cervical cancer every day?” Batselova remarked.

A rocky road

Health ministry data shows that 2024 was a particularly successful year for the programme. The number of vaccinated girls has doubled.

Despite specialists concluding that there is no proven cause-and-effect relationship between HPV vaccination and the resulting disease, mistrust and refusal of immunisation persist in society.

The increase in the number of vaccinated girls is due to the extremely successful campaign of the Civil Coalition to Fight HPV in 2024, supported by the health authorities.

Vaccination, “the intelligent choice”

In Sofia, a major international conference dedicated to eliminating cancers caused by HPV was held to support the fight against cervical cancer in Bulgaria and the southeastern European region. The event was supported by the Speaker of the Bulgarian Parliament, Nataliya Kiselova, the European Cancer Organization, and the HPV Coalition—Bulgaria.

During the conference, Kostadin Angelov, chairman of the parliamentary health committee and member of GERB – the leading party in the ruling coalition- announced that he would lobby for the continuation of free vaccinations.

“Personally, I will insist on the early adoption of the new National Program for Combating HPV-Related Cancers (2025-2028), which envisages vaccinating boys aged 10 to 13. Vaccination must be recognised by society as the intelligent choice that saves suffering and lives,” Angelov said.

It was reported during the conference that HPV vaccination coverage has increased across all EU countries.

Health Minister Slavi Kirilov commented that vaccination against human papillomavirus and screening for cervical cancer are the two most important conditions for success in the battle against this disease.

Cervical cancer

Increasing HPV vaccine coverage in Bulgaria is also key to reducing the country’s high cervical cancer mortality. Cervical cancer is also characterised as ‘cancer of the young’ as it has the second highest incidence among women aged 15 to 44.

According to the National Statistical Institute (NSI), the incidence of cervical cancer in Bulgaria has been increasing in recent years – 15,691 cases in 2017 and 16,006 cases in 2019.

Every day, two women lose their lives from cervical cancer, the cause of death of 8-10 per 100,000 women annually in the country.

This makes cervical cancer the second cause of death in young women after breast cancer.

During the conference, representatives from ten countries and organisations in southeastern Europe signed a memorandum to work together on eliminating HPV-related diseases and vaccinating everyone in the region, regardless of gender. Representatives from the European Organization for Cancer Control (EOC) and Professor Daniel Kelly, Co-Chair of the HPV and Hepatitis B Elimination Action Network, supported the document.

[Edited by Vasiliki Angouridi, Brian Maguire]