Bulgaria should revise its national programme for free vaccination against human papillomavirus (HPV) to cover boys as well as girls if it wants to stamp out the virus, Michail Okoliyski, Head of the World Health Organization (WHO) Country Office in Bulgaria, told journalists on Monday. Okoliyski said the best time to administer HPV vaccine is between ages 9 and 14, and the procedure should include two doses. Inoculation at 15 and over requires three doses.
The expert noted: "The idea and the possibility of health education in schools have been systematically aborted in Bulgaria. The Recovery and Resilience Plan includes health and sex education, which should be devised by the Ministry of Education and Science according to the children's age."
Okoliyski added that Bulgarian society has failed to create herd immunity. According to him, Australia is about to eliminate HPV, and Romania has administered 100,000 HPV vaccine doses over the last three months. The only disease in Bulgaria for which treatment is provided to all who need it is HIV/AIDS, but even in this field the national authorities have stopped searching actively for at-risk people, the professor said.
"WHO recommends adding HPV to the routine immunization programme, ensuring adequate monitoring of women who were diagnosed with the virus after a screening test under the national screening programme, and expanding the scope of the screening," Okoliyski said.
The WHO Cervical Cancer Elimination Initiative stipulates that, by 2030, 90% of under-15 girls worldwide should be vaccinated for HPV, 70% of under-35 women should be tested for the infection (with a second test to be made at 45), and 90% of women diagnosed with cervical cancer should be receiving treatment for the disease, Okoliyski said.
He pointed to antimicrobial resistance as another serious problem in Bulgaria. He noted that Bulgaria was the only country where the use of antibiotics increased by as much as 30% during the COVID-19 pandemic.
Virologist Radka Argirova, a member of the HPV Coalition, said that cervical cancer immunization coverage in Bulgaria is no more than 3%.
The HPV Coalition is an independent multidisciplinary organization of individual physicians and NGOs.
An average of 43 women are diagnosed with cervical cancer daily in Bulgaria, according to National Statistical Institute data. The HPV vaccine is the only registered type of vaccine against cancer, Argirova said. She explained that HPV is a virus which causes not only cervical cancer but also other cancers. It is a DNA virus like no other, which is why women of a certain age should have a cytosmear, and if necessary, other tests, too.
The HPV vaccine contains subviral particles rather than a virus, and vaccination does not entail any sort of genetic intervention, Argirova said. "The vaccine is safe," she stressed, adding that it is designed for girls aged between 9 and 14, and some countries immunize boys, too.
/YV/
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