UNICEF and WHO reports reveal that despite widespread vaccine hesitancy threatening child health across Europe and Central Asia, Bulgaria is showing promising improvements in childhood immunization rates. According to 2024 data, Bulgaria ranks among the top countries in the region for vaccination coverage. The six-component vaccine, which protects against diphtheria, tetanus, pertussis, hepatitis B, Haemophilus influenzae type B, and poliomyelitis, recorded first, second, and third dose coverages of 95.6%, 94.9%, and 94.2%, respectively. Meanwhile, the combined vaccine for measles, mumps, and rubella reached 94.2% for the first dose and 90.5% for the second dose.

However, despite these gains, coverage for the third dose of the six-component vaccine and the second dose of the MMR vaccine still falls short of the crucial 95% threshold required to establish herd immunity, a challenge shared by many countries in the region.

UNICEF Bulgaria’s Christina de Bruin emphasized the importance of providing parents with reliable information and support, underscoring vaccination as both a right and a critical protection for children’s health. On a global scale, 89% of infants received at least one dose of the diphtheria, tetanus, and pertussis vaccine in 2024, with 85% fully vaccinated, translating into modest progress despite growing challenges, including an additional 171,000 children receiving their first dose and one million more completing the series compared to 2023.

Regionally, vaccination coverage across Europe and Central Asia remains stagnant, failing to recover to pre-pandemic levels. Between 2019 and 2024, coverage dropped from 92% to 91% for the second dose of the MMR vaccine, and from 95% to 93% for both the third dose of the diphtheria-tetanus-pertussis vaccine and the polio vaccine. Likewise, the hepatitis B vaccine’s third dose coverage slipped from 92% to 91%. Over half of the countries in the region failed to meet the 95% coverage target, with nearly a third reporting rates below 90%.

Dr. Hans Henri P. Kluge, WHO’s Regional Director for Europe, highlighted the serious public health implications of these figures: nearly 300,000 pertussis cases were reported in 2024, more than triple the previous year, and over 125,000 measles cases, doubling from 2023. He reminded that behind these statistics are families grappling with preventable illnesses.

UNICEF’s Regina De Dominicis pointed to the paradox of vaccine success leading to complacency: with fewer visible cases of vaccine-preventable diseases, misinformation thrives and skepticism grows. The record measles outbreak last year, the worst in almost 30 years, warns that without stronger health systems and better access to information, more children risk severe illness, disability, or death.

Encouraging developments include progress with newer vaccines such as those targeting rotavirus, Haemophilus influenzae type B, and pneumococcal infections. Yet, low vaccination rates against human papillomavirus (HPV), particularly among boys, remain a significant hurdle.

Addressing this, Bulgaria launched a free national HPV vaccination program on 14 July 2025, offering immunization to girls aged 10 to 15 and boys aged 10 to 14. In just 24 hours, nearly 150 children received the vaccine through general practitioners, pediatricians, and obstetricians. This initiative is part of broader efforts to improve vaccine access and increase awareness among youth and parents.

Looking forward, Dr. Kluge stressed that vaccines must stay a top priority in Europe and Central Asia. Closing immunization gaps and preventing disease resurgence requires urgent, coordinated action, even in countries with high coverage.

Both UNICEF and WHO continue collaborating with regional health authorities to identify local disparities in immunization and tackle barriers. EU-supported projects focus on analyzing data to find unvaccinated children and studying behavioral factors like lack of reminders or misinformation.

Countries free from measles outbreaks are encouraged to proactively prepare to prevent virus spread, while those facing outbreaks must continue vaccinating vulnerable groups and conduct active case finding and contact tracing. Epidemiological data remain vital for identifying coverage gaps and safeguarding communities from future epidemics.

Source: UNICEF Bulgaria press release