Bulgaria has launched a national flu vaccination programme for young children, offering free immunisation for the first time after years of lobbying by paediatricians and GPs.

The health ministry said the five-year scheme, running from 2026 to 2030, would cover children aged six months to seven years, as well as those with chronic conditions up to the age of 17. It said the programme aimed “to reduce morbidity, complications and mortality linked to seasonal influenza in children by expanding vaccine coverage and improving public awareness of the risks associated with the disease in younger age groups.”

The government has set targets of achieving annual vaccination coverage of 17 per cent among children under seven and immunising 10,000 children with chronic illnesses each year.

Flu’s health burden

According to the health ministry, flu incidence in Bulgaria is highest among children aged 0–4 and 5–14. During the latest winter season, nearly one in two influenza-related medical consultations involved a child under 15.

The proportion of hospitalisations among children has also risen, accounting for more than one-third of all patients admitted with influenza during the last season. Authorities say this underlines both the serious risk of complications and the growing strain on the healthcare system and families.

International studies show that influenza vaccination reduces the risk of hospitalisation among children by more than 50%, and the risk of severe disease by up to 63%. Data from the National Statistical Institute show that more than 3,000 Bulgarians die every year from influenza and pneumonia, accounting for around 2.5% of all deaths in the country. Nearly 80% of those deaths occur among people aged over 65.

Financial impact

Beyond its impact on public health, influenza also causes substantial economic losses. A study by the Institute for Market Economics estimated that the cost of a single influenza wave could reach around €145 million, with the largest share attributable to parents missing work to care for sick children.

By comparison, the cost of a vaccination programme is significantly lower, making it a cost-effective measure with long-term benefits.

Across the European Union, seasonal influenza vaccination for children is widely recommended and, in many member states, offered free of charge as part of national prevention strategies. Bulgaria had remained one of the few EU countries without a dedicated paediatric influenza prevention programme.

“The introduction of the programme forms part of the broader policy to strengthen public health protection through vaccination,” the ministry noted.

Rising demand

Until last year, around 400,000 flu vaccines were administered annually in Bulgaria under the programme targeting people aged over 65. A further 150,000 to 200,000 doses are sold through pharmacies each year, meaning that no more than 10% of the country’s 6.4 million population participates in influenza prevention.

There is particularly strong demand for nasal flu vaccines, especially for children, but imports remain very limited, at just 15,000 to 20,000 doses annually, far below the country’s demand.

Health authorities report growing interest in influenza prevention, with annual increases in vaccine imports. However, imports are planned around six months in advance, making it difficult for the market to respond quickly when demand exceeds expectations.

[VA, BM]