Early HPV Vaccination as a Public Health Strategy to Promote Social Well-Being and Reduce Long-Term Health Issues

Abstract

Low coverage of vaccination against the human papillomavirus in Bulgaria poses a significant threat to the effective prevention of cervical cancer among the country’s female population. This study aimed to examine mothers’ perceptions of vaccination as a preventive measure against cervical oncological diseases and to identify the factors influencing their decisions regarding the immunisation of their daughters. The research was conducted as a cross-sectional sociological survey using a structured questionnaire among 264 mothers of primary school pupils in Varna between March and October 2024. Findings revealed that only 52% of respondents correctly understood the concept of primary prevention, while 61% recognised the necessity of vaccination before the onset of sexual activity. A willingness to vaccinate their daughters was expressed by 57% of participants, whereas 34% were firmly opposed to immunisation. Opinions regarding the safety of vaccines were almost evenly divided: 48% considered them safe, while 43% regarded them as unsafe. The main barriers to vaccination were fear of side effects (39%) and fear of pain (36%), while financial constraints accounted for only 11% of the reasons for refusal. The results indicated that psycho-emotional barriers outweighed economic and informational factors in shaping decisions about vaccination. The findings may inform public health communication strategies, clinical counselling practices, and school-based educational interventions aimed at increasing early human papillomavirus vaccination uptake. The multilevel recommendations developed on the basis of the obtained data propose a differentiated approach to various segments of the parent audience, with emphasis on overcoming fears through empathetic counselling and validation of parental concerns. Such measures may contribute to increasing the coverage of human papillomavirus vaccination in Bulgaria.