In Bulgaria, even many doctors have doubts about vaccination

Maria Bogoeva has become a modest celebrity in Bulgaria during the earlier waves of the corona pandemic. Camera crews came to her hospital to record how she, as the only infectious disease specialist in the western town of Dupnitsa, is fighting the virus. “I’m not really sure what exactly I deserve all this attention to,” she says, with a big smile and rolled up sleeves that, along with lots of gold jewelry, betray her age. “I’m not so special. There are many doctors as old as me in Bulgaria who are still taking care of patients every day.” Doctor Bogoeva is 82 years old.

In earlier phases of the pandemic, that was the story of Central and Eastern Europe: how healthcare is almost perishing due to demographic contraction and lack of investment. And that doctors like Bogoeva cannot retire because of a screaming staff shortage. With Covid-19 hitting this region again – and harder – Bogoeva faces a new and typically Bulgarian problem: this doctor has not been vaccinated. “I am not against it on principle, I have zero medical arguments,” says Bogoeva. “But my personal decision, for my own body, is that I prefer not to take the vaccine.”

Everyone I know advises against it. That affects you

Thanks in part to the EU’s joint procurement, Bulgarians have been able to be vaccinated since February, with four different vaccines now. But only one in five people has. Nowhere in the European Union is the skepticism and resistance to the jab greater. And nowhere is the number of infections rising faster this fall. Only neighboring Romania, with a vaccination rate of 30 percent, has relatively more deaths regrettable.

In Dupnitsa (35,000 inhabitants), an hour’s drive from the capital Sofia, the number of infections is more than twice as high as the national average. None of the nearly fifty corona patients in Bogoeva’s hospital has been vaccinated. It seems to be no different in the intensive care unit in the larger St. Ivan Rilski hospital, of which her clinic is an annex.

Overkill Democracy

Rationally, Bogoeva knows “that the vaccines save lives, are our only means.” Her husband has been vaccinated and “I recommend it to my patients, of course.” But she feels the same resistance and uncertainty as many of them. “We are inundated with so much conflicting information that people get lost in it. Even I as an infectologist get confused.” She shakes her head slightly embarrassed with dark red hair dyed.

Bogoeva is not on Facebook. But Bulgarian news sites, radio and television, match the disinformation on social media. Prominent antivaxers – including doctors – are given a stage without being critically questioned. The news is dominated by exceptional side effects and reports of vaccinees being infected anyway.

The country has been without a government since April. Instead of a caretaker continuation of the old regime, new acting ministers are appointed each time. And in two weeks, elections will be held for the third time this year. The permanent political campaign stands in the way of drastic corona measures and an unambiguous vaccination campaign, experts say.

Big Misconception

But Bogoeva blames the prick aversion, including her own, on “the strange Bulgarian mentality.” “When we are told by the state that we have to do something, we do the exact opposite. Maybe it’s a reaction to communism: in the past we were forced to obey, now we get to choose. In democracy, the pendulum has gone to the other extreme. There is nothing more, everyone just does what he or she feels like. No one feels responsible for protecting others.” That collective contramine, she says, is exacerbated by “the fact that all intelligent people are leaving the country.” Since the 1990s, the Bulgarian population has shrunk from nearly 9 million to less than 7 million. Covid-19 has killed 23,718 people so far, 755 of them in the past week.

After a hard day at the injection site in the center of Dupnitsa, doctor Jordan Nikulchin is about to step outside to smoke a cigarette when a thin woman with bleached curls knocks on the still open door. Kalina Ajdarova is full of doubts about the vaccine. She is afraid of needles, side effects, allergies and most importantly that she will infect her 90-year-old mother after she is vaccinated.

Calmly, Nikulchin explains to her that only by getting vaccinated will she help to protect her mother. “It is one of the big misconceptions that with a vaccine you would be a carrier of the virus. I’m just giving you a protein that encourages your immune system to make antibodies. I really don’t make you sick or contagious,” says the doctor.

She continues to ask questions as Nikulchin measures her blood pressure. It is a bit high “from the tension”, she laughs. Her doubts are based on rumors she’s read on Facebook about people dropping dead after being vaccinated and injected with microchips. “At first you think: what a bullshit. But if all your colleagues and your own daughter believe it, you start thinking: are they crazy or is it me? They say the vaccine was developed far too quickly to be reliable. Everyone I know advises against doing this. You are influenced by that.”

Ajdarova (59) sells banitsas, traditional puff pastries, and worries that a physical reaction to the vaccine will prevent her from working tomorrow. „If you are afraid that you will feel the flu, it is better to take Pfizer than Janssen. But then you have to come back again,” says Nikulchin. “If I survive!”, Ajdarova reacts with wide eyes. But she is convinced anyway and after a painless injection in her left upper arm she is cheering for the vaccination certificate that Nikulchin gives her. „Would you like to tell your colleagues how it went? Ask if they will come too,” he says.

When Ajdarova is back outside in the autumn sun, she says that her fear of the overcrowded hospitals overcame her fear of the jab. “The situation is getting out of hand here.” She also shares her own theory about vaccine rejecters. “Bulgarians are so used to being lied to that they don’t believe that something good can be available to everyone and free of charge. Only when something is scarce and you have to fight for it is it worth it. Before the vaccine, everyone wanted it. Now we don’t trust it.”

Paying for fake certificates

“Bulgaria is one of the happiest countries that have the most reliable vaccines available for their entire populations,” says Nikulchin, his head visibly full of graying curls. “Yet there are days when I only vaccinate five to ten people. I’ve had to throw away vaccines.” He becomes despondent. Especially when he learns that even colleagues are vaccine rejecters. “What a shame,” he says. “It is one thing that public opinion is negative. But if even doctors don’t believe in science anymore, where is it going?”

Nikulchin (48) is a surgeon, but can hardly support his family with five children on the 950 leva (485 euros) he earns per month. By working night shifts at the local hospital and vaccinating here during the day, he brings home about two thousand euros. Sometimes he is also offered money privately. By people who want a vaccination certificate, but without getting a shot. “Those people, and certainly the doctors who cooperate with it, deserve a severe punishment,” he says. Last week in Kyustendil, the capital of the province where Dupnitsa is located, four people were arrested on suspicion of forging certificates.

The reason there is a market for that is the same as why there is a sudden storm at Nikulchin. Surrounded by plastic bottles filled with used hypodermic needles, he counts how many people he has vaccinated today. Including Ajdarova: 83. Recently, the interim government decided to introduce corona tickets for catering, gyms and shopping centers. Hospitality staff does not or hardly cooperate with this (during a non-representative sample by NRC, during four days in Bulgaria, not once was such proof requested), but it seems to convince doubters anyway. “That measure should have been introduced months ago,” says Nikulchin. “It is my unpopular opinion that this pandemic can only be solved with authoritarian measures.”

Medium of Satan

On the central square of Dupnitsa, the response to pressure and coercion varies. Contractor Kamil Georgiev (45) is furious. “I will do my utmost to resist the pressure to get vaccinated. Our individual freedoms and human rights are being violated. It’s a tool of Satan,” he says. He even believes his 11-year-old daughter’s school wants to microchip her through a corona test. “If they start experimenting on my child, I’ll take her out of school.”

Others are resigned to it. Svetlana Marinova (61) has had herself vaccinated, “to be able to go on holiday”. Her daughter Kalina Marinova (44) waits “as long as she can”. She is undergoing IVF treatment and her doctor has advised her to wait. “In addition, I do not believe that corona is so deadly for people who have no other conditions.” The term comorbidity pops up in almost every conversation with Bulgarians about Covid-19. They are convinced that the virus exists, but not that it will affect them.

That’s what Ashen Michev (54) thought too, until he ended up in the corona department with Maria Bogoeva, short of breath and with a high fever. “I thought: a vaccine, I don’t need that,” he says with his nose and reading glasses just above a blue blanket. “It turned out that I needed it after all,” he says with self-mockery. Now that he is on the mend, he texts his friends from the hospital if they want to save themselves this by getting vaccinated.

And even doctor Maria Bogoeva, it turns out in the course of the conversation with her, has decided to put her doubts aside after all. “I’m almost ready to get vaccinated,” she says despite her skepticism. “But for no other reason than that coercion and restrictions.” She also wants to “have a bit of a nice life.” And see her son, children and grandchildren, who live in the United States. Although that journey will probably only be completed when she can finally retire. “Once this miserable pandemic is really over.”

This is how it goes with vaccination in Europe