Vaccinating Roma children in Bulgaria A new tool to reach vulnerable communities

April 2013
WHO’s innovative new "Guide to Tailoring Immunization Programmes", successfully pilot tested in Bulgaria, is helping countries reach children in vulnerable communities.
Nadezhda (“Hope”) is a settlement of 20 000 Roma people in southern Bulgaria. Families in Nadezhda live close together, in an area roughly the size of a dozen football fields, without proper sanitation and hygiene.

During a measles outbreak in Bulgaria in 2009-2010, more than 24 000 children fell sick, 90% of whom were from Roma communities, and 24 died. The children became infected because they had not been vaccinated, and because their living conditions made transmission too easy.
The authorities responded swiftly with an immunization campaign that protected almost 200 000 previously unvaccinated children. This stopped the outbreak. But the uptake of vaccines to protect against diseases like measles, diphtheria, polio and rubella remains lower in Roma communities like Nadezhda than it is among the general population.