The Open Society Foundations has submitted a complaint before the European Committee of Social Rights (ECSR) against the Bulgarian government for failing to prioritize persons over 65 years old and individuals with underlying conditions in its domestic COVID-19 vaccine rollout, which resulted in adults at lower risk for severe illness receiving doses before these vulnerable groups. Between January and May 2021, 8,813 people 60 years old and above died from the coronavirus in Bulgaria, accounting for more than 80% of COVID-19-related deaths during this period. Only about one out of five persons over 65 years old were vaccinated in Bulgaria by May 2021, and the country suffered one of Europe’s highest death rates during the third-wave pandemic surge in Spring 2021.
“By rolling out the vaccine in such a negligent manner, the Bulgarian government put lives at risk, leading to possibly thousands of avoidable deaths. Even today, only about one third of the Bulgarian population above 60 years old have been fully vaccinated—far less than most other Council of Europe countries,” said Maïté De Rue, a senior legal officer and international expert in human rights at the Open Society Foundations. “Today, as new COVID-19 infections in Bulgaria surge at record highs, we call on the government to initiate emergency measures to immediately boost vaccination rates among seniors and those with pre-existing health conditions, who are most likely to suffer severe health consequences or die from COVID-19.”
In Bulgaria’s national vaccination strategy, implemented between December 2020 and May 2021, those over 65 years old and persons with comorbidities, such as those with cardiovascular or chronic respiratory diseases and immunocompromised individuals, were penultimate in the five-phase rollout. This meant that they received doses after some vocational groups including individuals not involved in essential services, nor at high risk of serious illness, were prioritized.
In addition, in mid-February 2021, while vaccines were still available in very limited quantities, vaccinations were opened to the general population via “green corridors”, which exacerbated difficulties that vulnerable groups faced for access. These green corridors led to queues of up to thousands of people at vaccination centers, often outside in temperatures around freezing, making them physically inaccessible for older people and some with pre-existing health problems. Moreover, the Ministry of Health delayed issuing a directive instructing general practitioners and other vaccination centers to vaccinate persons aged 60 years and older until 17 May 2021.
The Open Society Foundations’ complaint before the ECSR, a Council of Europe body which monitors compliance with the European Social Charter on social and economic rights, argues that the actions of the Bulgarian authorities directly violate Article 11 and Article E of the Charter guaranteeing the right to protection of health and the principle of non-discrimination. The complaint also alleges that, in addition to failing to protect vulnerable groups with priority access to the vaccine, the Bulgarian government did not adequately inform and educate the population on the need to get vaccinated. These shortcomings in official public health messaging may have led to less vaccine uptake among vulnerable groups as well as the general population. Since then, following general elections on 14 November 2021, in which the We Continue The Change (PP) party won the most votes, the government of Bulgaria has been replaced by a new four-party ruling majority coalition.
The complaint calls on Committee to compel the Bulgarian government to take the following immediate measures:
- Adopt and implement an emergency action plan with targeted measures to reach out and vaccinate the persons above 60 years old and persons with underlying medical conditions against COVID-19 as a matter of priority;
- Organize proper access to vaccines, including locally for those who cannot move because of their age or health, and if appropriate in collaboration with general practitioners; and
- Develop and implement a campaign of information about the need for people, and especially vulnerable groups such as the elderly and the sick, to be vaccinated against COVID-19, to achieve high levels of vaccination among these groups, and the wider population.
On 14 September 2020, the WHO published guidance urging national authorities to prioritize “groups experiencing greater burdens” from the pandemic in their vaccination programs, including senior citizens and individuals with comorbidities. Other bodies, including the UN Committee on Economic, Social and Cultural Rights, the UN High Commissioner for Human Rights, and more, have also come to a consensus on the need to prioritize persons at risk for reasons such as age and preexisting conditions for the COVID-19 vaccine.
The filing of the complaint before the ECSR in Brussels comes after a domestic case was brought forward on 21 December 2021 by the Bulgarian Helsinki Committee, an independent non-governmental organization for human rights based in Sofia, Bulgaria, against the Council of Ministers and the then Minister of Health. This complaint before the Sofia Regional Court alleges that the national vaccination plan adopted by the Council of Ministers violated the Anti-Discrimination Act because it discriminated against adults over 65 years old and people with underlying conditions based on health and disability.
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