Bulgaria Makes Chickenpox Vaccination Mandatory

Bulgaria is set to make vaccination against chickenpox compulsory starting this July. The new ordinance on immunizations, published in today’s “State Gazette,” stipulates that the vaccine will be provided free of charge. Mandatory vaccination will apply to children born after January 1, 2025, following a two-dose schedule: the first dose between 12 and 15 months of age, followed by a second dose at age four. Children who contract chickenpox after receiving the first dose, provided they have medical documentation or laboratory confirmation, will not be required to receive the second dose.

The rationale behind the change, outlined in a November explanation from the National Expert Council on Immunizations, emphasizes the health risks associated with chickenpox. In children, complications can include severe forms of the disease and skin infections caused by bacteria. Adults are at higher risk of hematological issues and pneumonia, while immunocompromised individuals may experience more frequent hematological and gastrointestinal complications.

In addition to the varicella vaccine mandate, the new regulation introduces targeted immunization against the respiratory syncytial virus (RSV) for pregnant women between 24 and 36 weeks of gestation. This vaccination is also free and recommended. The inclusion of RSV immunization follows the proposals of the National Expert Council on Immunizations and has received support from both the Expert Council on Obstetrics and Gynecology and the chief coordinator of the Expert Council on Neonatology.