site.btaBulgaria Makes Chickenpox Vaccines Mandatory for Children

Bulgaria makes vaccination against chickenpox mandatory for children from July 2026. An amendment to Bulgaria’s Immunization Ordinance was published in the January 9 issue of the State Gazette. The vaccine will be provided free of charge.

Mandatory chickenpox vaccination will apply to children born after January 1, 2025 and will follow a two-dose schedule: the first dose at 12–15 months of age and a booster dose at four years of age. Children who develop chickenpox after receiving the first dose will not be required to receive the second dose, provided that medical documentation or laboratory evidence of the illness is available.

In November, the explanatory notes to the draft amendments stated that the National Expert Council on Immunizations proposed including a standalone chickenpox vaccine in the national immunization schedule as a mandatory vaccine, followed by a booster dose. Among children, the most common complications are severe forms of chickenpox and skin lesions caused by secondary bacterial infections. In adults, the most frequent complications include hematological disorders and pneumonia. Immunocompromised patients with chickenpox more often develop hematological and gastrointestinal complications, according to the rationale for the regulatory changes.

The published ordinance also introduces the option of targeted vaccination against respiratory syncytial virus (RSV) for pregnant women between the 24th and 36th week of gestation. This vaccination is free of charge and recommended. The targeted immunization was included in the ordinance at the proposal of the National Expert Council on Immunizations, supported by the Expert Council on Obstetrics and Gynecology and the chief coordinator of the Expert Council on Neonatology.