The Bulgarian government has announced a significant expansion of mandatory vaccination starting in 2026, with the state set to sponsor free varicella (chickenpox) vaccines for all children aged one to four.
Until now, the varicella vaccine has only been recommended by Bulgarian health authorities, with the costs borne by parents. Due to its price on the Bulgarian market (€80 for two doses) and the lack of a positive information campaign, the number of vaccinated children in the EU’s poorest member state has remained negligible.
“There will be new vaccines introduced in 2026. One of the new mandatory vaccines will be for varicella. This is a serious step forward in prevention,” Health Minister Sylvi Kirilov said.
The health minister hinted that further changes to the immunisation schedule could follow, with the introduction of more vaccines.
Varicella in Bulgaria
Varicella is one of the most common childhood infectious diseases, it’s caused by the varicella-zoster virus and usually presents with a characteristic skin rash, fever and general malaise. Although it typically has a mild course, in some children and the elderly with weakened immune systems, it can lead to serious complications, including pneumonia, bacterial skin infections and even encephalitis.
The vaccine authorised in Bulgaria is up to 98% effective after two doses. However, in the past five years, successive Bulgarian governments have refused to follow the advice of epidemiologists and immunologists to include it in the mandatory immunisation schedule.
Until three years ago, the vaccine was almost impossible to find in Bulgarian pharmacies, forcing parents to purchase it from neighbouring countries, mainly Greece.
Varicella also causes significant disruption to pre-school education in Bulgaria (children aged 4 – 6), as all contacts of infected children are placed under quarantine for nearly three weeks. This leads to prolonged interruptions in education, while children with weaker immunity often suffer from recurrent viral infections for months after contracting varicella.
Policy U-turn
With the new coalition government led by GERB (EPP), the health ministry came under the control of the small populist party There Is Such a People (ITN), which had opposed restrictions on the unvaccinated during the Covid pandemic.
Despite ITN’s flirtation with anti-vaccine groups during the Covid crisis, Health Minister Sylvi Kirilov now appears to support state investments in expanding vaccination coverage.
The ministry first backed and introduced the expansion of HPV vaccination, which, from this year, can be administered free of charge not only to girls but also to boys in Bulgaria.
The government has also funded a controversial measure subsidising antibiotic treatment for all children up to the age of seven. However, this was met with criticism from paediatricians, who argued that the state should prioritise more meaningful measures.
One of the proposals from general practitioners was precisely the introduction of mandatory varicella vaccination, given its strong impact on the health of the youngest children.
(VA, BM)