GET THE JAB DONE

by Ani Ivanova

Vaccinations in Bulgaria can be a complicated affair

If you're already staying in Bulgaria, you know that no specific vaccinations are required for visitors to this country. And if you have already checked yours and your dependants' immunisation record with your GP or practice nurse in your home country, have the due tetanus and polio vaccinations or the usually advised hepatitis A and tick-borne encephalitis shots, you may skip this article. But if you haven't or in the meantime a child was born to you, your child has become a teenager, or you now need immunisation of hepatitis B or influenza, you can have the relevant shots here. All you need to know is how to proceed, as the Bulgarian health care certainly differs – as do most of the things here – from that in your home country.

Getting the shots is possible for foreigners in this country in two ways, depending on their status. You can seek assistance – either free of charge or at a reduced cost – from the state health care system if you are entitled to it by virtue of your temporary or permanent resident status, if you have refugee status or if there's a bilateral agreement regarding provision of health care between Bulgaria and your country. Alternatively, you can pay for it from your own pocket and seek reimbursement from your country's national health fund or your health insurance provider.

If you are entitled to health care provided by the Bulgarian state and, importantly, have registered with a local GP, discuss immunisation issues with them. There are different immunisation schedules in the European countries, and this makes welcome any evidence of your vaccination record. But even if you are unfamiliar with your immunisation history, your doctor should be able to decide if you need a shot depending on your age, health status and/or if you are exposed to risk.

Routine age-related vaccinations in Bulgaria – such as a follow-up immunisation against polio for 16-month-olds, a combined MMP shot for 12-year-olds and a tetanus jab for anyone over 25 (see box) – are part of the so-called mandatory immunisation schedule in Bulgaria, approved by the Health Ministry. The vaccines on the schedule (see box) are all paid for by the state health care system and are provided and applied free of charge, save for the 2,20 leva fee you pay for each visit to your GP. To check if you need one, your local GP may refer you for a blood test or an antibodies search. These are also free, save for the additional 2,20 leva at the laboratory. Then the doctor provides and performs the injection. The mandatory BCG and HBV1 immunisations for new-born babies are administered in neonatology wards at the maternity hospitals/wards.

If, however, you need a shot which is not in the mandatory immunisation schedule – either because you are outside the relevant age group or because you want a different one – say for hepatitis A or meningoccocus meningitis – you will have to pay for them. Note that these and other vaccines – for pneumococcal and haemophillus B infections, typhus, yellow fever, influenza, chickenpox as well as for polio, measles/mumps/rubella and hepatitis B for those who had not received immunisation as children – are not on the Bulgarian state health fund. The same applies also for immunisations for the tick-borne encephalitis and rabies; they are only recommended here. You can buy them at a pharmacy – which in the case of the meningoccocus meningitis is not advisable, as it needs specific storage – and are offered and administered also at the immunisation facilities at the Regional Inspectorates for Protection and Control of Public Health, which are located in all the regional centres. In Sofia, you can also visit the immunisation service at the National Centre for Contagious and Parasitic Diseases (26 Yanko Sakazov Blvd; phone 944 6999, ext.221). You will be charged for the vaccine as well as for any blood tests and antibody searches that you may want done or that may be necessary.

If you are not entitled to Bulgarian state-funded health care, you can have any of the vaccines of the above two groups and the relevant blood tests at a private or a state clinic, as many of the latter service private patients. Make sure you keep all your papers and receipts and check reimbursement procedures from your home country's state health fund – they may want you to claim while still in Bulgaria rather than upon your return home. Similarly, take note of all necessary procedures for reimbursements from your private health insurance provider.

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