Children who were fully vaccinated abroad will have to show their vaccine records and a statement from a regional health inspectorate (RZI) before they start kindergarten, the Ministry of Health proposes. The ministry has put draft changes to the rules on health requirements for kindergartens on its website for public comment.

The reason is that vaccines given outside Bulgaria cannot be entered in the National Health Information System (NHIS).

The new rules apply to children whose mandatory vaccinations and boosters were all given abroad. Before the first day at kindergarten, parents will give the health office a copy of a vaccine document issued by the responsible institution in the country concerned. It must show the date of each shot, the order of the dose and the trade name of each vaccine.

The copy must come with a Bulgarian translation and a statement from the regional health inspectorate. In it, the inspectorate confirms that the child has the vaccinations and boosters required for their age under Bulgaria's immunisation rules.

According to the reasons given with the draft, data can be entered in the NHIS only for activity within the Bulgarian health system.

The NHIS rules require an electronic record of every action by medics at medical facilities, including vaccinations.

As a result, children who lived or were born outside Bulgaria and were vaccinated by doctors abroad face practical problems when they try to attend kindergarten. Their parents or guardians have official medical documents, but these do not show in the system that the child is vaccinated.

The ministry says this is why there must be clear rules, and why the institutions that check and confirm that a child's vaccines meet the Bulgarian rules must be named.