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No vaccines are "required".
All travelers should have up to date tetanus protection, unless they are allergic to the vaccine components. Tetanus spores are everywhere, even in house dust, though they are most common in soil contaminated with animal wastes, and they live for a long time. It's also easy for people to get tetanus, since it enters the body through breaks in the skin -- for example, if you walk barefoot in your yard and step on a rusty old nail. Tetanus has a high mortality rate, and people with the disease need prompt treatment, which may include treatment in an intensive care unit. Such care may be difficult to access while traveling in Eastern Europe.
Travelers to Eastern Europe should probably be vaccinated against any of the childhood diseases they haven't had, such as measles, mumps, chickenpox, and rubella. Immunization rates aren't all that high, and if there is an outbreak in the area where you will be traveling, or if there are cases in the orphanage where your child is living, you could be exposed. Most of these diseases are much worse in adults than in children, and you don't want to be unable to parent for weeks or faced with some nasty complications.
Polio is making a comeback, and it's not a bad idea to have a booster, especially if you suspect that you did not have the full series of shots as a child.
Travelers have always been advised to get Hep. A shots, since many countries have a problem with contaminated tap water and limited oversight of food safety. Nowadays, even non-traveling Americans are being advised to get the shots, since it's easy to pick up the disease if an infected food handler in some fast food restaurant doesn't wash his/her hands well after using the bathroom, and then processes your dinner.
Hep. B is recommended for travelers who are likely to have contact with blood or bodily fluids. Adoption travelers may well be in this category, along with medical workers, people having sex with strangers, users of illicit IV drugs, etc. Many countries have a significant number of children infected with Hep. B as a result of having infected birthmothers or as a result of medical care with unsterile equipment. Even if your child tested negative, he/she could possibly be positive, and you could acquire the virus by dealing with a nosebleed, etc. Also, if you shouuld need medical care in a foreign country, and especially in a remote area of the country, be aware that people have gotten Hep. B because of reused needles and poorly sterilized medical equipment.
Sharon
The difference of eastern europe is the water which you do not drink, always drink bottled water but the tap water is fine to boil for coffee etc and use from the tap to wash with. Bulgaria is not known as an unclean country and is a popular destination for vacations, sking, hiking and sight seeing. It is a poor country though this is changing and will continue to change. Alot of Europeans and buying property there as it is a beautiful country and very cheap to live. We ourselves are at the moment buying a home there for holidays and i have to say you have nothing to be frightened of when going there. Enjoy the country and its beauty on your visit. Ok the orphanages are old and tired but even those are being updated by the good work of charities.