Travel vaccinations: when, which, how much and how painful
By Dave • January 14th, 2008There are a great many ways to die on a trip round the world. You could get snapped up by a crocodile in Australia, or bitten by a rabid dog in Thailand. If you’re heading to India, you should probably be on the lookout for crowds of shifty-looking monkeys, after they pushed a politician to his death from a first-floor terrace.
So it makes good sense to take a few precautions. Not being able to predict whether I’ll be eaten by a crocodile or murdered by a macaque, my wife and I have spent the last few months having money pulled through our noses for travel vaccinations.
Before I go much further, I should say that, on a basic level, travel vaccinations are Good Things. Hepatitis is, by most accounts, a bad way to go, and Japanese Encephalitis is worth missing as well. I don’t much fancy Polio, and tetanus is something my nervous system isn’t keen on seeing. But as much as my body would object to any of these, my wallet liked the vaccinations even less.
Travel is something you choose to do, you see, so vaccinations aren’t covered by the NHS. So you go from free jabs for hepatitis A, to hepatitis B, which is £35. And, just when you were thinking that wasn’t so bad, it turns out that’s £35 per shot, and there are three shots before you’re actually any more immune than anyone else. So that’s £105 you’ve just spent. More than that, you’ve just blown it on a disease that barely anyone gets and is hardly ever serious. (Around 30 per cent of infected people never realise they have it.)
But still, it kills two million people annually, so you get it done. Then you need Japanese Encephalitis, another three-injection course, this time at a cost of £38 a go. So your medical costs (this is before you’ve even seen a plane, mind), go from £105 to £219. If you’re really lucky, like me, you’ll get to have some days where you have an injection of Hep B, immediately followed by one for Japanese Encephalitis.
(Incidentally, here’s some good advice for those about to have a course of injections. Always eat first. If your blood sugar is low and you’re even half as wimpy as I am, the best case scenario is that you’ll feel seriously weird afterwards. If you’re unlucky, you’ll wake to a nurse dragging you out of her office. Also: injections always hurt, but there appears to be a technique that some nurses have and some don’t. If you find someone you like, never let them go. Finally, I’ve had two injections in the same arm, and two injections in different arms. Having two injections in the same arm is eye-wateringly painful, but at least you have the use of the other for the rest of the day.)
If you’re really, really, lucky, you’ll also need Yellow Fever, which costs £50. Those working with animals should probably get rabies, which is three more injections, at £40 each. So even those with a relatively modest itinerary could find themselves splashing out the better part of £400. The worst part, of course, is that you don’t know whether you’ll need any of these, because if you come into contact with one of the various nasties lurking around the world, you’ll never know how close you were.
The final, crushing blow to your confidence, the last thing you’ll realise before you cancel your trip and go to hide under your bed, will come if you talk to more than one healthcare professional about your trip. First we didn’t need yellow fever vaccinations, then we did, then we did. (We eventually opted not to). Then we didn’t need rabies, then we absolutely did if we didn’t want to go out like Old Yeller, then we’d “probably†be ok if we avoided animals and didn’t let bats spit in our faces. One nurse suggested a flu vaccination.
If you’re going somewhere even remotely exotic, you’ll be taking malaria pills. You’ll be used to shelling out for medicine by now, so you’ll take it on the chin. We’ve opted for doxycycline, on the dubious grounds that it’s cheap, and you only need to take it for two weeks before and four weeks after you’re in an affected area. Unlike Lariam it’s not psychiatric: a good friend told me how he laughed off people who claimed Lariam would make you mad, only to be surprised when he started having mentalist dreams. The other candidate, Malarone, was ruled out because of its laughable cost of nearly £2 per day.
So there you have it. We’re vaccinated to the back teeth and we chose our malaria medicine on the grounds that it was cheaper than all the rest (including Lariam, interestingly). Oh, we can’t go near wildlife, and we’re screwed if Yellow Fever breaks out.
I used to laugh at people who were despondently paranoid at the prospect of going anywhere interesting. Now I kind of get it.
TRAVEL HEALTH LINKS
www.travelclinicroyalfree.com The Royal Free Hospital’s travel clinic. Sound advice, good location, terrifying prices.
wwwn.cdc.gov/travel The Centre for Disease Control’s site on common traveller afflictions.
www.travelhealth.co.uk More travel advice. It’s unlikely to tally with anything you’ve heard from anyone else, though.
www.rocheusa.com/products/lariam Links to documents detailing the myriad drawbacks of Lariam. Remember: around 20 per cent of users get to enjoy depression, aggression, or vivid nightmares. Happy days.
Now you’ve read that, how about one of the following posts?
Paying by Visa. Going to Russia, Mongolia and China? You’ll need the paperwork. Click here to find out how.
How to use a squat toilet. Leave the comfort of your home and sooner or later you’ll come across one of these. Click here to find out how.
Negdelchin Hotel, Ulan Batar, Mongolia. Worried about sexual health ? You will if you stay here. Click here to see why you should always bring a sleeping bag.
How to have a suit tailored in Vietnam. Sure, this post is mostly about clothes. But if you’re concerned about heat exhaustion, click here to find out what you need to know.
Dave is still in London. My arms hurt and I’m worried about mosquitos, toilets, animals, people and needles.
Tags: crocodile, good advice, good sense, hep b, hepatitis, hepatitis b, jabs, japanese encephalitis, lariam, macaque, maralone, medical costs, nervous system, nhs, polio, tetanus, travel vaccinations
Oh, Dave, you are so funny. I am going to miss you and Mendy-bop so, so, SO much. I am looking so forward to reading about your adventures.
Yeah, I’m hilarious.
You know what’s not funny? Finding out you need 300 malaria tablets and that the doctor charges you just for drawing up the prescription.
Also, now we’ve moved out of London, we’re a mile from anything at all. Getting a can of Diet Coke takes an hour.
Only a mile…….
I now have to drive 30km to get to the nearest petrol station/supermarket and its on solid snow. You townies don’t know how good you’ve got it.
Yeah, but you’ve got a giant cinema and wolves in the back garden. And you live in Finland.
And don’t you demolish, um, things for a living?
I do demolish things for a living but apparently this is the quiet time of year and I now haven’t worked since mid November. Will probably have to look for work in February if things don’t pick up but for now I am quite happy walking the dog, working on the house and building snowmen!
Hi - am I too late? Are you still here?
Where is this “out of London” of which you speak?
Si.
Verily, I’m in the New Forest, where the drizzle is constant, the shops are far, and the entire contents of our flat are in the loft.
We’re here until the 4th of Feb. Then it’s off to see if our vaccinations work.
Aha. I am “out of London” in Hove, which is much the same but with fewer trees and more buildings and shops and wind. And very few of my flat contents are in the loft.
In fact, now I think about it, they aren’t actually too similar at all.
If I wasn’t at the tail-end of my Freelance Month of Hell I’d invite you over, but I guess you’ve got plenty of walking to the shops to do. Let me know if, on the offchance, you and the wife have an evening that you can spare for a Brighton pub.
Certainly will. I’d have to drive there, of course, which would necessitate Not Drinking.
Which is crazy.
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