Many apologies for the lack of posts over the past 10 days! We’ve had technical difficulties accessing Squarespace here in Peru but we were finally able to find a decent connection. We said we would be posting our packing lists next, but we’re running into such low upload speeds that we’re getting disconnected before we can finish uploading the pictures of our gear. For now, here’s our post on vaccinations!
Getting sick on the road is the easiest way to slow down or force you to cancel your travel plans. The ills that can await you in foreign countries are often very different from those you’ve faced on a daily basis at home. In addition to travel health insurance, travel vaccinations are an important part of being prepared to stay healthy in your travels.
The CDC has a great guide that recommends what vaccines you should get for each country you want to visit. As we decided on each country that we wanted to visit, we made a trip to that website to see what recommendations the CDC had for it. They break down their recommendations into three categories: All Travelers, Most Travelers, and Some Travelers. The first two categories contain vaccines that you will most likely want to be up-to-date on before visiting that country. The final category contains vaccines that you may or may not want to get based on what sort of activities you’ll engage in while traveling.
In our research, eight vaccines came up over and over again as we looked at each country and one booster reared it's head unexpectedly. Here's what we did in terms of vaccinations:
Hepatitis A and B, Polio
We were both vaccinated as children and are up to date on our shots
We both received this one as it’s recommended in many of the places we’re visiting. I took the oral version of it as his health insurance covered it at a decent price of $40. Anais received her injection when she was visiting family in Paris.
Costs: $40 for Tyler, €40 for Anais (~$53 at the time)
There are a number of theories out there about whether or not this is required. Travelers who intend to spend time in certain parts of Africa where yellow fever is endemic are required to have the vaccine to get a visa. Similarly, it used to be a necessity to enter some South American countries, but rules have become more relaxed in recent years (in Brazil, for example). Since our current travel plans don’t include Africa, we debated back and forth on whether or not to get this one. In the end, we decided we couldn’t ignore our mothers’ ever present advice of “better safe than sorry” and decided to get this one. I visited a travel clinic in Los Angeles and got the shot there. As with Typhoid, Anais received her vaccination in Paris.
Costs: $145 for Tyler (included clinic administration fee of $25), €45 for Anais (~$60)
The best way to avoid malaria is to avoid mosquitos as best as one can using DEET or one of the natural ingredient repellants. Malaria prophylaxis can have pretty intense side effects, such as hallucinations or the extreme sun sensitivity associated with doxycycline. However, after discussions with our doctors, we decided to take the same approach that we did with yellow fever and carry with us generic malarone. Thankfully, our health insurance came through yet again and we were able to get 150 days worth in total (not per person) for $40. This should have us covered well into SE Asia, where it is cheaper to get the medication.
Cost: $20 per person
The decision about whether or not to get this vaccine is possibly the hardest on this list. One the one hand, you have the fact that only 1 out of every 250 people who are infected ever develop full-blown encephalitis. Of those that do, 20-30% die as a result - and for those that don’t, up to half of them suffer some sort of lasting brain damage. That being said, the CDC estimated that only 1 out of every 1 million travelers will contract JE, but the risk increases for those who spend longer than 1 month in endemic areas or who spend time in rural areas, especially in/around farms or native jungle.
If that isn’t enough to make the choice difficult, the added headache comes from the cost of the vaccine (at least in the US) - it costs around $600 per person for the full course. Some long-term travelers will look at the 1 in 1 million statistic, compare it to the $600 cost, and decide that the shot isn’t a necessity. We’re in a similar boat. While the cost of the vaccination is certainly harrowing, we will be spending an extended amount of time in infected areas and it’s likely that we’ll spend at least part of our time hiking and/or in national parks. As such, we looked into alternatives and found the Thai Travel Clinic in Bangkok. There, you can receive the vaccine for ~$21 all in. Since Thailand is one of the first stops we’ll make in SE Asia, we think this is a great option for us to get covered without destroying our budget.
When I asked the travel clinic where I received my yellow fever vaccination about the prices for typhoid, yellow fever, and rabies (we had already ruled out JE), the medical director responded to our email and for rabies the responses was “Super expensive....are you sure you need this? We rarely give it, usually we just educate our patients.” In the end, we followed their advice and decided not to get this shot. The excessive price combined with the relatively low risk of contracting the disease (assuming we stay away from infected animals) was enough to convince us to save the money. Plus, even if you receive the vaccination, it doesn’t completely protect you from the disease, it just changes the treatment plan (fewer follow up shots). This may also be something we look at getting at the Thai Travel Clinic.
This was a last minute addition for both of us. After seeing our doctors the week before departure for last minute preparations, both suggested we get booster shots. I was able to squeeze the shot in last minute before our insurance ran out, but due to communication issues with her doctor, our coverage lapsed and Anais had to go to the local Walgreens to get the T-dap booster.
Costs: $0 for Tyler, $64 for Anais
Final Pre-Trip Costs
Total : $402
We expect we’ll spend another $40 or so in Bangkok, and we’ll update this page when that time comes. For those in LA, I went to WellnessMart, which has multiple locations in the area. I found that they had the best prices for the yellow fever vaccine+certificate that was also highly rated for service. It might have been cheaper to visit the Long Beach Travel Clinic, but the time/hassle saved was worth the extra money spent.