I have had to get yellow fever, adult polio, japanese encephalitis, and a flu shot. I would have also had to get typhoid and hepatitis A but I am current on those. In addition, I will have to take malaria pills for the duration of my travels. Luckily, all three countries use the same malaria prophylaxis so I don't have to worry about taking two different kinds.
This post is dedicated in some way to these vaccinations but more importantly is making sure that people know they need to do their own research on the vaccinations they need to get and also be willing to be proactive and be insistent if you feel there is something you need but aren't being given (or actually being told you don't need).
This is what happened to me for this series of vaccinations. I went to one location, where I live (I won't mention where). I was told I would need the yellow fever and the adult polio. I specifically asked if I would need the Japanese encephalitis but was told no since I wasn't there that long. I was also given Lariam, which is a malaria medication that can induce terrible dark thoughts and night terrors especially if you are on specific types of medications. I ask the nurse about this and was told that "that is all in people's heads" meaning they just make those symptoms up because they hear someone else mention it. She said all the malaria drugs are basically the same thing and those reactions are in people's head. Ironic huh?
I took the prescription for it but didn't fill it and instead did my own research. I talked to some people who had been in the area I am going to and many of them said they were also given Lariam the first time they went and had the dark thoughts and some even the night terrors and these were people that did not know anything about Lariam before taking it other than it was a malaria drug.
I also was pretty sure I needed the Japanese encephalitis due to the fact that both the areas I am visiting in Sri Lanka and India are endemic areas. Also, I will be working with elephants and basically playing in nasty water. I tend to err on the side of caution when it comes to vaccinations as well feeling better to be safe then sorry.
So, due to this I decided to get a 2nd opinion. I, luckily, attended an OSAC, Overseas Security Advisory Council, meeting soon after this first doctor's visit and heard about this group of travel clinics called Passport Health. They had a nurse at this meeting form one of their clinics and I mentioned what I was told about the Lariam and she told me that due to issues with Lariam it is not even given to the military anymore for their travels. So why would I take it??? She also mentioned I was right to seek a 2nd opinion.
I was able to find a Passport Health clinic about a hour from where I live and made an appointment to talk to a nurse there. The Passport Health clinic was extremely helpful because they gave me a thick binder that included general information as well as individual information for all the countries I am going to. She sat with me and we talked about what activities I would be doing and which areas I would be going to and we came up with a plan for which shots I would need. She was the one that mentioned I needed a new flu shot since The Gambia has major cases of the flu all year round. She also said I was correct to seek the 2nd opinion about the Japanese encephalitis. I needed to have it due to the interaction and the bathing of the elephants. She also confirmed my opinion about Lariam and gave me a different kind of malaria prophylaxis that doesn't have these side effects and is still easy to take. She was also dumbfounded by the reaction I got at the other travel clinic. (I also found out later that there is now Lariam resistant in the Gambia so another reason not to take it.)
By telling my story, this longer blog post is really about being proactive and taking a part in your own travel health. I know these shots are expensive and medical insurance will not cover most of them but they will save you so much more agony in the end.
Do your research! Be insistent when you need to! Seek a 2nd opinion if you aren't happy with the 1st! Take your malaria medication! So many people don't and malaria is not something you want to get and why spend a few days sick in bed when you could be exploring your chosen destination.
I hope my tale and advise helps you and I have included links to Passport Health in this blog since I think they are a great organization and provide a wealth of information and resources. In fact, I have asked them to come onto my campus twice a year to provide travel vaccinations for my students preparing for their own adventures abroad.
More next time and if you have an travel advice or have topics you would like me to touch on please feel free to leave me a comment.