Vaccinations

Anytime you're travelling, you should definitely check with the CDC and your doctor/travel clinic to find out what immunizations/vaccinations you need.  If you have all the normal vaccines you got as a child, most others are optional (if you're from the US, anyway).  Some places require you to be further vaccinated if you're coming from a country with a high prevalence of certain diseases, but America is not one of those countries (yet).

SIDEBAR:  I told myself I wouldn't do this because I don't like to alienate people, but I just have to say that I'm a firm believer in having kids vaccinated.  I am literally shocked that this is a discussion people have.  These vaccines could save lives and people are listening to random celebrities instead of doctors.  The fact vaccinations aren't mandatory makes me crazy because I think in order to go to school or certain public places you need to be vaccinated.  If someone's kid is the reason my baby gets measles, I think that parent should face criminal charges.  Yes, I know these laws will probably never be real, and I know this will probably make me wildly unpopular, but what's happening right now is just insanity.  In this instance, I do not support a parent's right to choose.  I do however, support a child's right to live.  The benefits of vaccines far outweigh the risks (which are rare anyway).  Would you rather your child have a sore arm for a day or measles until death?

Sorry, I just had to do it.  Diseases like measles should have been eradicated long ago.  Get your kids vaccinated!

So, today I had an appointment with a private travel clinic in Pleasant Hill called Passport Health.  The nurse, Masooda, was fantastic, but it was daunting how many vaccinations I needed, not only because we're going around the world, but also because most of the places we're staying are near water and water=humidity=mosquitoes=disease.  It was really informative, since I've been reading so much conflicting information.  Let's break it all down, shall we?

Like I said before, make sure you're up to date on all your childhood vaccines: Measles-Mumps-Rubella (MMR), Diphtheria-Tetanus-Pertussis (TDAP), Hepatitis B, Varicella (chicken pox-unless you've had chicken pox before), Polio and Tuberculosis Tests (TB Test).  Those are the basic shots you get as a child, you might have had more (pneumococcal- if you're at risk for developing pneumonia or Hib (flu shots)).  This stuff you should really have, even if you're not travelling anywhere.  

If you've laid all that groundwork, here's what you need now:  boosters for MMR, TDAP and Polio (if you haven't had boosters before..ask your dr).  I think Polio and TDAP last a lifetime and MMR lasts 10 years, but don't quote me on that.  It might be TDAP that's 10 years.  I couldn't focus while she was prepping the shots.

You need Hepatitis A, which most people get at some point, but since it's not a vaccination you need as a child or for school I opted out (my intense fear of needles might have had something to do with it).  However, it's a good one to have, since you can get Hepatitis A from food and water (scary!).  It's a series of 2 shots spaced 6 months apart, so plan ahead (which I didn't, I just got my first one today...oops!). 

You should get a flu shot, just to be safe, even if you don't usually get one (me!). 

I got the pneumococcal because I have asthma, meaning I'm at higher risk for getting pneumonia.  Usually this is reserved for people over 50, smokers and those with chronic diseases (asthma, diabetes, etc).  

Now, let's talk strictly about traveling vaccinations.  It totally depends where you're going, so check the CDC website I gave at the beginning of this post (super easy, choose your country and it'll tell you everything you need to know, health-wise).  They update it regularly, so if there's an outbreak of something they'll be the first to know.  For our trip, there are quite a few recommended vaccinations.  Again, none of these are really mandatory, just recommended for your safety.

First up, rabies can be caught from rabid animal bites.  It's a series of 3 shots.  Dose 2 should be given a week after Dose 1 and Dose 3 should be given 3 weeks after Dose 2.  This is probably only really necessary if you're a vet or going to be working with bats or something.  I doubt I'm going to get it, as it's very expensive and seems kind of unnecessary.

Next, yellow fever is transmitted from mosquitoes and recommended in Argentina.  50% of people with yellow fever will die, so this one is important to avoid.  It's just one shot and when you get it, they give you something called a yellow card.

It's a small booklet and it's (you guessed it!) yellow.  Inside it lists the vaccines you've received with dates.  Some countries require a yellow card with entry (almost as important as a passport).  None of the countries we're going to require a yellow card, but I figured I'd get one since she was offering.  It's an internationally recognized way to display your vaccines.

Japanese Encephalitis is also spread through mosquitoes and is prevalent in Thailand.  This one is also important because Encephalitis means inflammation of the brain.  You really don't want this!  However, we were told that it's very rare, unless we're planning on trekking through jungles for weeks at a time.  It's a series of 2 shots 1 month apart.  We didn't get it and probably won't (it's another really expensive one).

Typhoid is transmitted through water contaminated with the feces of a person with typhoid and is recommended for Costa Rica, Argentina and Thailand.  Seriously gross and seriously painful, you basically wither away slowly.  Either you can get a shot (good for 2 years), or you can take a week's worth of pills (good for 5 years).  The pills contain live vaccine, so they can make you queasy, as you aren't supposed to take them with food.  Hey, anything to not have to get a shot!

Malaria is transmitted through mosquitoes and is somewhat of a risk in Thailand.  It's a pretty serious disease and sometimes hard to diagnose, leading to complications and sometimes death.  There is no vaccine for malaria, so this one is complicated and very expensive.  It's a pill you have to take every day you are in a risk area, starting 2 days before you enter and 1 week after you leave.  Did I mention it's $7 PER PILL!  Yup, you heard me!  Masooda was nice enough to tell me Costco sold malaria medication cheaper, so it'll be about $5 per pill.  What a bargain.  The other thing about malaria medication is there can be crazy side effects, like nightmares and hallucinations.  She told me the best malaria medication, with few if any side effects, is called Malarone.  

At this point, I'm feeling a lot like a Debbie Downer.  All I really want to do is travel the world, care-free and now I've got to worry about hallucinating!  Can't anything just be simple?  The easy answer: NOPE!

Moving on!  

Now that we've had all our vaccinations, we're safe from everything in the world, right??  WRONG!  I got 6 rounds of an anti-diarrhea medication called Cipro.  If there's ever a time when we get really sick with crazy diarrhea, we take 5 days of antibiotics and hopefully feel right as rain.  

I also got 5 altitude pills for traveling at high altitudes called Diamax.  It's just one pill and you take it the day before you climb up that mountain.  I get altitude sickness sometimes because of my asthma.  I'm just a mess.

We also need to get 20-30% DEET insect repellent to keep away the mosquitoes (your worst enemy when travelling to humid places).  Anything higher than 30% isn't more effective and can really dehydrate your skin.

Permethrin is a spray you put on clothes and bedding for mosquitoes.  One good spray can last 6 weeks (even through the washing machine)!

Also, you need a good first aid kit with Neosporin, bandages and pain medication.  They even recommend a sort of powder Neosporin for humid conditions, since a moist wound will fester.

Man oh man, I got 4 shots today (my worst nightmare) and I didn't pass out!  I did hyperventilate, but I guess you can't have it all.  Here's my poor, defenseless arm:

I got my MMR and Polio boosters, as well as pneumococcal and Hepatitis A #1.  My arm feels like I've been in a really bad fight (which I've never been in a real fight in my life, so I'm just guessing that's what it would feel like).  Masooda said you can get up to 7 vaccinations in a day, crazy!

Here are all my goods:

These are my Cipro (anti-diarrhea).  I have to go back and get one more round of Cipro, the Diamax (altitude) and the Malarone (malaria).  The rest of these papers are informative pamphlets and copies of the prescriptions, which they might want to see at customs (to prove I'm not just a really dumb drug smuggler).
My visit today: the consultation, the 4 shots, the anti-diarrhea x 6, the Diamax x 5 and the typhoid pills altogether costs me $857!  This shit ain't cheap when you don't have insurance!  I definitely think it's worth it for the peace of mind I'll have while travelling.  The last thing you want to think about while staring at Machu Picchu is what diseases you could be catching.  I still have to get Yellow Fever and the malaria meds, so I'm probably gonna be too broke to travel by the time I'm done.  I'll just pitch a tent in my backyard and pretend I'm in The Amazon.  If you'd like to join me, feel free.  No vaccinations required!