petitefrancaise

Ho hum.. seems our good health insurance doesn't cover travel vaccines, doctor says we have to go to their travel clinic as well and of course this isn't covered by the insurance.

I had a look online and a couple of the walk in places do the travel vaccines. Whilst the "consultation" fee is about the same everywhere, the vaccines themselves vary considerably in cost.

Any hints or tips?

we're looking at typhoid, malaria and possibly japanese encephalitis.

thanks

retzie

I've only ever tackled these at home, so no advice regarding insurance gymnastics. Just stopped by to say malaria does not have a vaccine - you have a choice between a variety of prophylactics, each with its own drawbacks. I would want to be able to sit down for a proper conversation about them - definitely not just accept whatever a walk-in place happens to prefer.

Also, typhoid was not the most enjoyable vaccine I've ever had... Don't make plans for the next day or so.

Bob

The various minute clinic type places around where I am, you can pick and chose what you want...but then there seem to be a lot of these places opening around here, even as part of UMass or Tufts who have gotten in on the act, so that might be why.

Our local place, $65 for a health check up with the doc and then cost of vaccine which I over heard ranged from $65-250 for someone that was asking and heading to somewhere in Africa.

petitefrancaise

So I just called one of these places and wanted to ask about the anti-malarial protocol they recommend...."oh we just recommend whatever the cdc website says". WTF am I paying for? Do you think I can ask them for a refund if I print out the relevant cdc info and take it with me?
At the doctors' travel clinic - the doctor who does the travel stuff is on holiday (ironic, non?) and is back towards the end of the month. I ask them does that give enough time for the typhoid vaccine to work? She says, "I'll check" and whilst she is off the phone, I look at the cdc info on this. "no, you need 2 weeks" she says....really??? "The cdc website says 1 week."

seawaternow

There's no vaccine for malaria - your options are pills - lariam (mefloquine) - once a week - comes with black box warning so if any psych issues don't take that one; malarone once a day or doxycycline also once a day.

I was fine on mefloquine but my husband had nightmares either seeing people at the foot of our bed, bugs and spiders walking all over him or just sitting up in the middle of the night staring into the corner of the room until we switched him do malarone.

Where are you going?

retzie

^This. Anti-malarials can be extremely variable from person to person - each traveller's psych history and the circumstances of your trip will play a big part in which way you decide to go. I was travelling on my own and couldn't risk freaking out in the back end of Africa!

I went with doxycycline, which doesn't have the terrifying reputation, but does need to be taken daily with food (really!) and obviously you'll need reliable clean water. You also have to keep taking in for 2(?) weeks after leaving the malarial zone, so it can make for a fairly brutal course of strong antibiotics for your system to deal with. Side-effects include sun sensitivity, so if you are travelling somewhere sunny (and/or happen to be attempting a seaside vacation afterwards /raises hand), it will put a crimp on that.

A family friend worked for Oxfam and travelled frequently to Africa. After becoming suicidal(!) on her first encounter with Larium, she was subsequently stuck with doxycycline and bemoaned the sunburn and daily water demands, in particular.

Any doctor who doesn't have this discussion with you should be avoided, IMO. (I got all this from my regular GP at home.)

Mr Weeze

I would recommend malarone of the 3 - it tends to have the least impact in terms of side effects and doesn't require the same long schedule as doxy. This is based on my own + lots of colleagues experiences in sub sarahan Africa.

Larium is generally the cheapest and the one that is notorious for the psychotic dreams.