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World Travel Vaccinations: Protection from the Ugliest

Anticipating the number of shots needed for world travel is enough to almost deter me from the trip - almost. Ugh, unavoidable misery (but worse than either alternative: getting the disease or not going).

How many is it? How soon do I have to start? And...how can I reduce the list?

We spent 2 hours reviewing the minutia at our hospital travel clinic. Here's the cliff-notes of that conversation, and all you need to make sure you are safe wherever you go.

First: Find out what you don't need. (This is my favorite part... like whew, right?! ) You are likely already immunized for some things. Either you've had the disease, (your body is immune as a result), or your parents hauled you as a screaming child for many visits to the doctor which you can now thank them for. Get the record to find out. If you can't get a record, have blood drawn to determine which antibodies you already have. This is the good news.

Second: There will likely be some immunizations which require a booster. This means that while you did get a shot at some point, it has “expired” in your system and you are no longer protected. Your list starts here.

Third: You will be asked where you will be traveling. This is to consider diseases that are not present in your country of origin (immunizations that you would not have needed at home) that you won't have protection for and will need. If you are like us (going everywhere) you will get the big list! Below is the whole kit-and-caboodle. I suggest printing out this chart, marking what you've had and taking it with you to the doctor to make sure you are covered.

Fourth: Determine what your insurance covers and where to get the rest in a cost effective way. They tell me that I have great insurance- essentially everything is covered. Except, as it turns out- vaccinations for diseases that are not present in my country (or cosmetic surgery such as a badly needed nose job, botox, laser hair removal, and liposuction...basically all the really important stuff).

Most of what you are likely covered for you've already had in your childhood immunizations (these are highlighted in yellow in the chart below), but for the nasty stuff abroad, you will have to pay out-of-pocket. This is important! The pain of these shots can reach deep into your pocket book very quickly if you aren't careful. Here are some options you probably won't hear about at your local doctor or travel clinic:

Our plan: We fly into Bangkok (huge city) first. The shots we need would total over $1000.00 per person if we got them in the US (some as much as $200.00 per shot!). However, if we get them in Bangkok upon arrival, we will pay $168.00 each total for all shots! That is a savings of roughly $1670.00! Our local travel clinic in the US even provided the name of a recommended hospital in Bangkok that could administer the shots. Ask for the list.

As long as you are not sharing bodily fluids with any of the locals upon arrival, you are safe in a large city abroad until you get immunizations. The most danger is traveling out to rural places where you are more likely to come in contact with mosquitos. If you begin in a large city, check out the walk-in clinics.

The chart below lists everything you should consider. Print off and check the ones you need. Yellow indicates a US common immunization- you probably already have antibodies for these (but check and confirm).

Name/Symptoms How To Get it How To Avoid it
Hepatitis A: Liver disease Flu-like illness, jaundice, severe stomach pains/diarrhea Personal contact with infected person: sharing utensils, foodFound in US and abroad Vaccine
Hepatitis B: Liver infection Acute (short-term) or Chronic (long-term) Pain in muscles, joints, stomach. Liver damage, liver cancer Contact with bodily fluids of infected person, or contact with contaminated object.Found in US and abroad Vaccine
Meningococcal (Meningitis) Infection of the brain, spinal chord, blood. Lose arms, legs. Have nervous system problems, deaf, retardation, seizure Bacterial infection. Coming into contact with bacteria.Found in US and abroad, only those considered at-risk have been immunized Vaccine
Yellow Fever Fever and flu symptoms, jaundice, bleeding. Liver/kidney/respiratory/ other organ failures. Death Bite of infected mosquito Found in Africa and S. America Vaccine
Typhoid Fever, fatigue, weakness, stomach pains, headache, loss of appetite, rash. Death *Some people become carriers Contact with infected persons, contaminated food and water Vaccine
Polio Paralysis, also Polio can cause Meningitis, Death can result By mouthFound in US and abroad Vaccine
Japanese Encephalitis Most have no symptoms others can have headache, fever or brain infection, stiff neck, seizures, or coma Bite of infected mosquitoFound in rural Asia Vaccine
Tetanus, Spasm in jaw, stiff neck
Whooping Cough Sneezing, Coughing Congestion Diphtheria Sore throat, fever, swollen glands
T: bacteria in dirt enters through wound
WC and D: contact with infected person
Vaccine for all 3:DTap
Measles, Runny nose, cough, fever, rash
Mumps, Fever, headache, swelling of facial glands
Rubella, Headache, pink eye, runny nose
All caused by contact with infected person Vaccine for all 3:MMR
Malaria Fever, flu, vomiting, diarrhea, jaundice. If not identified and treated in 10 days: shock, lung and kidney failure, coma and death. Bite of infected mosquito Found in rural areas of Asia and Africa Dusk most dangerous Curable Insect repellant.
Dengue Fever Fever, severe muscle/joint and low back pain “break bone fever” nausea, vomiting, rash. Lasts 6 days Bite of infected mosquito. Found in cities in tropical climates. Daytime most dangerous Insect repellant