On Vaccines, Health Risks and Overcoming Fear

I had no idea how many travel vaccines I'd be getting Tuesday morning. I guessed four.

I was somewhat correct in that I received four shots in my left arm... plus two in my right.

At least they gave me apple juice.

I wound up with six doses of the following lovely vaccines (Hepatitis A and B were combined in a vaccine called Twinrix):

I also need another dose of Japanese encephalitis and two more doses each of Twinrix and rabies in January. Whee!

But let's begin at the beginning. And please remember: This is simply my experience and is in no way a recommendation for which vaccines you should or should not elect to receive. Talk to a health-care professional and choose what you think is right for you!

I wound up visiting the Hall Health Travel Clinic on the campus of my alma mater, the University of Washington. My insurance company verified that the travel clinic is an in-network provider, meaning that the amount I'll be responsible for paying will be much less than if I visited another clinic that did not have a contract with my insurance company.

I patronized Hall Health for various ailments during my undergrad years, so I was very happy to return to a familiar setting for this somewhat intimidating errand.

Winter break = empty Hall Health. No sick students to deal with!

My visit began with an hour-long travel consultation with Britt, an ARNP (Advanced Registered Nurse Practitioner/A Really Nice Person). Britt has traveled extensively and served her two years in the Peace Corps in Nepal. Unfortunately, she's also seen many people suffer from the diseases I ended up being immunized against, but I'll get to that in a bit.

Britt entered my itinerary into an awesome Web site for health-care professionals called TRAVAX, which then spit out a detailed 44-page report that included immunization requirements/recommendations, health risks and various travel tips for each of the countries I'll be visiting (including South American countries that I haven't yet firmly decided upon). Excellent.

She walked me through the report and we discussed the recommendations for each vaccine. I erred on the side of "better safe than sorry" during my decision-making, even though I know my chances of being infected with things like Japanese encephalitis and rabies are very low.

Maybe I'm just paranoid, but I envisioned myself on the brink of death due to one of these potentially fatal infections, thinking, "If only I'd gotten that vaccine." Throw in Britt's story about the Japanese encephalitis outbreak she witnessed in Nepal and I was a goner.

Each person should do whatever he or she is comfortable with when choosing vaccines, and I was comfortable with opting for vaccines that others may deem unnecessary. I may not be so comfortable when I get the bill, but let's just cross our fingers, shall we?

The insurance representative I spoke with over the phone told me that the Tdap (tetanus/diphtheria/pertussis booster), hepatitis A/B, typhoid, rabies and yellow fever vaccines are considered "standard and covered." I asked her about this twice since it sounded a little too good to be true. Fingers. Crossed.

Various types of insect repellent, plus a malaria risk map of Cambodia.

The travel consultation also covered recommendations for obtaining travel insurance and compiling a medical kit, as well as methods for safe eating and drinking, avoiding insect bites, dealing with diarrhea and protecting myself from sexual assault. It was comprehensive, to say the least! I was so glad to be able to ask questions throughout, plus take home a huge folder full of information.

I also walked away with the following prescriptions:

• Zithromax (Azithromycin) — for diarrhea
• Cipro (Ciprofloxacin) — for diarrhea
• Doxycycline — malaria prophylactic
• Diflucan (Fluconazole) — for yeast infections (the malaria pills can make women more susceptible)

Sounds like fun, yes? : )


ON OVERCOMING FEAR

If you think I was overzealous with the vaccines I received, you should realize that it's a freakin' miracle I even got them! In the past, just learning about the health risks of travel would have been enough to make me stay home for good. Now I'm grateful that I have access to all the information I need, and there's no chance that even the scary stuff would quash my plans.

Many people never travel abroad because they fear the unknown. I hear a lot of gasps and receive many concerned looks — even from the woman who administered my vaccines! — when people learn that I'm traveling to so many countries alone. I just shrug and tell them I'll be fine.

It's not that I'm naive or fearless. I simply do as Chris Guillebeau suggests and acknowledge my fears, but proceed anyway. I've realized that the scary things are often the things that are most worth doing.

As I sit here typing, my upper arms aching from the six shots I received yesterday, I think about how I'll go about my travels with a mix of excitement, caution and, yes, fear. Luckily, the excitement reigns supreme, and caution and fear are just along for the ride.

What a hell of a ride it will be.

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