Drug Trouble: The Travel Vaccine Debate

Most people don't have the benefit of health insurance that will pick up the full cost of every vaccine the doctor recommends for your upcoming trip to x, y and z countries. That's why it's important to understand what immunizations are necessary to drop the dough on before you set foot in the clinic. Those who plan on following the doctor's orders may be in for a surprise: unless you visit a travel-specific medical center, you doctor may not know any more about malaria-resistant drugs in India than you do.

Although websites, doctors and fellow travelers can make a number of recommendations, in the end you are the only one that can make a decision. Here are some things to pay attention to when evaluating whether or not a vaccine is right for you.

1. Severity of Illness: If you get this disease, will it seriously harm, maim or kill you? Is there any cure? How long to symptoms last?


2. Chances of Illness: What are the chances of catching the disease? How does it vary from country to country? What can you do to diminish you chances of falling ill?


3. Effectiveness of Treatment: Are your malaria drugs effective in all the countries you plan on visiting or are some areas resistant? What are the chances of developing an illness anyway?


4. Cost: How much does the treatment cost? Is it worth spending $300 for a vaccine that prevents you against a illness that only affects .0001% of travelers?


5. Drug Side Effects: Do you suffer from any drug allergies? Is there a chance of a severe reaction to the drug OR the treatments for the disease?


6. Proximity to Adequate Health Care: Will you be traveling in big cities, with quick access to high quality health care or will you be in a remote village, two days away via camel from the nearest poorly-equipped clinic?


7. Piece of Mind: Are you a worrywart who will fret that every cold means you have malaria? Will your fear of disease ruin your trip? Can you accept what happens if you fall ill?


8. Personal Responsibility: How good are you at taking precautionary measures such as avoiding unprotected sex, eating seafood, drinking local water or consuming fruits and vegetables? Can you remember to spray bug spray every half hour?

Fortunately, there are a number of resources available on the web that can help you make some of these difficult decisions. In addition to BootsnAll's Health Travel Guide and forum dedicated to the topic, check out the following:

• Health Advice for Travelers: The U.K. government gets their say on major diseases and precautions to take. Especially helpful is the worldwide country-by-country disease and immunization checklist...if you can follow all the abbreviations and shorthand. Health updates are issued about once a month.
• MASTA: Based in the U.K., the heath library provides free information on diseases, health risks and safety and security. Of note is the listing of "special risk groups", which includes information for women, children and diabetics as well as travelers with no spleen and those who travel to visit friends and family. Customized health briefs with information on up to 10 countries are also available, for a charge.
• Travelers' Health: The link-happy National Center for Infectious Diseases (United States) is often updated with information on outbreaks and health-related news. The CDC (Center for Disease Control) also provides vaccination recommendations for travelers of all ages. The list of travel-related diseases includes many scary-sounding things to worry about.
• Travel Health: Although written for a U.K. audience, the information on this site is applicable to most travelers. Information focuses on disease prevention, including alternatives to vaccines and medications. The site also provides general health travel advice, a short list of travel health-related news articles, and recommended links and books.
• Trip Prep (Travel Health Online): Trip Prep provides destination and traveler information, as well as a list of travel medicine providers. You must register and consent to a user agreement to access the data, although it is free. The website also includes comprehensive information on travel advisories compiled from the U.S., U.K., Australia and Canadian consular offices. Although the doctors listed on the site have not been evaluated for quality, many work in travel-specific clinics, where available (most common in large cities in western countries).
• WHO International Travel and Health Publication: The WHO offers a downloadable book that covers a variety of dry-sounding subjects including: Health risks and precautions: general considerations, Travel by air: health considerations and Vaccine-preventable diseases, vaccines and vaccination. Note that the book was written for medical professionals, so you may want a medical dictionary nearby to help you sort out the gobbly-gook.

Article added on June 29, 2005

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