Travel vaccinations

[Sojourner]

Where have you gone to get your vaccinations for overseas travel? For example, things like typhoid, hepatitis A/B, yellow fever, etc. How much have you paid out-of-pocket for them, roughly? Did insurance lower the costs at all?

 

[Zona]

When I have needed them in the past, I’ve used Passport Health. They have a website with locations in many states.

Not sure about costs. At the time, I knew the county health department was cheaper, but Passport Health was more convenient and had appointments available sooner.

Edit: I paid out of pocket so not sure about your insurance question.

 

[OldShooter]

The health care system that we're in has a Travel Clinic. You can give them an itinerary and schedule an appointment. At the appointment you get a limited briefing and handouts based on US government (State Department IIRC) recommendations and they give you whatever shots you need. Insurance coverage of the appointment (Medicare Advantage) is a little spotty, but insurance seems to cover all the vaccinations. We are now in a concierge program, so I just ask the concierge RN to call the travel clinic and get the vaccination recommendations, then we go in and she gives them. No fighting about travel clinic visit coverage.

The only hitch we have had in many years was a last-minute (two days before departure) notice that we needed a yellow fever vacc to get into Nigeria. Apparently that vaccination is not common and there were only a few options in our large metro area. We picked one that was out of network and ended up private-paying as I guess Medicare would not cover it. It was a couple of hundred bucks for the two of us IIRC.

I had a good laugh a few years ago seeing a new doc. He looked at the screen and said "You've had everything!" Yes. Even smallpox many years ago. At this point all we ever get is boosters as the need arises.

 

[SecondAttempt]

25 years ago I went to a third world country for work. My company sent us to a travel medicine specialist. My project manager and I were the first to go for a design review. We met with the doc and she gave use about half an hour of "counseling" which was actually quite helpful. The concerns were mostly malaria, cholera, typhoid, and nosocomial (hospital borne) infections as well as HIV and car accidents. Then we got to be pin cushions for her nurse. She had preordered the vaccines we needed.
Unfortunately I can't tell you how much because company paid.

Her advice was simple. Only drink bottled water, don't have sex, cover up during twilight to avoid mosquito bites, and don't eat any fruit you don't peel yourself. She did say that many things like hepatitis are routine childhood illnesses in the developing world so they are not common but westerners are susceptible.

And as reported in another thread, she prescribed cipro, said to carry immodium, and if sick, get to a major city in China, Malaysia, etc. Immodium is to shut down your intestines so you don't die of dehyration while evacuating. Constipation is easier to treat than death.

But seriously, she was an expert and her advice was very reassuring. A few simple precautions and having an exit plan get you a long way.

A former boss also gave me advice he got from a WHO nurse. Put duct tape over you mouth in the shower to avoid inadvertantly drinking any water.

 

[Gumby]

You can look up your travel destination on this CDC site. https://wwwnc.cdc.gov/travel/destinations/list It will tell you which vaccinations you need for each destination. We needed a hepatitis vaccine to go to Egypt, which we got at the CVS drugstore. We did have to go tell them we wanted it and then wait a couple days while they ordered it. Our health insurance paid for it.

 

[athena53]

I'm in the KC area and use the Travel and Immunization Clinic, which apparently is not a franchise. Up to 3 years ago I'd used them for trips to India which typically included updating my tetanus vaccination if necessary and getting a prescription for pills to prevent malaria. Note that it takes a few days for most pharmacies to get those pills since they typically don't have them in stock, and you need to start them a few days before leaving.

Three years ago I consulted them before a trip to South America that involved high altitudes. They went over my itinerary with a fine-toothed comb and wrote a detailed plan for when to start and stop pills that prevent altitude sickness. The doctor even followed up with a call, emphasizing that people die from altitude sickness, so get them and take them as prescribed. OK, I was convinced!

I'm on Medicare, which doesn't seem to cover any of this, but the pharmacy bill has never run over $50.

Immodium highly recommended. I have a pretty healthy digestive system but have been hit with low-grade cases in India- just the body's response to unfamiliar viruses or bacteria. The two bad cases I had were after eating fish in good restaurants (one on a group tour, one in the very nice hotel where I stayed on business). I mostly stay vegetarian in India for that reason- their vegetarian food is wonderful. The clinic always gave me a just-in-case pack of Azithromycin with instructions about when to resort to them if the Immodium failed but I never needed them.

Bring packets of electrolyte powder (e.g., Liquid IV from Costco) if you're at high altitudes or in places where you might get dehydrated. Dissolve in a bottle of water and drink. Magic.

Most County Health departments offer these services, too.

 

[The Cosmic Avenger]

I just looked, and it looks like we got some things from our primary docs, but went to Passport Health for the rest, and I'm pretty sure we just paid out of my FSA, so basically out of pocket.

 

[braumeister]

You can look up your travel destination on this CDC site. https://wwwnc.cdc.gov/travel/destinations/list It will tell you which vaccinations you need for each destination. We needed a hepatitis vaccine to go to Egypt, which we got at the CVS drugstore. We did have to go tell them we wanted it and then wait a couple days while they ordered it. Our health insurance paid for it.

That is certainly the best place to start.
And if you need help finding a place to get what you need, this page is also useful:
https://wwwnc.cdc.gov/travel/page/find-clinic

 

[OldShooter]

Some have mentioned carry-along kits. I have cut down one of those seven-compartment pill carriers to just three: ibuprofen, generic immodium, and generic sudafed. In addition we carry at least one course of azithromycin aka Z-Pak or Cipro. The last item requires a prescription but we have never had a doc turn us down when we explain the purpose.

 

[FIYes]

Years ago we went to a travel health clinic before a trip to South America. We got hepatitis vaccinations and advice. We also got a prescription for a Z-park to take with us and an altitude sickness prescription.

The advice included drink bottled water only, fresh fruit only if you could peel it, and unexpectedly don’t drink draft beer…only bottled. Also, avoid ice in drinks.

 

[Sojourner]

I just looked, and it looks like we got some things from our primary docs, but went to Passport Health for the rest, and I'm pretty sure we just paid out of my FSA, so basically out of pocket.

I looked into Passport Health, as well, but determined that they charge substantially more than my local pharmacies for the exact same vaccines. And that's not even counting PH's mandatory $99 "consultation fee"! Also, they don't accept any form of insurance. For me, Walgreen's was the way to go.

Thanks to all for the various suggestions and feedback. Very helpful indeed.

 

[SecondAttempt]

Seems like you got your problem behind you.

I would just add that, except for government required vaccinations, travel medicine is largely a personal call. When I went in the late 90s the mararia prophelaxis was larium. I worked for an Australian company at the time and that drug had such a bad reputation with the British army that the employees there refused it. It has side effects including psychotic episodes.

Neither I nor my US colleague had any major psychotic episodes but we both had weird psycho symptoms including anxiety, strange vivid dreams, and so forth for a few months. I don't think I would take larium again just in case.

Good luck to you!

 

[brett]

We have used a travel clinic for things like yellow fever, etc.

We view Hep and tetanus shots as something we need for everyday at home. Or for quick, last minute AI trips to Mexico, Cuba, DR, etc. Not any different than flu shots etc. to us.

Last time we went to the travel clinic was well before a trip to Africa.

We had a good understanding of where we would be going. The travel clinic mapped our trip out and came up with a list of must haves and nice to haves.

 

[ClarkeK]

We have a trip to Peru and South Africa coming up next January and May. Just got off the phone with Passport Health, they quoted us $1200 for all required vaccinations, yikes!

We called CVS and they said they could provide the shots as long as we got our scripts sent over from our PCP but he didn't know how much. Working that now with our PCP.

Called Walgreens to try and get an idea on pricing and they quoted $130 pp for Hep A and $204 pp for Yellow Fever, w/o insurance. Significantly cheaper than Passport Health.

 

[Gumby]

We didn't need prescriptions to get a Hepatitis vaccine prior to our Egypt trip. We just went to CVS and said we wanted one. Just as we have done for flu and Covid.

 

[Pellice]

Some have mentioned carry-along kits. I have cut down one of those seven-compartment pill carriers to just three: ibuprofen, generic immodium, and generic sudafed. In addition we carry at least one course of azithromycin aka Z-Pak or Cipro. The last item requires a prescription but we have never had a doc turn us down when we explain the purpose.

And Cipro doesn't expire, or at least takes 20 years to do so. At one point I was able to look up that Department of Defense database of their estimates of the true shelf life of drugs. Cipro was one of the longest-lived.

However I can no longer find that website, although I've tried, and I wonder if it's been taken off line. If anyone has the url, I'd be grateful for it.

 

[OldShooter]

... At one point I was able to look up that Department of Defense database of their estimates of the true shelf life of drugs. ...

Yes. I also have some Tylenol 3 (with codeine.) When researching that I was surprised to find that the army works hard at this, obviously to avoid replacing their go-to-war medicine stocks when they are still perfectly good.

 

[Chuckanut]

Yes. I also have some Tylenol 3 (with codeine.) When researching that I was surprised to find that the army works hard at this, obviously to avoid replacing their go-to-war medicine stocks when they are still perfectly good.

+1

Also, in a time of war access to drugs may be limited to whatever the soldier can find in the field. It's nice to know if that bottle of two year old ibuprofen found in the bathroom of a bombed out house is still reasonably effective. Apparently, it is. Most of the use-by dates on OTC drug are very conservative.