Health and Safety

Vaccines

Not surprisingly, opinions about the need for vaccines range among traveling families as much as they do among families back home in the United States.  Nearly everyone we’ve encountered gets the ones recommended by the CDC.  For the countries we are visiting that included all the usual suspects the kids already got at the pediatrician’s, including Hep A and Hep B, which Nico and I didn’t have yet (you can get your immunities checked through doing a blood titer) and then Yellow Fever and Typhoid for everyone.  That was expensive enough–$1600 for four people! It’s among  the “advisable” shots –Rabies and Japanese Encephalitis–where I’ve encountered some debate.

In addition to being harder to find, these vaccines are particularly expensive and their expense varies widely among suppliers. On the forums for traveling families, there are posters who take the position that you can never scrimp on the safety of your kids and then others who report that in all seven or however many years of traveling, they have never gotten the Rabies vaccines and never needed it.  Most people fall in the middle, as we do, where you try to balance your level of paranoia against the expense–which when traveling translates into cool things that you won’t be able to do.  Add to that your discomfort with shooting your kids up with so much disease and some rational calculations on the actual risks, and you try to make the best decision you can.

For us , we decided (or rather I decided because this was a choice–along with the need for medical evacuation insurance–that I campaigned for relentlessly) to vaccinate our kids against Rabies.  They are animal lovers and stop to pet every passing dog on the streets of Brooklyn where we live.  Apparently it isn’t so easy to recognize a dog with rabies–they aren’t all like Cujo in the Steven King movie.  Sometimes they seem very docile or super friendly.  I also know myself and nobody was going to be happy to have me shrieking at the kids for ten months: Don’t touch that dog!

Because what we learned is that if  a kid gets bit or even scratched or licked on a cut–which they wouldn’t necessarily mention–they could contract the disease.  If exposed, you must get the post-exposure vaccine within 24 hours or else THEY COULD DIE.   Given that these vaccines can be hard to find, especially in developing countries, I think it’s crazy not to vaccinate for rabies, which is why we did it.

Rabies requires a series of three shots, each one costing $275 at most travel clinics in New York City, along with a $30 office visit. Make that times two for a whopping $1950.  Japanese Encephalitis runs another $295 per shot.  Suddenly, it’s $4500 dollars just to vaccinate our family!  A family of four could live off that sum in South East Asia for six weeks, which is the calculation that many families make.

A popular workaround for the cost of vaccines in the U.S. is to start your trip around the world in Thailand, where at the Thai Travel Clinic in Banghok, the same series of vaccines we got would cost $420 or one-tenth the price.  The one complication for this route is the time required for multi-shot series like Rabies and Hep-A and -B.  They both require sticking around the area for a month to complete the series and Rabies has a very strict schedule that you must follow.  (Hep-B also requires a third shot six months later).  But there are worst things that spending a month in Banghok, along with side trips to the countryside and beaches.  While you are there, apparently you can also get some dental work done at very reasonable prices.

Since we wanted to start our trip in Africa and weren’t able to find a travel clinic there where we could be certain of getting the vaccines we needed, we weren’t able to take advantage of this workaround and bit the bullet and vaccinated our kids in the US.  But wherever you get your family vaccinated, don’t forget to budget in some trips to the toy store afterward.  That was the only way we managed to get our kids to agree to go back to the travel clinic after the first series.