Even though the start date has been pushed back to October (or even later, though I hope not), we are still forging ahead with planning our trip to Asia. (We are starting in New Zealand, or NOT ASIA, but hey, it’s close.) One of my assignments for January was to research vaccines. I spent quite a lot of time on the Travelers’ Health page on the Centers for Disease Control and Prevention website. If you go to a specific country site, you will find pages titled “Vaccines and Medicines,” “Stay Healthy and Safe,” and so on. I recommend spending some time reading through the topics for each country, although you should keep in mind that not all the things mentioned in the advisories are likely to happen on one trip.
I didn’t know that vaccines are considered preventive care and thus insurance will pay for at least some of them. My three Hepatitis B shots should be covered, but I doubt that the Japanese encephalitis will be.
Our family physician, however, does not offer all the vaccines we want. So we trotted over to Denver Health Medical Center’s Immunization and Travel Clinic and met with a nurse who had a certificate in travel health. We told her our (incomplete) itinerary in advance, and she gave us a folder full of Travax Traveler Health Reports about various countries, plus lots of information about malaria and other hazards.
I’ve already been vaccinated for Hepatitis A (a food-borne form of hepatitis), and Todd has had one of those two shots. He has had Hepatitis B (transmitted by unclean needles or contact with the blood or sexual fluids of an infected person).
Because we will be in Asia for at least six months, and I want to work on some ecosystem restoration projects that will probably take me out into the countryside, and medical care in Asia is substandard in certain areas, the nurse recommended that I get the three Hepatitis B shots. For the same reasons she recommended protection against Japanese encephalitis (two shots, four weeks apart), which is common in Asia and is transmitted by mosquitoes, and against rabies if we will be more than 24 hours from a medical center that stocks rabies immune globulin.
We need to make sure we are up-to-date on tetanus (my last tetanus, diphtheria, and acellular pertussis shot, or TDAP, was in 2009, so it should last until 2019) and get shots for typhoid two weeks before travel. We will also need medication for malaria, but that can wait until the month before we leave.
If we go to Afghanistan (and I still want to), we may need to carry a certificate of polio vaccination, since it has not been eradicated there. My father contracted polio at nine months and is still with us at eighty-eight (though forgetful), so this issue is dear to my heart.
The nurse kept stressing that we must protect ourselves from mosquitoes. She suggested we spray our clothes with Permethrin (which she said might last through ten washings) and spray any exposed parts of our bodies with DEET at 20–35 percent strength. The thought of dousing myself with chemicals for six months to a year doesn’t thrill me, but I’m not sure I’m willing to depend on natural insect repellants. Those didn’t work nearly as well as I would have liked in Texas during warbler migration, and I’m not sure I want to trust them to fend off diseases like dengue fever (transmitted by mosquitoes that are active during the day) or filariasis (a parasite that invades the lymphatic system). I will need to do more research on natural remedies and check with other travelers.