Cost-Benefit Analysis of A Pre-India Travel Clinic Visit

note this is not intended to be medical advice. see your health care professional if you have any questions! also, this details my experience. YMMV based on your medical provider and insurance.

UPDATE: i found these pages on my medical group’s website about what travel medicine is, and why you should consider it.

almost 13 years ago, i went to India for the first time (and well, up until the end of this month, my only time) for a friend’s wedding in Coimbatore. it was also my first time getting shots in preparation for a trip, which i’ve only ever done once after, for my 2011 trip to Cambodia.

what you need

i’m usually pretty good about following CDC instructions for immunizations (though not always, i didn’t get any for my trip to Myanmar), and for India they recommend being up-to-date on the following:

• Measles-mumps-rubella (MMR)
• Diphtheria-tetanus-pertussis
• Chickenpox
• Polio
• Flu (which i would have gotten anyways)
• Hepatitis A
• Typhoid

with optional hepatitis B, malaria, Japanese encephalitis, and rabies depending on your activities.

because i already had many of these shots before, a lot of them ended up being boosters just to make sure i was covered.

what it cost

my medical insurance covered most of the shots i needed, as well as the visit to the travel medicine clinic itself (i think — i may owe a $16[?! random] copay, but it wasn’t billed and i didn’t pay it onsite):

unfortunately, they didn’t cover the typhoid vaccine (and the $31 it cost the nurse to spend 5 seconds injecting it in me — which conveniently was the first item billed; i wonder if it would have been $14 if they switched the order of the polio and typhoid…).

i was prescribed Malarone as my malaria prophylaxis. for my first trip to India i remember being put on Lariam. luckily i didn’t have any side effects but there’s now an FDA black box warning  about potential long-term neurological and psychiatric problems associated with it — so this was easily not an option. that left doxycycline and Malarone as the two top contenders. i did doxy before my Cambodia trip. it was cheap, but you have to take it FOR. EV. ER. (like for a month after travel finishes). the nurse was pretty set on Malarone and i wasn’t in the mood to argue since i’d rather spend a bit more and not have to deal with a daily pill for over a month.

i also got an antibiotic (only for when diarrhea is really bad, apparently — otherwise loose stools you use an over-the-counter anti-diarrheal), and both medications together cost me $40.

why (aka, benefits)

i’ve seen what skipping it can do

way back on my first trip to India, a friend (the bride’s brother, as a matter of fact) didn’t get immunizations and came back with typhoid. we pretty much ate the same things, and we think we narrowed it down to a meal (very delicious, actually — some of the tastiest chicken i’ve ever had) we had during the (slow and goregous) two-day train ride up the western coast.

yeah, it sucks that the disease i’m the most paranoid about now is the one that insurance didn’t cover the shot for, but oh well. i’d rather be safe and out some money than sorry later — from what i remember, he was down and out for quite a while!

you get much more than shots

my travel clinic gives out these very detailed folders full of information — about protecting yourself from the sun, nasties that can be hiding in food and water, treating common ailments, and avoiding mosquitoes. you could probably find a lot of this stuff online, but it’s good to have someone go over everything and be able to deal with your concerns.

is it worth it?

this is one of those things that is hard to answer since if you don’t get sick, you may never know if it was due to immunizations and things you learned from the travel clinic visit. and alas, even with insurance, my $194 out of pocket (not including things like mosquito repellent or Imodium) is definitely not cheap, at least not to me. i’m pretty bad about taking out extended travel insurance (beyond what i get from my credit card), so i think of myself as someone who lives slightly dangerously, but in cases like this, when it comes to easily preventable health issues, i’m a little more discerning.

$194, though. i’m trying to convince myself it is, and i’m pretty sure i’m succeeding. the typhoid — the big ticket item — is good for two years, so i’ve gotta take advantage of that. i already have trips to Nepal, Tunisia, and rural Philippines booked, and it’s CDC-recommended for those countries (especially if you’re a bit adventurous), so it’ll come in handy again several times over. i have to say, though, i think if i were not presented with this India trip first, given my previous experience with the country, i’d be less likely to have gotten all this done — i didn’t even think about shots for Mongolia last year, for instance (which falls into the same categories as the previous three countries).

oh, and that $21 for the visit (paid by insurance or not) — for 45 minutes spent with a medical professional? that’s practically a steal in the US!