I often find myself wondering, "Is ignorance truly bliss?" And I find, most often, that if not bliss, then ignorance is at least simplicity. Take, for instance, the rabies vaccine.
It's that inevitable time before I travel abroad when I need to think about preventative medicine. I was told that I'll need both the typhoid and the rabies vaccination series. To date, I've only really researched the later, and have found that the more information I have, the harder it is for me to made an adequate health decision.
If my health insurance covered the rabies vaccine, or it was somehow free, I probably wouldn't be writing this. However, the three shot series can run from $150 - $450.
If the vaccine was the only means of preventing illness, then again, I wouldn't have any hesitation about getting it. However, even with the vaccine, serious treatment is still needed
if I become infected with the virus. So, some could argue that "vaccine" in this case is loosely defined.
The key, it seems, is that less immediate (and I mean several hours vs an hour at most) treatment is needed if vaccinated. So ultimately, when considering the cost-benefit analysis of getting the vaccination, it seems that if you are going to a place with adequate medical infrastructure and low rabies endemnicity, the vaccine is really an unnecessary expense (given that post-exposure prophylaxis in an unvaccinated individual is almost 100% effective).
So, I guess the questions I need answered are:
1) can I get post-exposure rabies treatment in Maseru?
2) is rabies endemic there?
I'm apt to not spend the money on the vaccination if adequate treatment is available, but then, I'm sure I'll be paranoid without it.
Given that I haven't done any research on the typhoid vaccine, I am also apt to remain ignorant and just get it, so I don't have to do a whole other post on that!
I'm going to the travel clinic at CMMC on Dec 17. Though I don't have a lot of faith that the doctor I see will do anything more than consult an out of date reference book and ask me "So, where is Lesotho again?", I can at least try to peg my decision to whatever she has to say.
2 comments:
My best friend just got vaccines for smallpox and anthrax, and her smallpox vaccination site was contagious for thirty days. Smallpox. Contagious. WTF?
They offered rabies vaccs at the vet clinic I worked at, but I never got mine. It's supposed to be a super-painful one, if that helps your decision any. :)
Having spent a summer in Afghanistan, I am well aware of what you are going thru in terms of what you should and shouldn't do in terms of preventative vaccinations. We were strongly encouraged to get Smallpox (and yes, you are contagious for thirty days because you are vaccinated with the live form of the disease), rabies, typhoid, cholera, tetanus, anthrax and start malaria drugs. I too did lots of research on all of the above and wondered if I would have access to modern medicine that would negate my having to go through the pain and suffering of having the vaccinations. In the end, I passed on the rabies, smallpox (which i'd been vaccinated with previously) and anthrax because I felt confident that I could get medical care if I were exposed. What you need to determine is what the side effects are and what price you put on piece of mind. Yes, it's expensive but worth the cost if you are able to sleep better at night knowing that you had some kind of buffer against the disease if you contract it. Yes, it hurts but the disease hurts far worse. You are correct that the travel medicine Docs will just consult a book or chart that is outdated and err on the side of caution. Afterall, better to be safe then sorry. My best resource ended up being the medical clinic on the military base in Kandahar. I dropped them an email and asked how many cases of rabies they'd seen in the past year. The answer was zero. This was a no-brainer given the fact I knew the clinic treated the guys who were out in the villages and wilds of Afghanistan fighting. Smallpox was a scarier thing not because of it's possible presence in the general population but the threat of it's being used as a form of warfare. That was a harder call but i'd been vaccinated as a child and, again, I figured if I were exposed, medical help would be there. You are embarking on an adventure where many things will happen that you aren't able to predict or plan for now. Your best resource is to find someone who is already there and pick their brains. If you can't, then do what your gut tells you is the right thing.
Joan
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