Mar 16, 2011

How To Cut The Cost of Travel Vaccinations

In preparing for this trip, travel vaccinations played a major role.   Upon researching this further, we soon realised that there were two big issues to deal with:  1) the accessibility of good advice and 2) the cost of the vaccinations for a family of 4.  

While trolling the travel forums, we noticed that specialist ‘Travel Clinics’ were the popular route.  However, there was usually a hefty premium to pay (priced per person) to receive advice from these ‘specialists’, not to mention the accessibility to a good clinic near us. 

The closest Travel Clinic seemed to be  1hr drive from where we live.  We did realise that we would require the expertise of a specialist particularly to advise us on the issues of rabies, cholera and anti-malarial medications although the local GP/family doctor was able to advise us on the rest such as Hep A, Hep B, Typhoid, tetanus, and polio.  

We were just about to reluctantly book our appointment with the semi- local Travel Clinic when by sheer luck, we came across information on the internet about travel clinics in Bangkok.  

Specifically there are 2 very reputable ones, each with their own informative webpage.  We decided on The Thai Travel Clinic, which is run by the Hospital for Tropical Diseases at the Mahidol University, Faculty of Tropical Medicine, in Bangkok.  On their website was a price list of vaccinations and email contacts.  As we were scheduled to arrive in Bangkok 1 month after we started our trip, we decided that we would seek advice and additional vaccinations from them.

So within hours of arriving in Bangkok we hopped on the LRT and headed straight for the clinic, which is very centrally located near Victory Monument.  The doctors and nurses there were very friendly, thorough, informed and professional.  We first had a consultation and a discussion on our itinerary, and then we were prescribed our vaccination list.  The doctor had a few points of view which were a surprise to us.  

Firstly, he insisted on the Japanese Encephalitis shot, which he said that all Thai people receive in childhood. 

Secondly, he felt that the rabies pre-exposure course would be prudent given the areas that we were travelling to as well as proposed length of stay would increase our probability to being bitten by a dog.  

Thirdly, he stated that the use of anti-malarials in SEA was unnecessary as a) the actual number of cases that are reported in a year in Thailand and SEA are only approximately 3-4, and b) the anti-malarials are not effective against the malaria infected mosquito in SEA.  He did advise that we carried a box of Malerone for ‘just-in-case’ for our travels in India.  

At the end of the day, we valued his advice as he spoke first hand from daily experience as he’s actually living and breathing here in the very region as opposed to attending yearly workshops or receiving newsletters from abroad on the subject!

With some of the student nurses.

As a result, we are basing our Thailand itinerary around our rabies vaccination schedule.  It’s a course of 3 shots, given on day 0, day 7 and day 28.  So in between our shots, we are travelling to other parts of Thailand, and then returning to BKK for the shot.  So far this strategy is working out well, and financially it’s definitely worth the effort.

It's all smiles when it's Dad's turn....
..not so funny when the table's tuned!

We were explained many of these so–called ‘travel vaccinations’ are actually common shots here in Thailand/SEA therefore they can be purchased from the same drug suppliers as the developed countries buy from, but at better prices because they buy in larger quantities.  In some countries such as Australia, Canada and the USA, travel vaccinations are a ‘niche market’. Rabies shots in particular are VERY expensive (Bryan from Rider By My Side told us it’s $700 per person for the 3 shots in the USA, and Amy from  www.worldschooladventures.com said that a course was $600 pp in Canada!), but here in Thailand, they are approximately $12 per shot. Ditto for the Japanese Encephalitis shot—I’ve heard that the cost of it is right up there with the rabies in Canada and Australia.  At the Thai Travel Clinic, it was about $14.  Our Twinrix (Hep A & Hep B combo shot), of which Jim and I require 3 of, was half the price as in Australia--$35 per shot vs $70, so between the both of us, that’s quite a bit of savings.  

We’re also saving a lot of money on the ‘specialist fees’.  In Melbourne, it would have cost at least $125 per traveller just to have a consultation with a ‘travel doctor’, excluding the cost of the vaccinations, and there wasn’t a family rate either!  At the Thai Travel Clinic, the initial consult fee was $5.50 USD (160 THB) each for Jim and I, and the girls were charged $1.50 (40 THB).  At this point, it looks like we’ll be saving at close to $1,000 USD (probably  more) on our travel vaccinations by the time they are all done.  

If Bangkok fits in with your travel itinerary and if you are requiring any additional vaccinations or boosters, we would highly recommend you pay these people a visit.  The clinic is very centrally located although it can be tricky to locate at first as most hospital complexes can be.  Check out their website www.thaitravelclinic.com or that of the other one run by the Red Cross http://www.saovabha.com/en/clinictravel.asp.  It’ll certainly be an experience that you and your pocket book will not regret! 

Do you have any experiences with overseas medical services which you’d like to share?  Know of any other overseas travel medicine clinics that you can recommend?  Please feel free to share!

26 comments:

  1. Thank you for writing this! I think this will definitely be the route we take, the money we save will allow us to travel for a few months!

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  2. Well, that's something new, planning your vacation around vaccinations! Thanks for the info. Also the Thai Red Cross on I think Rama I is a good place to get shots too.

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  3. Jess, can't believe you took photos of your family having needles! Poor Maddy.

    Great advice! I'd never have thought about having immunisations overseas. We did know that Thai chemists are way cheaper than Aussie chemists - cold and flu medicine, buscopan, general first aid stuff etc. We'd top up our first aid kit whenever we went to Thailand.

    We'd also buy fake ISIC cards in Khao San Rd. It was less than AUD$10 to get a student card, valid for a year, and you can use it here at the cinema, gyms, various sporting event tickets.

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  4. Gosh I didn't realise travel jabs were so expensive in Oz and Canada (the US I can well believe!) In the UK prices are MUCH lower and advice is free and very up to date. Our Hep A jabs were free on the NHS as was Typhoid. Hep B and rabies were pricey but nowhere near that much - maybe £90 pp for the course. Unfortunatley we didn't get to BKK until month 4/12 and had been to India and Cambodia etc already! Great idea though, and great blog btw!
    Best wishes, Four Go RTW

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  5. We had the exact same experience planning our trip with our little ones, ages 1 and 3, to Nepal and India from the US. Luckily, I found great info on Lonely Planet about the economical cost of vaccines in Bangkok as well--and planned our whole trip around it. I figure it will save our family somewhere around $3000 (rabies for each member is $660x4, +all other vaccines +consulting fees). ..plus, we're going to the beach! We'll be staying at Shanti Lodge in Bangkok, and then off to ko phanghan!

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  6. Planning our trip around our jabs wasn't a big deal actually as BKK is so central. We stayed in the Siam Square area and found that it was really central and easy to reach the clinic, and having a place to stay for your subsequent stays for jabs made it even easier. The money we saved (over $1000) was well worth it and the fact that the experience was so 'pleasant' was really terrific! Those nurses were the BEST and made the shots near painless if you can believe!

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  7. Just out of curiousity-did you find it necessary to make an appt at the clinic or did you just show up with all four of you. Looking forward to it!

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  8. We initially did make an appointment which we ended up being late for anyway, but they didn't seem too concerned. They say that no appointment is necessary and on every occasion that we were there, we did not have to wait to be seen at all (it's the 'process' that takes time though!). each time we returned for a follow up shot, we consulted with the doc again. make sure you bring your vaccination records and your yellow books if you have, or they will issue you with them if not. Anna, I can't believe how much the rabies shots would be in your country! on the flip side, i met some people from spain who say that anyone can get any required travel injections, regardless of citizenship, for 15Euro ALL UP!! whatever you need!!! you going to europe first??!!

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  9. Ha! No Europe trip first, Bangkok or bust! Rabies truly does cost $220 per shot in all of California, where we live. Thank you for your information and your website--it's great fun to read!

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  10. Thanks for this info. We are Canadians and it is sooo expensive. Do you have any more info about Spain vaccinations? Every time I google vaccines and Spain all I can find is the info that I don't NEED vaccines to go there... having trouble finding info on clinics for travel vaccinations. Any ideas? Otherwise it's off to Bangkok before India:-B

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    1. Hi
      thanks for leaving some comment love :)

      make contact with the folks at Rider By My Side http://www.riderbymyside.com/ they lived in Spain for a while and she was the one who gave me the info. If you run into any difficulty, inbox me directly.

      Good luck!
      Jess

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  11. So how do you feel after all those vaccines? Did you research long term health problems from these vaccinations? How many people traveling to this area contract rabies. I must admit that I am shocked and so very curious.

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    1. To vaccinate or not is a highly personal and controversial topic. The vaccines which we received were not excessive nor out of the ordinary in light of the territory which we traveled to. we all felt fine after our shots.

      i'm also not sure if you have traveled to Asia or researched this, but rabies is a HUGE problem there, particularly in Bali and India. I'm not sure of the statistical details as to the number of people who actually contract rabies, but rabies is a fatal disease if not treated, so most people don't wait to see if they've got it before they commence treatment. Given that children are less cautious and rank lower on the food chain than adults in the eyes of animals, we considered the probablility of our young children to be scratched by a stray dog or monkey to be likely and if unvaccinated, you'd have to be treated immediately with the rabies vaccine, which can be rare to obtain outside of major cities and hospitals. I personally know of 3 people in the past year who traveled to Thailand, Malaysia and Bali and 2 were unexpectedly bitten by a stray dog (separate incidents) and the other 2 were scratched by a monkey respectively, and yet all were adults but luckily they were in a 'major centre' and could get treatment immediately (the one in Bali was a local too). if our children were scratched or bitten, we wouldn't have wanted to add the stress of obtaining immediate treatment to the situation, but that's just us. being parents has influenced our attitudes towards vaccinations greatly.

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    2. That's a really interesting point about the rabies vaccine and children. My husband and I never got it because of the inconvenience of the series of three shots. We also have never had any run ins with undesirable animals because we avoid them. However, I'll be thinking carefully about if that applies to our kids!

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    3. Sometimes despite how carefully you try to avoid 'any run-ins with undesirable animals', they can become unpredictable and attack you. I know of 2 ppl that this happened to, one while in Phuket while trying to cross the street, and another got scratched by a monkey who attacked them. Both had to go seek the rabies jabs immediately--luckily they were both in areas where the vaccine was readily available as they were in touristy areas.

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  12. Thanks for all this info - we are coming to live in Asia next year and although we are stopping through Thailand on the way, probably not long enough to get the shots (unless I can find a similar clinic in Chiang Mai). It is a great idea though!

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  13. Hi - I find this post really reassuring! We are a family of 5 setting off travelling to Nepal, India, Sri Lanka, Thailand and then who knows after that. We live in the UK and it would have cost us £1680 to get all our jabs here. We are saving about £1000 by having the first 2 rabies shots here, and the final one when we arrive in Nepal, plus having Japanese Enc. single shot on arrival in Nepal. We are going to a clinic with a good reputation called CIWEC in Kathmandu - no appointment needed, it's walk in from 9-4.30 daily. I felt it was a good compromise to spend a bit more money to get the first 2 shots in the UK so that we can set off trekking straight away without having to work around being back in Kathmandu by day 28. Interestingly, the UK advice was to give the rabies jabs to the kids but not to us as adults, but having researched this myself I think we should all have the shots as the immune globulin you need if you are not pre-vaccinated is hard to get hold of in India, and I just don't want to take the risk. Thanks for sharing.

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    1. Hi Janet,
      Thanks for your comment and just as you said, we too got our Rabies jab on the advice of our travel med dr who was concerned about the immediate availability of the rabies vaccine in India if you were not pre-vaccinated. At least with the vaccination, you buy yourself some time to get the additional jabs if you were bitten/scratched as without it, you'd have to find the immune globulin within 24hrs. have fun in nepal!

      Jess

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    2. Wonderful blog, and I must say that the information presented is detailed & quite accurate.
      I am a travel doctor from India, and I can say that the prices of vaccines & consultations in India are quite similar to Thailand, though again you may have some difficulty in finding a 'travel clinic'
      We have started with 3 branches of TravelSafe Clinic, India at Delhi, mumbai & chandigarh, and hope to add some more soon.
      I would just like to add that Rabies vaccine is quite easily available in almost all large towns & cities, and we have the latest cell culture vaccine. The cost is very reasonable too, approximately INR 500 (USD 10 or less) per dose.
      JE vaccine has been recently introduced (called JEEV, similar to IXIARO), and costs around INR 1500 (USD 30). It is a bit mroe difficult to find in India, but larger centers can arrange it within a day or two. We, being the largest travel clinic in the country do stock doses of all travel related vaccines at all times, and are happy to accept walk-ins. We are also members of IAMAT, ISTM and many other travel health organizations.
      Finally, you are quite correct, that finding RIG maybe difficult in most smaller towns in India, and given that there is a very large population of stray dogs, and India has the largest number of Rabies deaths in the world, it is definitely prudent to take PrEP for Rabies. Getting it in India can save a lot of money, but you need to be around a larger town/ city for at least 3 weeks to complete the same, and you would remain at risk till the completion of the course,
      Warm regards
      Dr Gaurav Gupta, MD
      TravelSafe Clinic, India

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    3. Thank you for your comment Dr Gupta and for bringing more awareness to the issue of rabies in India. The Rabies vaccination is a contentious one among travelers--"to get or not to get??"

      We actually competed our Havrix course while in India. Our children got the Havrix Jr while we were in Puducherry realtively simply at a private clinic in town. It took a bit of convincing in order to bypass a pre-examination and to just get the prescription in order to obtain it (thus saving us the examination fee) but all done within a couple of hours. My husband and I finished our course while in Cochin at a private hospital there. However, in our case, we were surprised at how hard it was to find the Twinrix vaccine in a centre as large as Cochin. There was only 1 box available so my husband had to get the separate Hep A and B shots instead. Even then, calls were made to pharmacies and suppliers all over Cochin!

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  14. I was amazed at the potential costs of vaccinations for a family of 5 but decided to go to a bulk billing clinic for the consults thus saving there. The vaccines we can claim some if the costs through our private health fund. Rabies was only advised as a precautionary vaccine if we would be working with animals whilst away. All this just for Bali!

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  15. Hi thanks for all your help over the past 6 months leading on from this article. We arrived in Bankok on Tuesday evening & had our injections done at The Travel Clinic. Brilliant place! Thanks again for this post.

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    1. Hi guys!
      I am so glad that it worked out for you there and that we did not lead you astray ;)
      Enjoy your trip!

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