Travel: Parting Shots [The Washington Post]
by Hope Katz Gibbs
Travel / The Washington Post
September 7, 1997
TRAVEL IS A WAY OF LIFE for Jim Hanney, manager of international security for the U.S. Postal Inspection Service. About 20 times a year he heads to some of the world’s most exotic-and often most infection-ridden-places. So Hanney needs to stay on top of the immunizations needed to protect him from common international diseases-yellow fever, diphtheria, tetanus, pertussis, hepatitis A and B, typhoid fever, rabies and meningitis.
Without the immunizations, Hanney could be denied entry to some countries, placed in quarantine and forced to receive the vaccine at the border station.
Like most travelers, he opts to get the shots stateside. But like an increasing number of travelers, he’s turning not to his general practitioner but to a growing breed of travel medicine specialists. His preference is an Alexandria clinic called SmartTravel, founded in April by registered nurses Jane Johnson and Donna Shipley.
“In addition to giving the necessary vaccines, we give travelers all the information they need about water purification, food safety, insect repellent and other things that will keep them healthy when they are abroad,” says Johnson. Both she and her partner are veterans of hospital-based travel clinic operations.
Special travel clinics are becoming more common. “More people are traveling to developing countries,” says Dr. David Freedman of the International Society of Travel Medicine, whose group publishes a directory of more than 500 travel clinics where exotic vaccines are their specialty.
THE COST OF PREVENTION
A dose of prevention doesn’t come cheap. Most clinics charge about $25 to $45 for an initial consultation, and vaccines generally range from $8 to $80, though the rabies vaccine costs considerably more.
At Passport Health, which operates franchises at six Adventist HealthCare offices in the metro area, the-total bill for someone traveling to Africa and who previously had none of the required shots would be $335 for a one-hour consultation -plus six vaccines (hepatitis A, yellow fever, DPT, typhoid, meningitis, cholera). Travelers heading for Europe would only need a DPT shot for a total cost of less than $100. Travelers to Latin America need a typhoid, hepatitis A and DVF, costing less than $150.
Given the alternatives, of course, these represent a small price to pay.
“If you don’t have appropriately documented vaccines some people at border patrol may try to give you the vaccine or they’ll make you pay money for not getting the shot,” says Fran Lessans, president and founder of Passport Health. “I understand that border patrol guards don’t make a lot of money and are looking to pad their pockets. I know of more than one case at a border patrol station in Africa where guards pulled a traveler into a back room and threatened to give a yellow fever shot if the traveler didn’t pay $70.”
That traveler paid the money, and that was the right thing to do. “Do not get a vaccine at border patrol,” Lessans warns. “There is nothing labeled there. They don’t use disposable syringes. The sterility is questionable, and a person who gets a shot abroad can get AIDS, hepatitis B and other blood-borne diseases. Don’t fool with the border guards. Take care of business and get the required vaccines before you leave.”
But don’t wait until the day, before you leave to make an appointment. Clinics recommend patients come in six to eight weeks prior to departure because the vaccines usually need time to take effect. Some vaccines, such as those for Japanese encephalitis and rabies, also require additional boosters 14 days before departure.
IT’S YOUR NICKEL
Vaccines may be the first line of defense when it comes to preventing disease, but many insurance companies and health maintenance organizations don’t cover the cost of the shots.
“In most cases immunizations for travel are not covered because the decision to travel is voluntary, often times associated with leisure activity,” says Richard Coorsh, a spokesman for the Health Insurance Association of America. “It varies from plan to plan. We suggest travelers’ check with their employee benefits manger regarding benefits. Employers are the ones who choose what the health plans will cover.”
Travel clinics will print up bills for patients to submit to insurance companies. But because clinics are fee-for-service businesses, patients are required to pay at the end of the visit.
HOW TO CHOOSE A TRAVEL CLINIC
Look for a clinic with a high volume of patients. Because it’s difficult to keep up with disease conditions in every country, a clinic needs to commit the time to do travel medicine properly.
• Find out if the clinic is listed in a national or international travel clinic directory, and if it is licensed to administer the yellow fever vaccine. Although a clinic need not have met both these guidelines to administer all vaccines, they show the clinic is committed to protecting and understanding travel medicine.
• Ask about printed materials. A good clinic will provide education during the initial consultation and offer stacks of brochures and pamphlets covering various topics.
• Do some research of your own, using such tools as books and websites.