My “pre-travel” to-do list typically includes nail appointments, packing lists, and last-minute shopping for travel essentials. Before my recent trip to Peru, I added a new activity to my to-do list; Visiting a travel clinic!
In this blog, I’ll share my experience and some helpful tips for deciding if visitng the travel clinic is necessary for your upcoming travels.
Why is it important to visit a travel clinic? When do I need to see one?
Travel clinics specialize in prescribing medications and vaccinations for visiting countries with viruses or environmental conditions that differ from a traveler’s home country. Despite frequently being called travel doctors, travel clinics will often employ pharmacists to visit patients, discuss preventative care options, and prescribe or administer the proper medications needed for travel. Unlike primary care physicians, travel clinics readily offer vaccines for common “live” viruses like Yellow Fever.
Before traveling to foreign countries, it is helpful to visit the CDC’s Travel portal to get a sense of what medications and vaccinations are recommended for your upcoming trip. Some countries require that foreign travelers provide proof of vaccination against some diseases before issuing visas. In this case, visiting a travel doctor will be necessary.
Where do you find a travel doctor? What is the appointment like?
I started my travel doctor inquiry with my primary care physician. In some cases, primary care physician offices may offer the same services as a travel doctor. In my case where a Yellow Fever vaccination was necessary, my physician recommended a few different clinics to research and compare. I opted to visit the Cedars Saini Travel Health clinic since my primary doctor is part of Cedar’s network.
I scheduled my appointment over the phone for a visit a month and a half before my planned travel. Before my visit, I was instructed to fill out a health questionnaire that included my vaccination record for common vaccines (Polio, Hep A, TDAP, Flu, etc.) as well as information about my travel like my itinerary, elevations for our accommodations, and planned water or animal-related activities. I was notified before the appointment to clear my calendar for two hours at the office due to planned monitoring after vaccinations.
On my appointment day, I checked in at the in-person clinic and had my vitals taken. Then the pharmacist met with me to discuss my medical history, current medications, and vaccination history. From there, we discussed my travel itinerary, the activities I planned to participate in, and the potential viruses and environmental threats I would face. We also discussed my main travel concerns (Altitude sickness, Yellow Fever, and Malaria). The pharmacist provided recommendations based on the information I shared and discussed the side effects of the vaccinations and medications he recommended. He also provided a cost breakdown for the vaccinations. All of the suggested medications and vaccinations were completely optional. I elected to receive two vaccinations, received the shots, and stayed in the office for around 20 minutes to monitor for side effects before I was released to go home. Upon exit, I received a packet of information including details about the viruses I could encounter in Peru and the vaccinations I received. A detailed medication list along with specific instructions was also provided.
What vaccinations are needed for Peru? And what are the side effects?
My doctor recommended I receive vaccinations for Typhoid Fever and Yellow Fever before traveling to Peru. Both vaccinations were recommended due to my plans to travel to the Amazon Rainforest while staying in a rustic jungle lodge. I completed both vaccinations in the office and experienced minor pain at the injection site upon receipt. Later that evening, I developed general arm soreness similar to a flu shot. Overnight, I noticed a bit of sinus congestion. I woke up the next day feeling a bit lethargic with continued arm pain. I started feeling better about 36 hours after the vaccination.
What prescriptions are needed for Peru?
Based on my itinerary, I received prescriptions for:
acetaZOLAMIDE - Generic for Diamox, an altitude sickness medication
atovaquone-proguaniL – Generic for Malarone, an anti-Malaria medication
azithromycin – Generic for Zithromax, an anti-diarrheal medication
Doxycycline Hyclate – Generic for Vibramycin, a drug used to prevent bacterial infection as a result of contact with fresh water in the Peruvian Amazon
What was your experience taking medications prescribed for travel?
Prepare for a little TMI... I wish I would’ve had the opportunity to hear about other’s experiences with these medications before taking them myself. My reactions to the medications prescribed were a mixed bag.
I hardly registered any differences in my body while taking Malarone and Doxycycline. The Diamox, on the other hand, was a different story.
After taking my first dose of Diamox about 24 hours before going to elevation, I felt light-headed with full-body sweats and numbness in my fingers and toes. The light-headedness escalated and I ended up passing out in a local market in Lima. I probably should have discontinued the use of the medication at this point but continued taking the medication as prescribed. I felt nauseous in the mornings and suffered from more painful than usual menstrual cramps and bleeding. After three doses over 36 hours, I began to have some rumbles in my tummy which ultimately led me to spend an entire night in the bathroom in the Sacred Valley near Cusco (Again, sorry, TMI). At this point, I halved my dose of Diamox and took my Zithromax. The Zithromax worked wonderfully (thank goodness).
Due to the halved dose of Diamox, I did experience an altitude headache while in Cusco at 11,800 feet, which improved after taking ibuprofen. I also experienced shortness of breath at the Sacred Valley, Machu Picchu, and Cusco, even when taking the full dose of Diamox.
Hindsight 20/20, I probably wouldn’t take Diamox again. That said, my partner didn’t have any issues with the medication or altitude. Others in our tour group taking the medication reported similar issues with tingling extremities but did not suffer the same more extreme side effects that I experienced.
How much does going to the travel doctor cost?
Because seeing a doctor for travel is considered an elective healthcare decision, most costs come out of pocket. I paid a $75 consultation fee, around $170 for the Typhoid vaccination, and around $250 for the Yellow Fever vaccination. The vaccinations were not covered by my health insurance. I have great pharmaceutical coverage, so the prescriptions only cost around $8. A few weeks after my visit, I was hit with another $120 bill for vaccine administration. This fee wasn’t disclosed during my appointment and was slightly frustrating to receive. All in, my travel clinic appointment cost around $625.
Is going to the travel clinic worth it?
I felt going to the travel clinic was worth my time for peace of mind while traveling. While I suffered from some heightened side effects from the Diamox, I believe the other medications improved my overall travel experience. I also felt the Yellow Fever vaccination reduced my anxiety around mosquito exposure while sleeping in our rustic jungle lodge accommodations. As a bonus, now that I’ve completed the vaccinations, I have a window of opportunity to travel to even more interesting and remote locations without needing another shot (Kenya in 2025, anyone?).
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