My students provided me with lots of advice about what vaccinations I should get before I travel to Senegal. Since I trust my students slightly more than most doctors, I headed off to the Indian River County Health Department for my travel immunizations with a list based on their research and advice:
1. Yellow Fever
3. Hepatitis A
5. A script for anti-malarial meds
If you've never experienced a County Healthy Department, I highly recommend a visit, it's a great place for people watching - think Walmart but with the added bonus of illness. Bring hand sanitizer, like a lot of hand sanitizer...also you might not want to breathe while waiting just as a precaution you know against getting sick? When you check in they give you a number on a piece of paper and then you watch the television screens for your number to be called, a bit like the DMV in NY if I recall. Then you go to registration, answer lots of questions, fill out paperwork, and then get sent back to the waiting room with your number. When you're number gets called you go to a locked door and show your number through a window to get buzzed in. You have officially left the cattle pens and entered the slaughterhouse, and by slaughterhouse I mean a place where they will jab you with lots of needles with very little warning!
The nurse I met with was wonderful and friendly. She informed me of my choices, for instance, did I want live oral typhoid which lasts for five years, or the two year injected vaccine? Huh, I'm not sure. Can I think about it? Then I find out there is a national shortage on Yellow Fever vaccine, so they don't have any in stock, and where I'm going in Africa is pretty low risk so even if they get some they wouldn't give it to me. Um, what?! If I really want the Yellow Fever vaccine I could call around and see if anyone else has it, but it is a live vaccine so make sure it isn't expired if I get it somewhere else - oh my god, I could be injected with expired vaccine?! Also, it turns out that the Hep A vaccine is a two shot series separated by 6 months, so I won't be fully immune by my trip - awesome, so I'll only drink some water while I'm there...at least I'm already vaccinated for Hep B, so I guess I can always drink blood instead. The nurse cannot believe I haven't received a meningococcal vaccine before, she literally asked me how I survived college without one - dear nurse, it wasn't meningitis that nearly killed me in college, trust me. Lastly, she indicated they'd write me a script for Malarone to prevent malaria, no options on that, that's all they prescribe even though there are three other options. I'll come back to that later. So we agree I'll take the injected typhoid, Hep A and Meningococcal immunizations. Getting the injected typhoid will permit me to get a Yellow Fever live vaccine if I can source some in the near future.
But before they will offer treatment of any kind, they send you BACK OUT to the cashier where you pay up front - I got lucky here since I have insurance they will bill me after they bill the insurance, otherwise it's cash only, my friend. Return to locked door - get buzzed in. I sat down, and that nurse jabbed me three times in a triangle so fast I never saw it coming. However, I felt it, it was like a rocket launcher being emptied into my upper arm, the swelling was immediate and dramatic. It's been 24 hours and my arm is still aching every time I lift it - the price of wanting a little adventure.
So let's recap: I still don't have Yellow Fever, my Hep A won't really be any good, I still haven't gotten a flu shot, and it turns out this script for Malarone is going to cost about $400 for the three week supply I need. Insurance doesn't cover prophylactics, but no worries, if I contract malaria, they'll cover the cost of my treatment for life. A little research indicates doxycycline is a highly effective anti-malarial medication and it costs much less, so I'm going to see if one of my awesome doctor friends might help a teacher out on this...as an added bonus, it protects against some other common infections found in developing countries.
Well I am just about 24 hours from arriving in DC for the Symposium on Global Education where I will meet my cohort traveling to Senegal with me. If they haven't received their immunizations yet, I'm totally willing to do a little back room centrifuging of a blood sample and share my developing anti-bodies - that's the way science teachers roll.