The following post discusses the pitfalls of vaccinating on the edge. Please don’t try this at home. Prior to any vaccination program, it’s really important to talk with your doctor, research, and decide what’s best for you. I know many people who avoid some of these vaccines like the plague, and others who welcome them with the fervor akin to protein pounding bodybuilders. As a fan of physical training, I fit more in the latter category, plus I’m not the best at planning… as you’ll see. Anyway!!
Today’s consultation fee was waived at the latest hospital in my string of clinical love affairs. Sitting with the nurse after spending an hour with the doctor discussing immunization, he came back out of his office to say the fee would be waived because researching, discussing, and explaining while practicing English was worth it. It was hard to keep from smiling.
At that moment, the nurse and I were in the middle of talking about courier shipping procedures for a dosage of rabies vaccine. You see, I need this dosage before leaving South Korea and only one facility in the city (and possibly the country) has the vaccination on hand, being that it’s quite rare to need in Korea. In order to get it before Tuesday, a courier will deliver it from that facility to Seoul National University Hospital. I’ll pick it up, walk over to the injections room where a nice lady will once again stab me in the arm.
how not to vaccinate prior to world travel
I have spent the last year planning this project around the world. It never occurred to me how important time was for vaccinations. So, with one month to go before leaving Japan, I jumped into a rigorous immunization plan. I made an appointment at Travel Clinic Shin-Yokohama in Yokohama, Japan and showed up with the barebones skeleton of a plan to travel around the world.
I sat down with the doctor while four nurses looked on. It seemed like overkill at first. I just couldn’t fathom why they were all there. The doctor and I laughed over the variety of epidemics I would need to safeguard against. We decided I would watch for signs in regards to Malaria, choosing only to take medication if I went on safari. Outside of this, The tally for the day included five injections and one cocktail of cholera I would need to drink before leaving the building. These five injections included Rabies (crazy dog disease), Japanese Encephalitis (brain swelling from hell), Menigococcal Polysaccharide (spinal cord extravaganza), Typhoid (Fevers of boiling intentions), and a flu (not of Spanish descent) shot to round things off.
That’s when I saw the reasoning behind four nurses. This was a rare moment. Five syringes needed to be prepared at a clinic used to providing one or two vaccinations at a time. I remember sitting on the cold hospital bed surrounded by five little plates. “Ha, This will be fun!” I exclaimed. The nurses, doctor and I laughed in unison before the skewering of my poor biceps and triceps began.
I left the clinic with sour arms and a warning. “If any nose bleed occurs in the next few days, immediately go to the hospital” The next few days saw intense flu-like chills mixed with nausea and constant attention to my happily dry nose.
A week later, I found myself in Dr. Sakabe’s office in Kyoto, Japan. My first doctor gave me explicit directions to receive a second dosage of Rabies, Japanese Encephalitis, Cholera, and the first dosage of Hepititis A. Dr. Sakabe rightfully explained to me that my Cholera vaccination wasn’t 100% helpful, so we skipped out on that one. He also explained that I needed to wait on Rabies and JE. We went ahead and jabbed my arm with Hepatitis A. Rui and I left soon after. Oh yes, I forgot to mention, Rui was also in need of a slew of vaccinations for the beginning of her expedition in Madagascar. Dr. Sakabe was quite enthused to be helping the two of us on such a crazy quest.
Visiting America, I sadly didn’t have the chance to get the next onslaught of vaccinations due to conflicting data about the various activated and inactivated parasites swimming in my system.
Yes, this is where it gets interesting. Most vaccinations are inactivated. This means you’re getting injected with a virus or bacteria that won’t actively attack you. Some though, are not. Vaccines for Polio, Yellow Fever, and some Japanese Encephalitis vaccines fit into the later variety. The confusion, in my case, was whether my JE vaccination was live or not. It turns out, it wasn’t. This is important because I have set and cancelled five Yellow Fever vaccination appointments so far.
And then I went to Korea
In Seoul, I visited SNUH to receive second Rabies, JE, and Hep. A vaccinations. I showed up on Friday, January 18th, roughly one month and a week after my first set of vaccinations. After a short consultation, the doctor expressed distress over my Hep. A and Rabies schedules, recommending only my second JE vaccination. After receiving another punch to the shoulder, I left disheartened and barely understanding what just happened.
I went home, called many different doctors and then I made another appointment at SNUH for the next day to find out exactly what just happened. That discussion (mentioned at the head of this post) lasted for one hour and here are the basic details for those interested in such things…
First, Hepatitis A. This badboy is usually administered twice with six months between injections. The purpose of this is to solidify and make permanent the immunization against it. My original doctor had put me on such an accelerated schedule not for permanent immunization, but to make sure I would be temporarily immunized for the duration of this specific project. Even that being the case, my immunization will start to lose it’s effectiveness at about month number 4. My Korean doctor and I decided I would get another Hep. A vaccination in April to boost my immunity for the following months. Then to solidify this vaccination, I will receive a third injection 6 months after the April injection. (A mouthful, I know)
Secondly, Rabies… The schedule I was on in Japan was a different practice than in Korea as well as the CDC’s recommended schedule for Rabies vaccination. According to my doctors in Japan, the two shot system would hold out for the duration of my project but may not provide semi-permanent immunization. The CDC’s recommended schedule includes 3 initial shots (Day 1, Day 7, and Day 28) with a boost after one year and then boosters every five years. I also learned that Dr. Sakabe in Japan had recommended I receive this second Rabies vaccination on January 8th. Receiving a second dosage after one month doesn’t help solidify the immunization, it simply restarts the process.
Basically, I’m starting from square 1 in regards to Rabies. So the doctor at SNUH and I decided to take an initial vaccination in Korea, followed by a second dosage in Hong Kong (Next Friday), and a third dosage in Beijing (3 weeks later).
And what about Yellow Fever?
Good question. After discussing with a few doctors, I’ve learned that it is the only activated vaccine I will have the joy of injecting myself with. That being the case, I could have received it at any time. So, I will be vaccinated on Tuesday of this next week.
So, do I regret having put myself through this whole thing?
Not in the least. It would have been better to have started months ago, but it wouldn’t have been nearly as much fun.