Yesterday I had an
appointment with the Travel Doctor to talk about vaccinations I will need while
I am in Botswana. I got Typhoid, Hep A, Meningococcal something or other and
one for mumps. I was supposed to get the mumps one when I was younger but like
a lot of girls my age I missed out on the booster for that. All I can say is that I am glad I have avoided
getting Mumps or Rubella for 21 years and I am now fully protected.
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Malaria-endemic countries in the
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I now have most of the
vaccinations that I need to get so that is good, the only one I need to look at
getting is yellow fever, but I am still looking into that.The next step for me is
that I need to start looking into preventative malaria medication and so far
this is proving to be somewhat of a difficult process. There are three options
that the Travel doctor presented to me; Atovaquone-proguanil (Malarone), Doxycycline or Mefloquine (Larium).
All three of these come with their own pros and cons and side effects.
Atovaquone-proguanil or Malarone is the super
expensive option ($6 a day for every day you are gone) so I spent a lot of time
on the phone to day trying to see if I can get it covered by insurance. I am waiting to hear back from both the UW
health plan and the one through my mom’s work.
Next is Doxycycline it is a less
expensive pill that you take once a day for the duration of your trip. It is still very effective it also has its string
of side effects as well, including upset stomach, head ache and increased
sensitivity to the sun. It is the last one that I am most concerned with because
my skin has decided to like to burn very easily in the last few years and I am
already nervous about being that much closer to the equator. My final option is Mefloquine (Larium) this
is similar in price to the Doxycycline but it is taken once a week instead of
once a day. This once comes with its own special little assortment of side effects;
these ones make me much more hesitant. The side effects of this one may include
anxiousness, depression and even hallucinations. The travel doctor told me that that is only
common in 8-10% of people but I think that statistic is a little too high for
my liking. I know a lot of times the drug companies put those warnings on to
cover their butts but after doing research I have found too many stories confirming
the scary side effects.
For now I am going to
wait to hear back from the insurance places to see what they are willing to
cover for me and until then I am going to keep doing more research. I think
that is the most important thing that we can do.
Check out this link
from the Centre of Disease Control, this link is specific to Malaria and there
is a good chart if you scroll down that compares the options.
My question to any
of you that are travelling in the fall is -- Have any of you started to look in
malaria medications or any other vaccines? Has anyone found anything
interesting that you want to share?
So how can the cost and side effects for the malaria meds be such a difference? What if you're not the percentile that experiences the side effects of one of the malaria meds how do you find that out? Also, through the link you gave, I found that with the western hemisphere malaria endemic map that the better healthcare countries seemed to not have the endemic or is it just a coincidence?
ReplyDeleteI am no expert on drugs and their side effects, but all drugs are different and have different side effects. The only way you can find out if you will have the side effects is to actually take the drugs. The travel doctor prescribed me a 4 week trial of the Larium (the one that can cause hallucinations and anxiety) but I am still hesitant to try that. I got a call from the insurance through my mom's work this morning saying that they had agreed to cover the expensive medication for 8 months instead of just one month. I know that there could still be side effects but I have heard less negative stories related to this one and the fact that it is going to be 90% covered makes me happier.
DeleteThat is also a good observation about the map. It mostly depends on the climate of the area and the habitats where the mosquitos that transmit it are present. According to Directors of Health Promotion and Education Malaria is most common in “Central and South America, sub-Saharan Africa, the Indian subcontinent, Southeast Asia, the Middle East, and Oceania”, most of which are located in the Southern Hemisphere. A more accurate map comparing hemisphere would look at northern vs. southern hemispheres.
But it is also important to look at the health care and accessibility to prevention and treatment in the different areas as well. My friend Kevin who is in Burkina Faso right now even though he is on malaria medicine still came down with malaria. He is better now but through his blog he talked about how the medicine he needed to get better cost only around ten Canadian dollars but that is often too much for many of the local people to afford. I would encourage you to check out Kevin’s blog for more insight: http://kevinmcgregorsblog.blogspot.ca/2012/03/le-paludisme.html
Then that all comes back to the cycle of poverty and the fact that if people are unable to work because they are sick, they then cannot make enough money to afford the medication to get better which just perpetuates the cycle. Harsh reality for a lot of the world.
You have the coolest life Kelsey! I heard all of those shots hurt a lot to get but it'll be worth it once youre there and having a blast!
ReplyDeleteThanks Emily, my right arm recovered after a few days so yes it is definitely worth it in the long run!
DeleteI had my appointment today! I only had to get one shot - the HepA/Typhoid combo, since I was up to date on the others. I also still need yellow fever, and I'm looking in to where I can get that, but it is mandatory for me to have it to enter the country.
ReplyDeleteThe doctor told me that she understands that all of the malaria medicines are covered under the student health plan, which really allowed me to choose which one I wanted by looking at their side effects, not costs. I would prefer to take a daily one, since I think it will be easier to remember than once a week. But, between Doxycycline and Malarone, I was really indifferent and didn't know which one to choose! I ended up choosing Doxycycline, since Malarone hasn't had much research done for use over a longer time frame, but the doctor said that if I change my mind I can see her to switch that.
It is a little scary to start preparing for all these drugs and precautions we will have to take. What's weird is that we go through all this trouble, when local people there are unable to do so. They drink local water, they get malaria and yellow fever and many other diseases that we are protected against. Such a stark difference.
I know it is really crazy to start getting all ready for this adventure we are going on. It makes me excited and nervous at the same time.
DeleteI decided to go with the Doxycycline for the same reason as you and as for yellow fever I do not need to get it but I am going to because I know that the girls in Botswana needed to travel to Malawi because they flew through Kenya because that was cheapest and I do not want to close any doors travel wise. I am going to go to Guelph to get that because that way the travel doctor said we do not have to pay the $50 fee again. just have to figure out when that's going to happen. I heard that needle hurts the most :S
The contrast is crazy when you think about it, especially when it comes to malaria. We are spending how many hundreds of dollars on the preventative medication and then if you do get malaria all we have to do is spend $10 and take a pill for a couple days in a row and you are better. It's a sad but true reality.