If we’re talking about injections then we’re talking about my second biggest fear. I’m aware it’s not logical, as I tell myself every time I walk into the surgery, but, after heights, injections are my least favourite things in the world. I can’t explain why but the thought of having liquid going under my skin (possibly in a painful way) and crawling through my body sends shivers over every inch of my skin.
*Disclaimer: I’m not a medical professional, all my information I got from my doctor or a website, and neither of those things are guaranteed to be flawless. Double and triple check everything you find online with a doctor and don’t always take your friends advice for granted either, what may have been the case when they travelled a few years ago, may not be now. The majority of the information I got is also from the NHS pertaining to people who use the NHS, especially in terms of prices, private health care may charge differently and other countries may have completely different rules.*
Injections are something you can’t start planning early enough though. As soon as you have an idea of where you are heading, you may as well check out what injections you need. You can find a pretty comprehensive idea here, I personally found. It gives you an overview of all the possible injections, all the ones I’m aware of anyway, if you’re going somewhere extremely obscure, it’s always worth checking with your doctor if there are more you don’t know about. Some injections are obligatory and some aren’t; which is great for budgeting and early planning. Compulsory for me heading to India are Hepatitis A and B, Typhoid and Tetanus, Polio and Diphtheria. This was a good chance for me to see what I was already inoculated against, since I couldn’t remember my last injection apart from Tetanus. An aside here, if you’re not at your registered surgery, they probably can’t give you your records, and they can’t tell you by phone either (more fool those of us that live abroad) so it’s very worth popping into the surgery you’ve registered with.
If you’re living in the UK then you’re probably clear for Tetanus, Dip. and Polio, but not necessarily, I believe the booster time is once every ten years, so you should double check. That’s a free one from the NHS though and you don’t even notice it’s come anywhere near your skin – this from the girl who almost had to be tied down the last time that injection was pointed at me, since then I’ve learnt to tell doctors that I’m going to look the other way and hum loudly, and I don’t make a fuss anymore. Typhoid should also be free from most surgeries, it was free at every surgery I asked, and if I got the first Hep A shot with it, then that was free too. Typhoid is another pain free affair.
Hepatitis A and B vary however, you should check with the surgery you’re registered at how much they cost, since I was registered miles from home and living in another country for a year this is where my problems arose. They cost different amounts at different surgeries but with careful planning, and cajoling of the nurses, I’ve managed to persuade them to split my injections over three different surgeries. Hepatitis A (2 shots) cost me nothing, and B would have cost me £30 per injection (3 shots) but the second shot had to be done in Germany – don’t even ask how much that cost!
The biggest problem I’ve faced is organisation, aided wholly by the fact I’m out of the country, registered at my university, but staying at my parents’ when I’m home; this is why I say you can’t plan early enough. I would get all your injection dates down in your calendar about 6 months before travel if you can, although if you start as early as a year in advance you can have all your jabs complete before you go. Organisation was a big problem in that I was told a different schedule for injections by every single person I asked, which is immensely helpful, and they’re all meant to be getting their information from the same source. However, I eventually managed to get, one Hep A in January and one 6 months later, and three Hep B’s, all exactly a month after one another.
The main ‘non-compulsory’ injection for me is against rabies and it’s also the most expensive I have encountered. I’ll admit, I’m still deciding. It’s three jabs which cost, usually, £50 each and this one is, in all fairness, supposed to hurt a little bit more but not as much as having rabies. Yellow fever is another that you’re supposed to be able to feel, but this time possibly afterwards, since it is a live injection (yep, the idea makes me want to vomit, but it’s injected for a reason). I didn’t have to have this, but it’s worth checking thoroughly even if the country you’re going to doesn’t have it. If a country you touch down in on the way has it, you will (in my experience) need an injection just for that, in order to secure entry into your final destination country. I’ve also heard you need a certificate sometimes to say that you haven’t been anywhere near any kind of yellow fever, that you are ‘clear’, but I’m still looking into what this is and how I get it; if anyone has any ideas, let me know.
An injection I decided against, based on advice from an official website, was Japanese encephalitis. The advice seemed to say that the injection can have some pretty grim side effects; again I assume they’re still nothing on the disease itself, but the likelihood of getting it was also down as low risk. The site and subsequent advice from doctors lead me to decide that the risk wasn’t worth getting the injection. It’s something that is definitely on the list to be discussed with your doctors though, in case you are heading to an area where the risk is far more real. However unlikely this is though, I’m going to try and prevent it in the same way I’m trying to prevent everything else that is mosquito-borne and nasty; cover up, take mosquito nets, wear repellent, and stay away from swamps and stagnant water.
Basic Injection Facts:
Tetanus, Polio, Diphtheria: All come in one jab (these days), free. Booster jabs are needed I’m just not sure when.
Typhoid: 1 jab, in my experience this has been free but ask about combining it with various hepatitis combinations, you may get some of those for free too. I’ve been told this is valid for three years, so don’t forget to check you’re clear even if you’ve already had it.
Hep A and B: Can be combined or separate. Hep A is 2 shots, Hep B is 3 shots. There are various time scales for these, I was told a different thing by every single person I asked, but just settle a time frame that works for you and your doctor, and that works out cheapest for you too. I don’t know how long Hep A keeps you covered for but I have just found a scrawled note from my GP saying that Hep B is valid for life – do double check this with yours though.
Rabies: 3 shots, costs everywhere, usually somewhere around £150 for all 3 jabs on the NHS. Unsure of timescale, although I do know that with emergency travel anything is possible, I have plenty of friends who’ve had everything in one day – they can do it if push comes to shove, it’s just not as friendly on your body.
Yellow Fever: I believe this is the only live injection of the lot, although I’m not entirely sure. I didn’t have to have this so I don’t know how many jabs, but I do know that it can be hard to get hold of, there are special centres for it and it won’t just be carried as standard at your GP’s. I would ask about this well in advance if you need it.
So far in my experience can I say there’s really anything to fear from these injections? As a true member of Injection-Phobes Anonymous (the IPA that’s not the International Phonetic Alphabet) I put my hand on my heart and say no. I have barely felt all the injections I’ve had to far. My tactics, if you happen to feel the same way, are to look away, to try and put my mind somewhere else, which is really difficult, and to ask the doctor not to talk to me about what they’re doing. Most doctors are really good at this, however bad you are, they have probably had patients who cope worse.
My main tips are to start early, as much as a year in advance is great for budgeting and organisation. Get those dates fixed with your doctor in your diary, whatever time scale you are given. Then to put aside money for them; definitely do not forget to factor injections into your budget if you’re going somewhere far-flung, and don’t scrimp if you do find out you need multiple inoculations – it’s all got to be cheaper than foreign hospital bills, right? And finally, don’t be scared, this is a small step on the way to your big trip, be excited! I am glad I’ve had a large chunk of possible vaccinations done in one go, although this has pushed the budget of my India visit up somewhat, it could hopefully push budgets of future trips down and reduce stress, because after you’re covered once you only need to check what boosters you require.