Getting Vaccinated

This is exactly the wrong spot to look for medical advice. What's required for entry into another country, or re-entry into the US from someplace, is probably vastly different from what is prudent - - depending on exactly where you're going, what you're going to be doing while you're there, and your own medical history. I'm in and out of western europe several times a year. Eastern europe, Turkey, and Morocco less often (every couple of years, maybe). In these spots I've never been asked for my shot card, or been quizzed upon returning. I also go a bunch of other places, some of which it would be really goofey to go to without vaccinations. Strangely enough, and depending on the source, some of these are also recommend for places you're probably going (Hep A and B come to mind). I get my medical advice from my quack, a guy who knows my history, what I'm likely to do, and what detours I'm likely to make. Here's a question: If you think your appendix is acting silly, are you going to give your buddy a rusty knife, a gob of guaze, a handfull of clothes pins, and a stinking web page?

It sounds to me, though, like he's already asked his doctor for advice, and was told to go elsewhere. I would. I'd find another doctor; one who was willing to take care of me.

Melody may not realize that many family doctors has gotten out of the vaccination business because of liability issues. I suspect that is what Matt's doctor is telling him. We now go to a public health clinic run by the county that specialized in vaccinations. We go with the recommendations from CDC which the clinic has and, of course, it is not covered by our insurance. You can get on the CDC web site for their recommendations.

Matt, I won't offer specific medical advice, but rather will provide some information on how I handle this issue. I believe it's a good idea to keep my vaccinations up-to-date, especially when travelling for things like tetanus, Hep. A & B, etc. If I'm going to be heading somewhere a bit unusual, I try to get specific vaccinations for diseases I might encounter there. Previously in this area, vaccinations were provided at Public Health clinics, sometimes for a fee (depending on which vaccination it was). However, this function has now been "privatized" and a chain of Travel Medicine Clinics is now providing these. These operate in a similar fashion to the one you described, charging a one-time "consulting fee" and varying charges for each vaccination. As I recall, the consulting fee was about $50. I'm a bit curious on why the Travel Medicine Clinic in your area will charge a consulting fee, but your Doctor provides the vaccinations? The entire process here takes place at the Travel Clinic, and my family Doctor may not even know that I've been there. I use the services of IAMAT when I travel, and usually check their recommendations in terms of which vaccinations may be required for a certain area. To answer your question on whether this is "the correct route to take", IMHO it's a good idea to get appropriate vaccinations, regardless of whether you obtain these from a Travel Clinic or your family Physician. As I'm not thoroughly familiar with the medical treatment options in your area, I'd rely on the advice of the Doctor. Good luck!

Just to clarify, I'm not seeking medical advice on what specific shots I should be taking or anything like that. I'm just trying to see if other people have had the experience of being referred to a secondary source (like a travel clinic) who can "medically" determine what shots I should have administered by my doctor. When I called the number of the clinic that was provided by my doctor's office I felt as if I was being up-sold like a weird scam or a used car salesman. That, and the fact that I have never had to go through this process (of what my doctor's office has described) before. Didn't know if the process has changed since I last traveled OR based upon my length of stay in numerous countries. It all sounded odd to me so just seeing if others had done it this way through their personal experience. Thank you all for your input, I have enjoyed this dialogue....keep it coming! Thanks!
Matt

I've never heard of a "travel clinic", but often infectious disease specialists will get referrals asking for vaccination or prophylaxis recommendations for certain destinations. For practical purposes, in most of Europe, the vaccine recommendations are the same as for the general population of the US, with the exception of those who expect extensive contact with livestock. I'm not positive about Turkey as a whole, but there are no specific recommendations for the Istanbul area. I don't know about Morocco.

Been travelling for many years. No one has ever suggested vaccinations for Europe. They were recommended for certain trips to Africa, and for those I had to go to a specialist clinic (makes sense). Also depends on what countries/areas you visit in Africa

Travel Clinics exist in big cities. This place is popular in NYC for those that need the more "exotic" shots:
travelclinicnyc.com

Matt, The vaccinations you'll require will vary depending on which specific countries you'll be visiting in Europe. A Travel Medicine Clinic will be able to offer recommendations (which of course you can follow or ignore). There's a LOT of information on the CDC website, so you could use that to get some idea on what vaccinations you might need. While western Europe is very safe for travel, some diseases like Tickborne Encephalitis can be a concern in some areas, especially the warmer ones. For Backpackers and those travelling in some "less developed" countries, taking something like Dukoral is something I'd consider (protects against Cholera and Traveller's Diarrhea). Packing along some Immodium AD could be considered also. If you're only going to western Europe, that's probably not required. The method I've been using lately is to visit the Travel Medicine Clinic and get recommendations specific to the areas I'll be visiting, and then make an "informed decision" on which of their recommendations I feel will be necessary. Good luck!

Matt, I have used a travel clinic (similar to what Tom stated, the clinic that I went to was run out of a practice of Infectious Disease specialists). I too had to pay a consulting fee, but I considered that similar to an "out of network" doctor visit. I went to the clinic before a trip to Africa. I found it quite useful. They reviewed my travel plans (e.g. what regions was I visiting, what type of accommodations, etc.). They made recommendations for the types of vaccinations that I needed and explained why they recommended. They also provided the vaccinations. They provided the international certificate that listed the immunization record. They discussed the various anti-malarials and side-effects and gave me a prescription for the one I chose. They also gave me a prescription to fill for Cipro (just in case) and provided instructions for the situations under which I should take it. I'm not sure why you would need to return to your own doctor for the shots; the travel clinic should be able to take care of all of it. Regardless, I can't say if there is anything special that you need for the areas to which you are traveling; I just wanted to let you know that I did feel that I got a good service with my consulting fee and that a referral to a travel clinic is not unusual. The travel clinic was definitely more knowledgeable on travel vaccines.

Hands up anyone who has ever had any "shots" before travelling to anywhere in Europe, including Turkey.

I ain't falling for Norma's question. She'll wait a while and then want to know what about after. Then she'll want to know about pills as well as shots. Some things are best just left alone.

shots for europe?!? you've got to be joking! are you afraid of malaria, or what?

Melody did not realize that family doctors are getting out of giving vaccinations, citing liability issues. Frank, if your doctor will not give basic immunizations, you are getting substandard care and need to find another doctor. I'm sorry, but his/her argument of liability issues is bogus. If it is an issue of cost of the vaccine, and the health clinic can provide it to you for free or cheaper, your doctor may be suggesting the clinic for that reason; mine did when my kids were little and DPTs tripled in price over the course of a year. I live in a state where it is hard to find an OB/GYN because malpractice insurance is too high, so I do understand the liability thing. But the doctors who have not left the state, family doctors and specialists alike, do what is needed for the patient. My point was that Matt's doctor might not be giving the care he needs, and he should find another. I spoke with my doc this morning about this issue, and was told that they have basic vaccines; DPT, tetanus HiB, HepB, etc. But, if I needed something exotic, like typhoid, or smallpox, for a trip, they would have to refer me to a travel clinic. There is no way for them to keep those vaccines viable at the frequency at which they are needed in their office. Even that, though, they would closely monitor. BTW, you can speak to me in the first person.