One interesting thing about travel clinics is that they don't make much of an effort to give you an idea of the risks you really face. There's not much talk about the things that kill travellers in any numbers (traffic accidents and drowning), or about the diseases (like dengue and hepatitis C) that aren't preventable by vaccines or drugs. And there's no mention of the probability of actually getting those that are: Just lists of the diseases you can expect to pick up in the countries you're visiting.
The nurse suggested I consider getting the Japanese encephalitis vaccine. The odds of a tourist getting Japanese encephalitis are roughly 1 in a grillion -- giving an impressive absolute risk reduction of maybe 0.9 in a grillion. Against which you have to set the risk of side effects and the $100, or whatever it is.
On the other hand, she wasn't keen on a new vaccine against traveller's diarrhea. It works only against e. coli, which causes only about half of cases, and it's only 50% effective against that. And the protection lasts for only 3 months. But half or more of all travellers to India get sick. So the vaccine might cut your risk from 50% to 37.5%. Unlike Japanese encephalitis, these illnesses don't cause your brain to fall out in clumps, but they're so common that the $80 vaccine actually starts to seem worthwhile. (It's also raspberry flavoured, and is surprisingly refreshing, as oral vaccines go.)
Even if you dig up the information you need to really think about these things, the decisions are extremely strange ones. For a tourist spending 3 weeks in northern India in October, the odds of getting malaria might be, say, 1 in 5000. What's it worth to lengthen them to 1 in 25,000? How do you make a decision like that?
Anyway, rabies vaccine was $600. I'm going to just scale back my monkey taunting instead.
The nurse suggested I consider getting the Japanese encephalitis vaccine. The odds of a tourist getting Japanese encephalitis are roughly 1 in a grillion -- giving an impressive absolute risk reduction of maybe 0.9 in a grillion. Against which you have to set the risk of side effects and the $100, or whatever it is.
On the other hand, she wasn't keen on a new vaccine against traveller's diarrhea. It works only against e. coli, which causes only about half of cases, and it's only 50% effective against that. And the protection lasts for only 3 months. But half or more of all travellers to India get sick. So the vaccine might cut your risk from 50% to 37.5%. Unlike Japanese encephalitis, these illnesses don't cause your brain to fall out in clumps, but they're so common that the $80 vaccine actually starts to seem worthwhile. (It's also raspberry flavoured, and is surprisingly refreshing, as oral vaccines go.)
Even if you dig up the information you need to really think about these things, the decisions are extremely strange ones. For a tourist spending 3 weeks in northern India in October, the odds of getting malaria might be, say, 1 in 5000. What's it worth to lengthen them to 1 in 25,000? How do you make a decision like that?
Anyway, rabies vaccine was $600. I'm going to just scale back my monkey taunting instead.
