Consider consulting a travel medicine specialist doctor before you leave. In Vancouver, Canada, go to Vancouver Coastal Health Travel Clinic or Travel Medicine & Vaccination Centre. Note: tick-borne encephalitis vaccine is currently only available at the latter.
If you will have medical coverage at home, any travel coverage you purchase needs to cover emergency treatment and evacuation.
You can join International Association for Medical Assistance to Travellers for free. IAMAT maintains a worldwide list of affiliated medical and dental care providers. Should you have a problem while on the road, they will direct you to the best local medical or dental service provider .
We can attest to their efficient response when Chris had a dental emergency in Urumqi, China.
Their site also provides comprehensive travel health resources and includes a World Immunization Chart of recommended immunizations for all countries. If you are a seasoned traveller and know exactly what immunizations you need for your proposed trip, you may be able to dispense with the consultation visit and simply book for the required injections.
Cycling in areas where rabies is endemic puts you at significant risk. Dogs chase bicycles, and we’ve had a few near misses with bared fangs snapping at our heels.
It’s wise to have the course of three pre-exposure injections before departure. These provide you with a base level of immunity, but if bitten, you’ll still need four follow up injections. However, you won’t need the initial immunoglobulin injection — sometimes difficult to obtain — that is urgently necessary if you haven’t had pre-exposure injections. There is also less urgency to start on the follow up injections if you have had the pre-exposure imunization.
Even those with pre-exposure immunization must seek medical help as soon as possible if bitten or scratched.
Alternative Method of Rabies Immunization
The cost of pre-exposure injections at a travel clinic are about $200 each, so a course of three injections is about $600 per person. At clinics, the standard injections are delivered intra-muscularly using 1.0 ml of vaccine.
We learned from a physician friend that there is an alternative method of immunization that not only reduces the risk of side effects, but also costs significantly less. A skilled medical person can inject only 0.1 ml (rather than 1.0 ml) intra-dermally (rather than intra-muscularly).
We purchased a single 1.0 ml vial of Rabivax vaccine (prescribed by our physician friend) and this allowed him to administer 9 injections privately to a group of acquaintances who needed immunization for travel. At the later suggestion of the travel clinic, we had our antibody titers (immunity levels as determined by a blood test) checked to prove our alternative immunization had been effective. It had.