Getting immunizations in a developing country
September 3, 2013 10:44 AM   Subscribe

I'm going to be traveling to Ecuador in a few weeks. I have most of the immunizations I need, but I need one and my travel partner needs several. We're seeking info on getting them in Ecuador.

We'll be there for five months, primarily in a fairly rural area in the Andes and probably taking a trip to the Amazon and some neighboring countries at some point.

We've done the research on what immunizations are recommended-- I need the second shot in the Hep A vaccine (I got the four years ago, but it looks like that's okay), he needs Hep A and Typhoid. We both may need Yellow Fever if we decide to go to Bolivia. We're planning to forego anti-Malarials based on our itinerary.

We're both currently visiting my parents in a rural area that doesn't offer much in the way of community health centers or travel clinics, and neither of us have insurance that is going to cover non-routine vaccines.

So, we're considering getting them done in Quito when we arrive, but we're wondering if this is a good idea, both from a safety perspective and also considering the hassle factor involved (I am semi-conversational in Spanish.) Does anyone have any experience with this, specific to Ecuador or in other developing countries.
posted by geegollygosh to Health & Fitness (9 answers total)
I received a Yellow Fever vaccine in Puno, Peru, which is loads more backwater than Quito. I'm semi conversational in Spanish. I went to front and asked for the vaccine, in spanish, to someone who looked like they had seen backpackers like myself try to save $100.

In about an hour and $5 later, I had my yellow fever vaccine. It was very disorganized, but was a cool experience,and the Bolivian border accepted my certificate.
posted by sandmanwv at 11:16 AM on September 3, 2013

Don't most vaccines take a few days to a week to really to become effective? You could be exposing yourself during that period when you really are not fully protected.
posted by COD at 11:18 AM on September 3, 2013

As COD points out, I was just going to say that the Typhoid vaccine takes 1 week to build immunity. Other vaccinations will vary. Yellow fever I'm seeing estimates of 10 to 14 days.

You'll have to judge the risk yourself. If you're going to be in a (relatively) low risk area for the first two weeks then getting your vaccinations in Ecuador might be viable. But I am not a doctor, and you shouldn't take this for medical advice.
posted by sbutler at 11:25 AM on September 3, 2013

Yeah, we're aware that there is a gap, but we'll be in low risk areas for that time and we aren't too worried about that aspect-- more worried just about the availability/process.
posted by geegollygosh at 11:34 AM on September 3, 2013

Note that insurance doesn't cover vaccines for travel even if you were insured. Also note that having only 1 hep A vaccination may mean that you have a sub-optimal level of immunity. One dose usually confers only temporary immunity. You will definitely need one more dose, and maybe two. You'd have to test your titer (a blood test) to know for sure.

Far easier to simply get another shot - you should be good for your trip. Hep A vaccine may be available here, at a health center if you can find one. It's pretty commonly given here in the US at no charge.
posted by citygirl at 11:34 AM on September 3, 2013

Most real countries have public health programs. For example, while in Mexico I would just show up at any hospital and ask for whatever, within reason, and inside of 15 minutes Nurse Ratchet would show up to attempt murder with the world's largest needle.

A few times I got a flu vaccine at a bus station during the swine flu scares. Granted, buses are a much bigger deal in Mexico though, part of that whole essential basic layer of infrastructure thing we keep meaning to get around to in the United States. I frequently see government health outposts on any given major border crossing I've been to in Latin America.

I've never been asked for payment, paperwork or proof of citizenship, but I can't speak for everywhere. In conclusion it should be really, really easy, and you might even be able to get it before leaving the airport. If you're traveling by ground, it should be even easier.
posted by hobo gitano de queretaro at 3:37 PM on September 3, 2013

I think that you should either (a) do a lot of research or (b) get your immunizations in the U.S.

I suggest doing a lot of research because you are going to be in a vulnerable position. Although the State Department's Web site says that medical care is available in most large Ecuadorian cities and towns, you'll need to be knowledgeable in order to successfully navigate their medical system. I recommend researching their medical system, what is culturally different about Ecuadorian medicine, and what red flags to look out for.

In addition, some countries require travelers to have up-to-date vaccines to receive a visa and/or enter the country. I suggest checking Ecuador's visa requirements. (The Web page is in Spanish, and I am not fluent in the language.)

Honestly, I am leaning towards Option B, which is getting your immunizations in the U.S. While it's more expensive state-side, you will ensure that you are protected for the length of your trip and you know that you will be getting good medical care. Plus, medical evacuation is really, really expensive (without adequate traveler's insurance).

This is not to say that medical care in Ecuador is bad; I have never traveled there and have no firsthand knowledge otherwise. My gut feeling is based on the fact that you're putting yourself in a vulnerable position and getting bad medicine could really impact your health.
posted by emilynoa at 4:21 PM on September 3, 2013

While I'm heading to India and not Ecuador, I wanted to jump in to say that you should look into the cost of the pills for Typhoid vs the shot. My 4 pack dose of Typhoid pills were only $30 vs the $169 for my anti-malarials and neither were covered by insurance, as mentioned above. I felt like the Typhoid pills were a (relative) deal after seeing how much the hepatitis vaccine would've been if my insurance didn't cover it.
posted by icaicaer at 7:05 PM on September 3, 2013

An update: we wandered around Quito looking for a place that had these vaccines, and eventually found them in a private clinic for around $40 total per person. We had to communicate a fair amount of info in Spanish, but nothing too complicated. The clinic was clean and the staff professional (although they clearly thought the situation was hilarious).
posted by geegollygosh at 4:19 PM on November 17, 2013

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