According to the Oklahoma Health Department, for a trip to Manila there is no need for additional medications or vaccinations. However, if you plan to spend any length of time outside Manila in undeveloped areas, several extra precautions should be taken. Vaccines for Typhoid and Polio are recommended. The Typhoid vaccine is in the form of three expensive pills taken every other day two weeks or so before departure. The Polio vaccine is a small vial of liquid taken orally. An injection of Gamaglobulin is recommended for prevention of Hepatitis. A Tetnis booster is also a good idea if you haven't had one in less than ten years. Finally, Plaquenil or Primaquine should be taken to help prevent Malaria. These pills are taken once a week beginning two weeks prior to departure and ending four weeks after return. If you are worried about acquiring the EColi bacteria in food and spending several days in the bathroom with diarrhea, it would not be a bad idea to acquire some Sulfatrim DS from your doctor as well.
This sounds like a simple enough list of items to acquire, but in actuality it was a rather frustrating process. I started by going to my general practice physician and seeking his advice on the subject. He called the health department and returned with the above mentioned list of items. He wrote prescriptions for the Typhoid, Malaria, and Sulfatirm DS drugs, and had a nurse come in with the Gamaglobluin injection. The doctor's consultation was covered on my medical plan from work so it was free of charge. The prescriptions were filled by my medical plan's pharmacy and two of the drugs were covered under the plan. The Typhoid drugs were not, and cost $28. This only left the Tetanus booster injection and the Polio vaccine. I don't remember his excuse for not recommending the Tetanus shot. However, he told me that at my age (32), I needed an injectable form of Polio vaccine not the oral form he carried in his office. He suggested I go to the Oklahoma County Health Department in Oklahoma City to acquire this vaccine.
To my surprise, I found an expensive traveler's trap at the health department. There are several lines to stand in, depending on your needs at the health department. I chose to ignore the "travel abroad" line (which, by the way, is only open on Fridays from 12:00 noon to 3:00 PM.) and got in a line for "injections". This made sense to me since I knew what I wanted as per my doctors directions. I got up to the window and told the woman I wanted a polio injection. She filled out a form, told me it would be free, and sent me to the nurse's office. The nurse came in, took one look at me and said "I can't give you a polio vaccine". She explained that no native US citizen over the age of 18 should need one. I countered her argument with my doctor's advice to come down and get one. She returned the volley with "why did he tell you to do that?" At this point I gave up and told her I was going out of the country. Two minutes later I was standing in the "travel abroad" line.
Here is where the traveler's trap comes in. The travel abroad line at the Oklahoma County Health Department has a $50 processing fee associated with it. No matter what drugs or services you need, they first tack on a $50 charge for paperwork and processing. All I really came here for was a polio shot which was a free vaccine readily available to the public, but for travelers they found a way to charge $50 for a free vaccine. That $50 charge does get you some extra attention however. You write your itinerary down and a nurse goes over it looking up each destination in a book to find out what medications are recommended for that area. I agree that this would have been a valuable service had my family doctor not already performed it for me for free. The nurse sat me down and flipped through her books on the subject and told me exactly what my doctor had already quoted me. She then gave me a tetanus injection and the polio vaccine.
Here is the real kicker to this story. The health department does not give the injectable form of polio vaccine that I was there for in the first place. They only give the oral form of the vaccine which I could have acquired at my doctor's office. Had my doctor known that the health department was a traveler's trap he could have saved me $50 by giving me the polio injection himself. I would bet that in my doctor's conversation with the health department they told him to send me in to get my polio injection there.
Lani, in preparation for this same trip went through this same trap with the same results. She works for a hospital and couldn't acquire the polio vaccine there. She called all the other major hospitals in the area and got the same results. Everyone told her to go to the Oklahoma County Health Department.
One final insulting irony about this story came several weeks afterwards. Through my company's health care plan, I am allowed to siphon off a fixed amount of my gross income to be spent for medical purposes. I turned in the $50 health department bill for reimbursement and it was rejected as a valid medical expense. It took a long letter detailing the events, several phone calls and a faxed note from my doctor to get the bill reimbursed.
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