auspicacious

In the months before leaving home for a long trip abroad, many Americans play out a familiar ritual, visiting a travel medicine specialist in order to be stuck with a series of needles and given pills that cause nightmares. But the most painful part is often the price.

Just like other medication, the cost of travel vaccines and common prescription medications like Malarone has gone up sharply in the US over the past decade. Moreover, travel medicine is often not covered by insurance, and is provided by doctors who work on a cash-only basis.

I like my travel medicine practitioner in Baltimore, but I've kept copies of her price lists from 2009 to 2016, and I can see the changes.

Here are some sample costs from 2009 and 2016 for single doses of vaccines:

• Yellow fever: $90 (2009), $150 (2016) -- 67% increase
• Typhoid fever: $60 (2009), $75 (2016) -- 25% increase
• Japanese encephalitis, $115 (2009), $300 (2016) -- 160% increase

These prices were from a private practitioner. My experience is that the well-known Passport Health chain is more expensive. She also charges per-visit and per-shot fees separate from this; these can range from about $20 to $80.

Moreover, I planned on being outdoors in eastern Europe, where tick-borne encephalitis is present. This can be deadly, yet the safe, effective vaccine is not approved in the United States.

Given that I had the time, I decided to take advantage of my stay in the United Kingdom to get the immunizations I needed, rather than do so in the United States. I chose to use Superdrug's chain of travel medicine clinics, because they were very flexible about letting me start a vaccine series in one city and continue it in another. Their whole appointment system is unified across the country, so they could easily set it up for me. Unlike most American practitioners, they also post their vaccine costs on their website and don't charge separate administration fees.

Here's those same vaccinations at Superdrug in 2018:

• Yellow fever: 58 GBP ($75)
• Typhoid fever: 30 GBP ($39)
• Japanese encephalitis: 89 GBP ($116)

A visit to receive all three of these vaccines would be at least $300 cheaper, possibly more once administration fees are included. Japanese encephalitis vaccine requires three visits; that's hundreds more saved. British prices in 2018 are still lower than American prices in 2009.

Both Superdrug clinics I visited were easily accessible in city centers. The nurses were professional, knowledgeable, and efficient, and the records digital; I was seen within ten minutes of my appointment each time. Note that this is a private service and not affiliated with the NHS.

The UK is certainly not the only place to get travel vaccinations done. It's probably not the cheapest. But it made sense for me.