Getting all the shots

Robert Peck is currently in Mongolia, largely out of contact with the outside world. He filed several blog  entries before leaving Philadelphia and early in his trek, including this one:

It seems there is no immunization against bubonic plague (the "Black Death" that wiped out one third of the human population of Europe during the Middle Ages). I greet this news with some relief, for I've had about as many shots as my arms will hold this afternoon. I've had injections for meningitis, typhoid, and tetanus today; for hepatitis A, yellow fever, and rabies on an earlier visit.


It's not that there isn't bubonic plague in Mongolia, it's just that there is nothing I can do to prevent catching it except to "stay away from the marmots and the fleas that infest them." Dr. Jennifer Aldrich proffered this good advice at Main Line Health's clinic for travel medicine and infectious diseases as she stamped the newest entries in my yellow inoculation book. "Keep this with your passport," she urged. Easier said than done. I lost my last yellow book at some border crossing in Botswana. Who knows how long I can hold on to this one.

We decided to forego the shots that might protect me from Hepatitis B, not because I shouldn't have them, but because there isn't sufficient time to administer the full course of three before my departure. "What do I do without them?" I asked. "Try to avoid dirty needles and the transfer of blood," Aldrich advised. "Don't hang out with prostitutes, avoid accidents, and stay away from the Mongolian heath system." Sounds like a plan.

Except for the shots, I quite like going to Lankenau's travel clinic. There isn't much of a wait, the doctors and nurses are friendly, and the reading matter is way better than in most doctors' offices. If the Conde Nast Travelers in their waiting room tell you all the reasons you might want to travel, the other reading matter they dispense at the clinic paints a different picture. Their "Advice to Travelers" booklet, loaded with horror stories of the diseases you are likely to contract, offers lots of reasons you might rather stay home.

In my case, many of their suggestions simply don't square with the realities of Mongolia. For starters, they recommend swimming only in clean, chlorinated swimming pools while traveling (dream on!). Are there any swimming pools in Mongolia? They also insist that I must not even think about consuming any of the raw milk products that will make up the bulk of my diet for the next two months. Maybe because the unpasteurized milk, cheese, and yogurt I'll be eating will come from horses, yaks, sheep and goats, the hazards won't be as great as from the dairy cows they worry about. I wonder where camel milk fits on their spectrum of forbidden foods, or drinking from communal cups and bowls. I don't ask.

An hour and $330 later, I leave the clinic feeling sore, but better prepared for whatever I might face on the steppes of Central Asia in the weeks and months ahead. Now, if I can just remember to avoid dirty needles, prostitutes, and those flea-infested marmots …

Continue Reading