Yellow Fever Immunization in Bengaluru

In preparation for our trip to Africa over the 2009 holidays we needed to get Yellow Fever immunizations. India requires WHO proof that you have been immunized before they will let you back into the country when you have visited equatorial Africa or South America. When we visited SA in 2008, our physician in the US talked about the yellow fever shot, but when he looked at the map of where we would be in SA, he did not give us the immunization.

A quick search of the net led to several posts about only being able to get the immunization from India Public Health, and they would only do them when they had 10 persons ready to receive, and you had to bring your own syringe with needle. Three vs. 10, hmm, and we needed to get done in the week following the discovery of need. There needed to someplace else, but where was the question. A quick call to the health group that Jessie had been to indicated they did the immunization. Larrie and Jessie went to the group that evening, paid the Rs. 300 (about $6) to see the doctor for the immunization only to have the doctor say that "we cannot do that here, you can only get that done at public health". The money was refunded and the switchboard procedures were updated with a new "we cannot do that" item.

Larrie and Jessie had another false start. A neighbor indicated that one of the more prestigious medical groups in the city had opened a new clinic close to the house. A quick call to their switchboard indicated that yes, they could provide the shot. So we went to the clinic, waltzed up to the counter only to be told that they did not do that immunization, and that it could only be done at public health. Again, switchboard procedures were updated.

Larrie then called the hospital where he had taken Jessie when she contracted viral fever. It is one of the larger and better facilities in the city. Yes, they confirmed they could do the immunization, but you needed to see a doctor first. So, Alli took a half day off, and she and Larrie went to the hospital. We sat in the waiting room for over 1 hour for our turn to see the doctor. Oh, BTW, it cost us each Rs. 350 (about $7) to see said doctor. The doctor was an elderly gentleman who inquired what we wanted and why we wanted it. Once understanding our need, he placed a phone call, wrote the prescription orders, and we were escorted by one of the nurses first to the pharmacy to get the immunization (Rs. 1500 each, about $30) and then to the ER for a different nurse to do the stick. I am not sure why the nurse at the doctors office could not administer the shot.

Well, walking into an urban Indian ER in the middle of the day is not unlike the tv show ER - except without air conditioning and sometimes the lights went off, for quit awhile. There was a body, not a person mind you, on a gurney partially hidden by curtains. Grieving relatives were around. Ambulances arrived and unloaded. And, we just wanted to get a shot. The doctor, a very polite young man, indicated that they were a tad busy, and would we mind sitting - in the middle of the ER, until a nurse came available.

So, there we were in the middle of the ER watching a full episode be acted out by real people. Finally, a nurse escorted us to an examination room and prepared to give Alli her shot. With needle poised to jab, the lights go out. No emergency lighting and no generator backup, and we were in an interior room. It was pretty dark. We just sat there thinking that the generator will kick in any second now, but it never did. After what seemed an eternity, we had lights again, and Allie got her jab. Next was Larrie who did not have to endure darkness; however, without A/C it was questionable if Larrie would be conscious after the shot. [He almost passed out when a nurse had to do a second stick for an IV in Minnesota on a hot day.]

Upon completion of the process, the nurse calmly asked if we had our WHO forms for her to record the administration. What forms were those, we asked. Turns out that there is an international form for certain types of immunizations, and the WHO standardized the form. The hospital did not stock them providing Larrie with another opportunity for a citywide search and acquire mission the following day to get some (cost Rs. 50 each). The hospital did give us a local form to show we had had the shot, but that would not do for Immigration.

The whole process took over 3 hours. Our friend Pam, who was going to Africa with us, walked into the ER the prior Friday night, and was in and out in 20 minutes. Friday Night!

After the appropriate WHO forms had been acquired from a local travel agency, which begs a question as to why you get the form from your travel agent rather than the doctor who provides the shot, Larrie booked an appointment with the hospital for Jessie's shot.

Children are handled a bit differently at this hospital as there is some attempt to separate their experience from the pain and suffering of adults. We adults do not handle our pain well, and we suffer much too loudly. I guess there is a reason they call ER a trauma unit - if you don't have it, you'll get it. At any rate, after paying to see the doctor (Rs. 400 this time as pediatricians cost more than internists), we waited only to be told by the doctor that they did not do that here, which I found out minutes later meant that they did have the immunization in Pediatrics. When I explained the situation and my experience to date, the doctor called the pharmacy where she learned that the vaccine existed. She wrote an order, and we were off to the pharmacy for the kit. Once obtained, back to Pediatrics (not the ER), and the nurse gave Jessie her shot.

I had the proper WHO forms with me, and I had the documentation of Larrie's and Alli's shots so that the information could be transcribed into the WHO document. The Pediatrics nurse looked at me, and said "I cannot complete that form, I do not have the hospital stamp". Beware of Vogons, they just complicate your life. Curse you WHO!! (said with shaking fist in the air) Ok, with all the documentation, we headed down to see the ER doctor to get the WHO forms signed by the doctor and stamped with the correct stamp. We had hoped to spare Jessie a trip to the ER, but alas, it was not meant to be. Luckily for Jess, ER was pretty quiet, but she did see a couple of suffering adults that provided us with conversational material.

All forms signed, documents updated, and persons immunized, Larrie and Jessie headed for home. Moral of this story is that when you move to India, do not rule out visiting Africa. I only wonder what shots we will need when we go to Southeast Asia that seems to be the breeding ground of so many new bugs out to get us humans. Oh, well.