Immunizations for Indians before enrollment in US universities

Recommended immunizations and medical checkup for Indians before enrollment in US universities are:

Hepatitis B or A/B combination:

The Hepatitis B vaccine was developed a few years back, so we definitely have not been administered this. For all of us who have taken this vaccine, great. You are safe against this potentially fatal disease. For those of you who have not taken this, you can take this now. It is a 6-month course of 3 doses - 0, 1 month and 6 months but do not even think of getting the vaccine in the US unless you have really deep pockets.

Varicella (chicken pox):

Most of us may have had chicken pox in our childhood. Once it occurs, a person gets life-long immunity. The university form has a provision for this - immunity by positive blood titer. I would advise you to undergo a blood test to prove that you had chicken pox before. The test is called "Varicella Zoster IgG" and can be done from any diagnostic center. You can get it done at SRL Religare (Ranbaxy) and the cost is approximately 1750 INR. You can get the result in 2-3 days.

Tuberculin Skin Test [PPD]:

Now, this test is tricky. The tuberculosis vaccine we get as a baby is the BCG in which a small amount of live tuberculosis virus is injected in the body. Our body develops antibodies to the virus and we become immune. But the university form asks for a skin test, which is called the Mantoux test. The Mantoux test involves injecting a small amount of medicine under the skin of the forearm. (I know it sounds painful but it is not.) Then we have to ensure that the area around the medicine is not contaminated by soap, shampoo, or even excess sweat. A rash will develop around the area. There are two readings taken after 48 hours and 72 hours. A person will check the diameter of the rash with a ruler. If the diameter of the rash is more than 8-10 mm, the result is positive (positive is bad in this case). Then you will have to get a chest x-ray done.

Now, there could be some minor side effects of the Mantoux injection. Some people experience weakness for a while. So, better take some Glucon D in a bottle to drink after the injection. The rash will mostly be a small one. DON'T freak out if it's a big rash. As I had said, BCG is a live tuberculosis virus, so Indians may test +ve. Don't worry. Get a chest x-ray done. The Mantoux test costs Rs. 200/- at Dr. Suri Lab Pvt. Ltd. and SRL Religare.

Meningococcal vaccine:

This is mentioned separately so you may think that it is important. First of all, meningitis is caused by bacteria or virus. Meningococcal vaccine means immunization against the bacterial strain. However, there are many strains of bacteria.

The meningococcal vaccine is administered on your arm, near the place where you have had your BCG vaccine done as a child. The local brand of vaccine available is Quadri Meningo. It is same in composition as Menomune which is mentioned in the university medical form, so you can take that and tick the menomune option. Get it done you're your physician. That is more than sufficient. That part of your arm will hurt like a normal muscular pain. Not a problem.

Optional immunizations:

These are optional, so it is up to you to have them or not. However, the haemophilus influenza type b (HIV-B) is an infectious and fatal one. It is a type of pneumonia and has no cure. So you may take the vaccine. This is not to be confused with the AIDS virus, it s a different one.

Now you must be thinking: "Why should I go through all this trouble if I can just get my doctor's sign on the form?".

The answer is "Hope for the best but prepare for the worst.".

Any medical checkup in the US is extremely costly. If you are asked for immunization proof after going there, it will burn a deep hole in your pocket, so it is better to be prepared. The first page of the university immunization form says that you have to attach proofs of immunizations, so, in my opinion, get these tests done here in India rather than getting them done later in US.

Medical checkup:

Get a general medical checkup done before going. A thorough dental checkup is absolutely necessary. The cost of a root canal in the US is so much that if you can return to India, get it done here and travel back to US, it will still be cheaper. So, don't risk your health and your money by ignoring the immunizations and checkup.

Hope this information is useful. If you have any doubts, feel free to ask me. I will try to answer them.

For DTP, one dose must be taken within last ten years. Most of us would have received these doses before age of 3. You have to take one dose of that and it costs around 750 INR.

For MMR (mumps measles and rubella), you either have to prove by serological testing that you have antibodies for MMR or you should be more than 50 years old. Serological testing will cost you around 2500 INR. And if you take one dose (MMR is given combined) it will cost you 350 INR, so it is better to take a dose.