In Reply to: what vaccinations to give and when posted by olivia on February 20, 2003 at 12:17:32:

Conventional vaccine protocols are designed to give multiple vaccinations to puppies a few weeks apart. Most people and even many veterinarians believe that more than one vaccine is needed to "prime" the immune system or build immunity, but in the case of modified live virus vaccines for parvo and distemper, this isn't really necessary.

We don't repeat vaccinations for parvo and distemper because we need vaccines more than once to form immunity. They are repeated for two basic reasons only: Habit, and to catch those individuals who for some reason don't respond to the first vaccination. A single immunizing dose of a modified live virus vaccine - in other words, one vaccine that works - will form long term, probably lifetime, immunity to parvo and distemper. (Kirk's Current Veterinary Therapy XIII; 2000; "Vaccines and Vaccinations: Issue for the 21st Century", Richard B. Ford and Ronald D. Schultz; (Kirk's Current Veterinary Therapy XI, "Canine and Feline Vaccines," Phipps, Schultz; R.D. Schultz, "Considerations in Designing Effective and Safe Vaccination Programs for Dogs," May 2000; Schultz, "Duration of Immunity to Canine Vaccines: What We Know and Don't Know.")

We don't need to keep repeating the vaccines to know if they worked, either. Although titers as a measure of ongoing immunity aren't all that useful, as a measure of whether or not an animal formed immunity from a recent vaccination, they are very reliable. ("Vaccines and Vaccinations: Issue for the 21st Century", Richard B. Ford and Ronald D. Schultz. Kirk's Current Veterinary Therapy XIII, 2000.) Since it takes 7-10 days for the immunity to form, if you test titers ten days after a parvo and/or distemper vaccine, you will know if the puppy had an immunizing response. You don't need to guess.

If your puppy already seroconverted due to the vaccines he or she already was given, there is no reason or benefit to repeat them. She's already immune, and she won't get "more immune." There is no "booster" effect, because the antibodies from the first vaccine will wipe out the vaccine virus, just like maternal antibody does. (Schultz, R.D., "Current and Future Canine and Feline Vaccination Programs." Vet Med 3: No. 3, 233-254, 1998.)

Some puppies will be given a vaccination and not form immunity (seroconvert). Most non-conversion in puppies is due to the presence of maternal antibodies. Puppies get antibodies (passive immunity) from their mothers in the two days after birth, from the colustrum. It's common for a pup to have enough maternal antibody to inactivate the parvo vaccine, but not enough to protect from disease. Add to that the fact that parvo maternal antibody lasts a long time compared to other puppy viruses like distemper (sometimes as late as 22 weeks), and you can see why many puppies who are vaccinated for parvovirus still come down with the disease.

The answer is not to vaccinate earlier or more frequently, but to vaccinate scientifically. Earlier vaccination is clearly a doomed strategy, because maternal antibody wears off over time, and the puppy would have had more, not less, maternal antibody at a younger age. More frequent vaccination will often make the problem worse, as well, because it takes up to two weeks for immunity form after a vaccination is given; it's not instantaneous. If another vaccine, even for a different virus, is given during the two week period following a vaccination, you will probably interfere with the immunity from the first vaccine as well as the second. Waiting a bare minimum of two weeks between vaccinations is an immunological requirement.

Other causes for non-conversion include improper vaccine shipping, storage, or handling, using a low quality vaccine, or immune problems in the puppy. Most of the time when dogs get a disease shortly after vaccination, it's because of the immune suppression caused by the vaccine happening at the same time the dog encounters the pathogen in a vet's office, a vaccine clinic, or a shelter. It is not a case of primary vaccination failure. It is a case of the dog not being immunized at all at the time they encounter the virus.

If I could get a leading vaccine researcher here to tell you one thing, I guarantee someone else could find another to say something different. Each breeder needs to look at the evidence and come to their own conclusions. If you want my personal opinion, I believe that protocol "A" from Dr. Ronald D. Schultz of the University of Wisconsin School of Veterinary Medicine seems like the safest mainstream protocol I have seen. You can review it in his article Considerations in Designing Effective and Safe Vaccination Programs for Dogs.

Dr. Schultz does recommend giving Canine Adenovirus-2 (Canine Infectious Hepatitis)and an initial rabies vaccination, as well as parvo and distemper, at age 12-14 weeks. Since he himself says that there have been no cases of Canine Infectious Heptatis in the United States in over 20 years, I don't quite understand why he includes this vaccine. It is not available by itself, and has been shown to cause immune suppression when given in combination with Canine Distemper (Kirk's Current Veterinary Therapy XI, "Canine and Feline Vaccines," Philips, Schultz), so I would consider not giving it. (Rabies is governed by laws, not science, so I really have no comment on this other than to recommend giving rabies vaccine by itself, at least two weeks before and/or after any other vaccines.)

I would also prefer to give parvo and distemper separately. If you do that, though, the question is, which do you give first? There is a good argument to be made that distemper is easier to vaccinate for at a younger age, as maternal antibody is almost always gone by 8 weeks. However, parvo is much more common than distemper, and the younger the puppy is when he or she gets it, the worse the outcome is likely to be. My own choice would be to give parvo first, but it's an individual decision. Giving the two in combination is also a reasonable choice, although not one I would make.

I get a lot of mail asking where single parvo and single distemper, or a parvo/distemper combination, can be obtained. Galaxy makes the "Galaxy-D" single distemper vaccine; Intervet (Proguard) and Duramune both make single Parvo vaccines, and Intervet (Proguard) also makes a combined parvo/distemper "puppy" shot; if your vet won't order them for you, you can buy them online at http://www.revivalanimal.com/. I have no commercial interest in any of these companies nor any experience purchasing anything from them or using their products; they are simply resources for single-antigen vaccines of which I've been made aware. Use at your own risk.

I would also suggest that instead of guessing when maternal antibody is gone, you can increase the chances of vaccine success for parvo by doing a simple blood test for maternal antibody. That way you can give the parvo vaccine at the moment when you know the maternal antibodies are really gone, and can be sure it's going to work.

Most breeders don't want to wait that long, and instead use so-called "high titer" vaccines such as Intervet's Proguard, which was designed to overcome maternal antibodies.

Whether you give the high titer vaccine, a regular parvo vaccine, or do the maternal antibody test, you can then wait ten days after giving the vaccination and run a parvo titer to see if they seroconverted. If they did, and you gave only the parvo shot, you can now give a distemper vaccination. Wait two weeks, and you can check the distemper titer, too.

If the puppy had an immunizing response to the vaccines, then it just doesn't get any better than that, as far as vaccinating for parvo or distemper goes. That is the brass ring and your puppy got it.

If you are nervous you can do a parvo/distemper titer at one year of age, but the correlation between post-vaccine sero-conversion to these two diseases, and protection from the disease throughout the dog's life, is extremely high. Parvo and distemper are almost unheard of in vaccinated adult dogs. (Kirk's Current Veterinary Therapy XIII, 2000; "Vaccines and Vaccinations: Issue for the 21st Century", Richard B. Ford and Ronald D. Schultz.)

Some people say... but my puppy goes to all these places where there's parvo! Well, GOOD! Every time your puppy encounters the wild virus, or the vaccine shed in the stool of the other dogs in your area, it will cause the memory cells to produce antibodies. While research now suggests this doesn't actually improve immunity, it does give you the peace of mind of being able to think of every trip to the local dog park as a safe booster shot.

Seriously, I'm not trying to convince you if you're not sure. What vaccination protocol to use is a highly personal decision. Most vaccine protocols are "one size fits all," and based on "just in case" and guessing. If you make the decision to give puppy shots, then design a vaccination program based on science and reason, not superstition, fear, habit, and marketing strategies.

Good luck!

Christie Keith
Caber Feidh Scottish Deerhounds
Holistic Husbandry since 1986
http://www.caberfeidh.com

Background

In the past there have been many different vaccination recommendations for dogs and cats from veterinarians across the United States based on the best available information. In light of new information, the Colorado State University Veterinary Teaching Hospital is offering its clients the following vaccination program. This program is designed as the routine immunization program for Colorado State University's clients' dogs and cats living in Larimer County, Colorado, USA in conjunction with a complete physical examination and health evaluation. This program is modified for any patient with specific risk factors.

Not all available small animal vaccines may be suitable for our program. Infectious disease risk may vary and our routine vaccination program may not be suitable for all localities. Anyone using our routine vaccination program is encouraged to follow the guidelines that are its basis and use the program at their own risk.

For pet owners, your local veterinarian is your best resource to develop a vaccination program tailored for your pet. The health status and infectious disease risks of your pet should be considered in the selection of a vaccination program.

Our adoption of this routine vaccination program is based on the lack of scientific evidence to support the current practice of annual vaccination and increasing documentation showing that overvaccinating has been associated with harmful side effects. Of particular note in this regard has been the association of autoimmune hemolytic anemia with vaccination in dogs and vaccine-associated sarcomas in cats -- both of which are often fatal. With boosters (except for rabies vaccine), the annual revaccination recommendation on the vaccine label is just that -- a recommendation without the backing of long term duration of immunity studies, and is not a legal requirement. Rabies vaccine is the only commonly used vaccine that requires that duration of immunity studies be carried out before licensure in the United States. Even with rabies vaccines, the label may be misleading in that a three year duration of immunity product may also be labeled and sold as a one year duration of immunity product.

Based on the concern that annual vaccination of small animals for many, but not all, infectious agents is probably no longer scientifcally justified, and our desire to avoid vaccine-associated adverse events, we are recommending the described routine immunization program to our small animal clients.

Vaccine Schedule

This Program recommends the standard three shot series for puppies (parvovirus, adenovirus 2, parainfluenza, distemper) and kittens (panleukopenia, rhinotracheitis, calicivirus) to include rabies after 8 weeks of age for cats and 16 weeks of age for dogs. Following the initial puppy and kitten immunization series, cats and dogs will be boostered one year later and then every threeyears thereafter for all the above diseases except for rabies in cats which receive the new sater canary pox rabies vaccine that requires annual boosters. Similar small animal vaccination programs have been recently adopted by other university teaching hospitals and the American Association of Feline Practitioners.

Other available small animal vaccines, which may need more frequent administration, i.e., intranasal parainfluenza, Bordetella, feline leukemia, Lyme, etc., may be recommended for CSU client animals on an "at risk" basis but are not a part of the routine Colorado State University protocol for small animals. Recent studies clearly indicate that not all vaccines perform equally and some vaccine products may not be suitable for such a program.

Nonroutine Vaccine Recommendations

Intranasal Bordetella/Parainfluenza

To be used just prior to possible exposure to kennel cough carriers, i.e., shows, field trials, etc. May be repeated up to six times per year.

Feline Leukemia Vaccine

To be used ONLY IN HIGH RISK cats. Two vaccines prior to 12 weeks of age. One booster at one year of age.

For those interested in reading more about small animal immunization issues, the following is a suggested reading list.

Small Animal Vaccines Selected For The Program At The Colorado State University Veterinary Teaching Hospital

Fred Wiener Canine

Brand Name:     Vaccine Type:

Progard ®-5        Modified live canine distemper, adenovirus type 2, parainfluenza, parvovirus vaccine

Progard ® KC      Canine parainfluenza, Bordetella bronchiseptica (intranasal)

Imrab® 3              Killed rabies vaccine - three year duration of immunity

Desmond Kee Feline

Brand Name:     Vaccine Type:

Imrab® 3              Killed rabies vaccine - three year duration of immunity

Protex ® -3          Feline rhinotracheitis, calici, panleukopenia modified live virus

Trivalent              Modified live rhinotracheitis, calici, panleukopenia (intranasal)

Fel-O-Vax Lv-K ®              Killed FeLV vaccine

Purvax A new canarypox vector rabies vaccine from Merial with a one year duration of immunity replaces Imrab®3 in cats.

Suggested Reading List

Dubielzig RR, Everitt J, Shadduck JA, et al: Clinical and morphologic features of posttraumatic ocular sarcomas in cats. Vet Pathol 27:62-65, 1990.

Dubielzig RR, Hawkins KL, Miller PE: Myofibroblastic sarcoma originating at the site of rabies vaccination in a cat. J Vet Diagn Invest 5:637-638, 1993.

Duval D, Giger URS: Vaccine associated immune-mediated hemolytic anemia in the dog. J Vet Int Med 10:290-295, 1996.

Esplin DG, McGill L, Meininger A, et al: Postvaccination sarcomas in cats. J Am Vet Med Assoc 202:1245-1247, 1993.

Fawcett HA, Smith HP: Injection-site granuloma due to aluminum. Arch Dermatol 120:1318-1322, 1984.

Greene CE: Vaccine induced complications verses overvaccination. Proceedings of the 65th annual AAHA meeting, Chicago, 1998, pp 368-369.

Hendrick MJ, Brooks JJ: Postvaccinal sarcomas in the cat: Histology and immunohistochemistry. Vet Pathol 31:126-129, 1994.

Hendrick MJ, Dunagan C: Focal necrotizing granulomatous panniculitis associated with subcutaneous injection of rabies vaccine in cats and dogs: 10 cases (1988-1989) J Am Vet Med Assoc 198:304-305, 1991.

Hendrick MJ, Goldschmidt MH: Do injection site reactions induce fibrosarcomas in cats? J Am Vet Med Assoc 199:968, 1991.

Hendrick MJ, Goldschmidt MH, Shofer F, et al: Postvaccinal sarcomas in the cat: Epidemiology and electron probe microanalytical identification of aluminum. Cancer Res 52:5391-5394, 1992.

Hendrick MJ, Kass PH, McGill LD, et al: Commentary: Postvaccinal sarcomas in cats. J Natl Cancer Inst 96:5, 1994.

Hendrick MJ, Shofer FS, Goldschmidt MH, et al: Comparison of fibrosarcomas that developed at vaccination sites and at nonvaccination sites in cats: 239 cases (1991-1992). J Am Vet Med Assoc 205:1425-1429, 1994.

Kass PH, Barnes WG, Spangler WL, et al: Epidemiologic evidence for a causal relation between vaccination and fibrosarcoma tumorigenesis in cats. J Am Vet Med Assoc 203:396-405, 1993.

Larson LV, Schultz RD: Comparison of selected canine vaccines for the inability to induce protective immunity against canine parvovirus infections. AJVR 1997 58:4, 360-363, 1997.

Larson RL, Bradley JS: Immunologic principles and immunization strategy. Comp Cont Ed Pract Vet 1996;18:963-970.

Macy DW. The potential role and mechanisms of FeLV vaccine-induced neoplasms. Sem Vet Med Surg 1995;10:234-238.

Macy DW, et al. Vaccine associated sarcomas in cats. Fel Pract 1995;23:24-27.

Macy DW, et al. Postvaccinal reactions associated with three rabies and three leukemia virus vaccines in cats. Proc. 14th Annual Vet Cancer Soc Cof., Veterinary Cancer Society, Townsend, Tenn., 1994:90-91.

Macy DW, Hendrick MJ: The potential role of inflammation in the development of postvaccinal sarcomas in cats. Seminars in Vet Med and Surg 26:103-109, 1996.

Olson P, et al. Duration of immunity eliceited by canine distemper virus vaccinatons in dogs. Vet Rec 1997;141:654-655.

Pedersen NC: Perspectives on small animal vaccination: A critical look at current vaccines and vaccine strategies in the United States. Proceedings AAHA 145-156, 1997.

Phillips TR, Schultz RD: Canine and feline vaccines. Kirk R and Bonagura JD (eds). Current Veterinary Therapy XI, WB Saunders Co., Philadelphia, 1992, pp 202-206.

Schultz RD: Current and future canine and feline vaccination programs. Veterinary Medicine 233-254, March 1998.

Schultz RD: Veterinary Vaccines and Diagnostics in Advances in Veterinary Medicine, 41, 1999 pp. 1-853.

Scott FW: Duration of immunity in cats vaccinated with an inactivated feline panleukopenia, herpesvirus, and calicivirus vaccine. Fel Pract 1997;25:12-22.

Smith CA: Current concepts: Are we vaccinating too much? J Am Vet Med Assoc 207:421-425,1995.

Tizard I: Risks associated with the use of live vaccines. J Am Vet Med Assoc 1990;196:1851-1858.

Experts say annual vaccines waste money, can be risky

By

Leigh Hopper- Houston Chronicle Medical Writer

Debra Grierson leaves the veterinarian's office clutching Maddie and Beignet, her Yorkshire terriers, and a credit card receipt for nearly $400.

That's the cost for the tiny dogs' annual exams, including heartworm checks, dental checks and a barrage of shots.

"They're just like our children," said the Houston homemaker. "We would do anything, whatever they needed."

What many pet owners don't know, researchers say, is that most yearly vaccines for dogs and cats are a waste of money -- and potentially deadly. Shots for the most important pet diseases last three to seven years, or
longer, and annual shots put pets at greater risk of vaccine-related problems.

The Texas Department of Health is holding public hearings to consider changing the yearly rabies shot requirement to once every three years. Thirty-three other states already have adopted a triennial rabies schedule. Texas A&M University's and most other veterinary schools now teach that most shots should be given every three years.

"Veterinarians are charging customers $36 million a year for vaccinations that are not necessary," said Bob Rogers, a vet in Spring who adopted a reduced vaccine schedule. "Not only are these vaccines unnecessary, they're causing harm to pets."

Just as humans don't need a measles shot every year, neither do dogs or cats need annual injections for illnesses such as parvo, distemper or kennel cough. Even rabies shots are effective for at least three years.

The news has been slow to reach consumers, partly because few veterinarians outside academic settings are embracing the concept. Vaccine makers haven't done the studies needed to change vaccine labels. Vets, who charge $30 to $60 for yearly shots, are loath to defy vaccine label instructions and lose an important source of revenue. In addition, they worry their patients won't fare as well without yearly exams.

"I know some vets feel threatened because they think, `People won't come back to my office if I don't have the vaccine as a carrot,' " said Alice Wolf, a professor of small-animal medicine at Texas A&M and an advocate of
reduced vaccinations. "A yearly exam is very important."

The movement to extend vaccine intervals is gaining ground because of growing evidence that vaccines themselves can trigger a fatal cancer in cats and a deadly blood disorder in dogs.

Rogers conducts public seminars on the subject with evangelical zeal but thus far has been unsuccessful in persuading the Texas Veterinary Medical Association to adopt a formal policy.

"I'm asking the Texas attorney general's office if this is theft by deception," said Rogers, whose Critter Fixer practice won an ethics award from the Better Business Bureau in 2000. "They just keep coming out with
more vaccines that are unnecessary and don't work. Professors give seminars, and nobody comes and nobody changes."

When rabies shots became common for pets in the 1950s, no one questioned the value of annual vaccination. Distemper, which kills 50 percent of victims, could be warded off with a shot. Parvovirus, which kills swiftly and gruesomely by causing a toxic proliferation of bacteria in the digestive system, was vanquished with a vaccine. Over the years, more and more shots were added to the schedule, preventing costly and potentially deadly disease in furry family members.

Then animal doctors began noticing something ominous: rare instances of cancer in normal, healthy cats and an unusual immune reaction in dogs. The shots apparently caused feline fibrosarcoma, a grotesque tumor at the site of the shot, which is fatal if not discovered early and cut out completely. Dogs developed a vaccine-related disease in which the dog's body rejects its own blood.

"That really caused people to ask the question, `If we can cause that kind of harm with a vaccine ... are we vaccinating too much?' " said Ronald Schultz, a veterinary immunologist at the University of Wisconsin School of Veterinary Medicine. "As you get more and more (vaccines), the possibility that a vaccine is going to cause an adverse event increases quite a bit."

Less frequent vaccines could reduce that risk, Schultz reasoned. Having observed that humans got lifetime immunity from most of their childhood vaccines, Schultz applied the same logic to dogs. He vaccinated them for rabies, parvo, kennel cough and distemper and then exposed them to the disease-causing organisms after three, five and seven years. The animals remained healthy, validating his hunch.

He continued his experiment by measuring antibody levels in the dogs' blood nine and 15 years after vaccination. He found the levels sufficient to prevent disease.

Fredric Scott, professor emeritus at Cornell University College of Veterinary Medicine, obtained similar results comparing 15 vaccinated cats with 17 nonvaccinated cats. He found the cats' immunity lasted 7.5 years
after vaccination. In 1998, the American Association of Feline Practitioners published guidelines based on Scott's work, recommending vaccines every three years.

"The feeling of the AAFP is, cats that receive the vaccines every three years are as protected from those infections as they would be if they were vaccinated every year," said James Richards, director of the Feline Health Center at Cornell. "I'm one of many people who believe the evidence is really compelling."

Texas A&M's Wolf said the three-year recommendation "is probably just as arbitrary as anything else," and nothing more than a "happy medium" between vaccine makers' recommendations and the findings by Schultz and Scott aimed at reducing vaccine-related problems.

But many vets are uncomfortable making a drastic change in practice without data from large-scale studies to back them up. There is no animal equivalent of the U.S. Centers for Disease Control and Prevention, which monitors outbreaks of vaccine-preventable disease in people, thus keeping tabs on a vaccine's effectiveness.

Federal authorities require vaccine makers to show only that a vaccine is effective for a reasonable amount of time, usually one year. Richards notes that studies to get a feline vaccine licensed in the first place are
typically quite small, involving 25 to 30 cats at most.

There is no federal requirement to show a vaccine's maximum duration of effectiveness. Arne Zislin, a veterinarian with Fort Dodge Animal Health, the largest animal vaccine maker in the world, said such studies would be expensive and possibly inhumane, requiring hundreds of animals, some of them kept in isolation for up to five years.

"I don't think anyone with consideration for animals would really want to go through that process," said Zislin, another vet who believes current data are insufficient to support an extended schedule.

Diane Wilkie, veterinarian at Rice Village Animal Hospital, said she tells pet owners that vaccines appear to last longer than a year, but her office hasn't officially changed its protocol yet. She said 20 percent to 30
percent of her cat patients are on the extended schedule.

"It's kind of a hard situation. The manufacturers still recommend a year, but they're the manufacturers," Wilkie said. "It's hard to change a whole professional mentality -- although I do think it will change."

In Houston, yearly pet examinations typically cost $50 to $135, with shots making up one-third to half of the expense. A dental check, heartworm test, fecal check and overall physical are usually included in the price. Without the shots, vets could expect to lose a chunk of that fee.

But an increasing number of vets are emphasizing other services, such as surgery. Wolf said savings on vaccines might prompt pet owners to get their pets' teeth cleaned instead. An in-house test to check antibody levels is in development.

"I definitely think there's a profit issue in there; don't get me wrong," Wilkie said. "(But) people are willing to spend money on their pets for diseases. Although vaccines are part of the profit, they aren't that big a
part. We just did a $700 knee surgery."

 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Vaccination findings - Veterinary research challenges the notion that pets need to be vaccinated every 12 months. Some of the findings:

Dog vaccines/Minimum duration of immunity

• Canine rabies - 3 years
• Canine parainfluenza - 3 years
• Canine distemper (Onderstepoort strain) - 5 years
• Canine distemper (Rockborn strain) - 7 years
• Canine adenovirus (kennel cough) - 7 years
• Canine parvovirus - 7 years

Cat vaccines/Minimum duration of immunity

• Cat rabies - 3 years
• Feline panleukopenia virus - 6 years
• Feline herpesvirus - 5 or 6 years
• Feline calicivirus - 3 years
  

Recommendations for dogs

Parvovirus, adenovirus, parainfluenza, distemper: Following initial puppy shots, provide booster one year later, and every three years thereafter.

• Rabies: At 16 weeks of age, thereafter as required by law.
• Bordatella: Use prior to boarding; may be repeated up to six times a year.
• Coronavirus: Not recommended in private homes. Prior to boarding, may be given to dogs 8 weeks or older, and repeated every six months.
• Lyme: Not recommended.
• Giardia: Not recommended.

Recommendations for cats

• Panleukopenia, herpesvirus (rhinotracheitis), calicivirus: Following initial kitten shots, provide booster one year later and every three years
• thereafter.
• Rabies: At 8 weeks of age, thereafter as required by law.
• Feline leukemia: Use only in high-risk cats. Best protection is two vaccines prior to 12 weeks of age, with boosters repeated annually.
• Bordatella: Use prior to boarding.
• Feline infectious peritonitis: Not recommended.
• Chlamydia: Not recommended.
• Ringworm: May be used during an outbreak in a home.

Copyright 2002