MJ Wixsom: Vaccination schedule can be tricky
Published 6:01 pm Saturday, November 7, 2020
Doctor, which vaccines do I get up for Roxie?
While at many veterinary hospitals that would be an easy answer to an easy question, it is not at Guardian Animal Medical Center.
We shifted to a ‘not all vaccines every year’ protocol about two decades ago, but there are many clinics who still vaccinate for everything, every year.
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We took our guidance from Richard Ford, DVM an expert in vaccine immunity.
“The science is abundantly clear on this point,” Ford said. “While some vaccines must be administered annually to sustain a reasonable level of protective immunity, others – namely the core vaccines – provide years of protective immunity in the majority of dogs/cats that are vaccinated. There is simply no medical justification that warrants administering core vaccines to all pets annually.”
In 1996, the new vaccine protocols were considered revolutionary.
Now, it is estimated that half of the U.S. clinics use a less than annual booster for all vaccines. Although I still think the most important part of the annual exam is the physical exam, there are some vaccinations for dogs, cats and ferrets that are due every year.
All puppies and kittens need a series of vaccinations that do not end until they are over 16 weeks of age.
After that they get booster vaccinations at about the time of their birthday. Those vaccinations are routine and all of my staff can get them ready for me to check and administer. Starting on the second birthday, things get somewhat complicated.
In dogs, distemper, hepatitis (adenovirus), parvovirus and rabies all last well more than a year. Leptospirosis, Lyme vaccine, Bordetella and influenza are lucky to last a full year.
We had a dog that tested positive for Lyme disease that was only two weeks overdue for its annual booster.
When I called the tech support veterinarian, he said that Lyme really only lasts 50 of the 52 weeks in a year, which supports our long-term practice of trying to get boosters in three weeks before the one year mark.
In cats, feline rhinotracheitis, calicivirus, panleukopenia, chamdia and rabies have longer immunity from a vaccine series. Feline leukemia, Feline Infectious Peritonitis (FIP) have shorter durations of immunity.
While cat vaccines probably started the whole vaccine duration debate (because of feline vaccine related sarcomas), they are even more complex than dog vaccines. Feline vaccines come in adjuvant free and adjuvanted vaccines.
All adjuvant free vaccines only last a year, even if it vaccinates for one of the core vaccines. The adjuvant makes the vaccines last longer, but one cat per 10,000 to 30,000 vaccinations can develop a vaccine related tumor.
Because one in seven cats without vaccines can contract feline leukemia alone, this vaccine tumor risk is tiny compared to the risk of going vaccine-less. But it is greater than none. This is why an adjuvante free vaccine was created.
Dr. Ford believes that some veterinarians don’t follow the protocols because, “This is what I’ve always done and it works, so I’m going to keep doing it that way.” Ford also said some practices are driven by financial incentives to stick with annual core vaccinations, as annual “boosters” get pet owners into clinics at least once a year. Still others don’t believe or “They aren’t trusting the protocols,” he said.
Blood titers may have some role in the future of vaccines, but many of the current titer checks may not correlate with vaccine protection. It’s “emerging and it’s going to get a lot of attention in veterinary medicine.”
We may be vaccinating less, but vaccines are not going away. Recombinant technology can be used to prevent new and old infections, but also the treatment of disease.
We have a vaccine that treats oral melanoma for dogs. Having had two dogs that died of oral cancers, I think that is amazing! Imagine the future with a breast cancer or prostate cancer vaccine.
So, when a patient shows up for annual vaccinations, the prior vaccination status, the age, health, risk factors, exposure factors, geographic prevalence, history, maternal antibody interference, immunodeficiency, immunosuppressive therapy, concurrent disease, nutritional status, chronic stress and aging immune response all get taken into account and that requires the experience and knowledge of a caring veterinarian.
We once had a patient come in because it was mildly sick.
After fixing the problem, I mentioned that it was overdue for her vaccinations. The owners produced a vaccine record from a distant vet. They had driven to get cheaper vaccines.
Unfortunately, the only vaccines they had gotten were distemper, parvo and rabies. Those vaccines were not due for one or two years. But the leptospirosis (a more expensive vaccine and therefore not lways used) and bordetella were not done.
After discussing the risk factors, we vaccinated for the only two vaccines they were really due for.
Saving money on vaccines that are not needed allows us to do more of the things that are needed, like heartworm prevention, dental care and behavior counseling.
So, even for seemingly routine things, they really do need me and sometimes, less really is more.
MJ Wixsom, DVM MS is a best-selling Amazon author who practices at Guardian Animal Medical Center in Flatwoods, Ky. GuardianAnimal.com 606-928-6566