Vaccines and Vaccinations:
While most of us are accustomed to annual vaccines for our pets. Recently, several studies have been conducted to see if this is truly the safest and most effective schedule, or if other vaccine protocols may be safer and as effective. Based upon these studies, we have started recommending the following protocol for pet vaccines. We divide our vaccine recommendations into CORE and NON-CORE (optional) vaccines. We feel that all pets, regardless of whether they live strictly indoors or strictly outdoors should receive the same core vaccines. Non-core vaccines are then added in as appropriate for the pet and the environments it lives in or visits.
CORE VACCINES: Puppy series: Distemper, Adenovirus2 (Adenovirus type 2 - also protects against canine hepatitis virus [H]), Parainfluenza, and Parvo virus: dose at 5 - 7 weeks of age, repeat at 2 months, 3 months, 4 months, and 16 months of age. Rabies vaccine administered with DA2PP at 4 and 16 months. Then routine boosters for Rabies and DA2PP at three year intervals.
NON-CORE / SPECIAL PURPOSE VACCINES:
Leptospirosis is a systemic (whole body) bacterial infection picked up from urine of wild canines, squirrels, rabbits, farm animals or stagnant water. The vaccine is given only to at risk pets at 3, 4, and 16 months with annual boosters. Some experts are starting to believe that Leptospirosis should be "CORE" for all dogs in Indiana and certain other states, at least for breeds not at high risk for serious allergic reactions. Lepto vaccine tends to be less potent (not 75 - 80 % effective, and rarely provides protection beyond 13 or 14 months, requiring an annual booster) than vaccines against viral diseases, and also more likely to trigger severe allergic reactions, especially in pugs, dachshunds, and some other individual dogs.
Lyme disease vaccine (Lyme disease is transmitted by deer ticks) given only to at risk pets at 3, 4, and 16 months with annual boosters [also a bacterin].
Bordetella (Bordetella is one form of kennel cough) given when needed as first dose (anytime after 4 weeks), boosters given every six months for at risk pets, otherwise within six months of boarding (we will continue to honor the vaccine administered at this clinic for twelve months for dogs that we board).
PorphoroVax ["Dental Vaccine"]: a new (2007) vaccine for the prevention (and treatment?) of tooth loss, periodontal disease, and associated medical problems. An optional vaccine that may provide the greatest benefit to toy breed dogs and other dogs at specific risk for dental disease. This vaccine which requires two doses the first year (ideally in dogs < 2 years old) then one dose every six to twelve months (manufacturer recommends annual boosters, some veterinary dentists see more benefit in dogs that receive the vaccine every six months).
Influenza Vaccine: [Dog Flu Vaccine]: new in 2009, this vaccine appears to be safe as only minimal reactions have been reported. The vaccine is being recommended for any dogs that spend significant time in boarding or dog day care facilities and for dogs that visit dog shows. Sight hounds (Greyhounds, Whippets, Deerhounds, Wolfhounds, Borzois, Italian Greyhounds, etc.) appear to be at especially high risk for serious complications from canine influenza and therefore benefit the most from the vaccine.
CORE VACCINES: Feline Panleukopenia (Distemper Virus), Calicivirus, Rhinotracheitis, vaccines (Distemper three way/FDVCR) at 5 - 7 weeks of age, boosters at 2, 3, 4 and 16 months of age then every three years. Annual Rabies vaccines starting at 3 to 4 months of age with an adjuvant free vaccine (we will switch to a three year vaccine if a safe adjuvant free three year product becomes available).
NON-CORE/SPECIAL PURPOSE VACCINES:
Feline Leukemia Vaccines for all kittens at 2 and 3 months of age with boosters annually if pet is "at risk" (spends time outdoors unsupervised).
Feline CaliciVax - "Hot Calici": a new vaccine (2007) for a specific strain of Calici virus not included in the traditional 3 or 4 - way vaccines listed above. "Hot Calici" has been a particularly troublesome viral infection at times, and has a significant fatality rate in exposed animals. [Problem: current research shows that each outbreak of "Hot Calici" is a new, random mutation of one of the few thousand strains currently circulating in the cat population. Only one manufacturer is currently producing this vaccine: using one European strain and one common American strain, and the current vaccine is made using an older style of production involving a chemical adjuvant]. We are not currently commending this vaccine as it has been shown to have limited effectiveness against actual outbreaks of "Hot Calici".
Other cat vaccines: Mycoplasma (Pneumonitis Virus), Feline Immune Deficiency Virus, Feline Infectious Peritonitis Virus, Ringworm fungus, Giardia, feline Bordetella are available commercially, however, we do not currently believe that there is enough evidence of benefit/effectiveness to warrant use of these products.
FERRETS: Canine Distemper at 5 - 7 weeks, 2 months, 3 months, 15 months, then every two years.
Rabies annually starting at 3 months (we will extend interval if a ferret approved product becomes labeled for longer period in the ferret).
These are our recommendations only, owners wishing to continue with the more traditional protocol, or with annual rabies vaccine in dogs may continue to do so.
This protocol change should not be interpreted to mean that pets should only receive veterinary check ups every three years. Since pets age at approximately four to eight years for every year that we age, annual comprehensive check ups will continue to be a critical component to pet health maintenance, twice yearly exams are recommended for our geriatric pets (pets are considered senior citizens at 7 years of age). We may also recommend additional testing or even more frequent health checkups for some of our patients with special medical needs* to help further ensure their continued health and long life.
* Patients with periodontal (dental) disease, hyper- or hypo- thyroid conditions, diabetes, kidney disease, or chronic skin disease/allergy conditions are among the patients that may need special monitoring at more frequent intervals such as every three to four months.
* Vaccine Reactions:
While relatively rare, vaccine reactions are a significant factor in determining which vaccines are appropriate for which animals. I tend to lump reactions into two broad categories: Allergic and non-Allergic reactions.
Allergic Reactions are the most severe acutely: and can be further broken down by degree of severity. All of the allergic reactions will generally respond well to treatment as long as it is started immediately. Severe anaphylactic reactions are the most dangerous and demanding as it may not be possible to address therapy toward all organ systems at the same time, still anaphylacis usually will respond to extensive oxygen, fluid, and anti-inflammatory therapy.
1) Vaccine site lump: the slowest and mildest reaction - rarely bothering the pet at all. A small mass or lump may be detected at the vaccine site from one day to three weeks after the vaccine is administered. In most cases, the lump will resolve in approximately the same time frame as it appears (a day to a few weeks). this particular type of allergic reaction is generally not associated with a progression to other forms of allergic reactions.
2) Hives, Acute dermatitis. Usually showing up within two hours of a vaccine and presenting as an "uncomfortable pet". There will be significant itching or biting at the skin, there may be visible puffy areas developing on the belly, in the hair coat, or on the ears. Untreated, it may progress to the next level.
3) Neurangio-facial edema: an exaggeration of the "hive" reaction above with the puffy area primarily affecting the head and ears, especially the muzzle, lips, and eyelids. Untreated, it may progress to the next level.
4) Anaphylaxis: essentially a "puffiness" or fluid build up in the internal organs. Most commonly affected are the lungs (labored breathing, wheezing, respiratory arrest), kidneys and liver (not easily noticed in the early stages), heart (rapid, irregular heart beat). while this may be seen occasionally as an extension from the conditions mentioned earlier, it is my experience that in highly sensitive animals, it usually occurs first, generally within three to fifteen minutes of the vaccine.
Non-allergic vaccine reactions are more factor of the body responding to one or more components of the actual vaccine. Two are commonly reported:
1) Lethargy/malaise: Loss of appetite, laying around, sometimes having muscle aches, fever, generally "not feeling right" is a reaction to the "antigen load". The body is recognizing and trying to fight off an infection (even if the "infection" is already "dead" - as in high titer killed vaccines). To some degree this is a normal reaction and is fairly common even if usually mild enough not to be noticed. Certainly, any symptoms lasting beyond 12 hours should be reported to your veterinarian.
2) Persistent lump at the vaccine site: In some pets, especially cats, a lump will appear at the vaccine site and last longer than three weeks. In cats, a well documented series of events has been identified in which some adjuvants (chemicals added to the injection - most commonly chemicals added to killed vaccines to help the body produce a better immune reaction), or other material in the injection, set up a very long lasting irritation which leads to malignant transformation in the connective tissue in the area - the formation of a tumor. Any lump lasting longer than three weeks should be examined. Persistent lumps should be biopsied and if warranted, removed by wide surgical excision.
3) Vaccine Failure: a rare, and even more rarely reported "reaction" is actually no immune system reaction at all to the vaccine. The most common contributor is an inappropriate vaccine schedule in young animals - failing to booster vaccines often enough to exceed the maternal immunity (the "passive immunity" conferred to babies at the time of birth from their mother). In many young animals, maternal immunity will completely destroy the first one or even two doses of vaccine before the animal's own immune system can respond to produce protective immunity. Other causes of vaccine failure include poor health/immune suppression (physically not able to produce an immune response due to existing health issues, some medications, or severe stress), and lack of vaccine antigen presentation (no active vaccine component for the body to respond to due to poor manufacturing, improper vaccine storage, improper administration of the vaccine, etc). The major veterinary vaccine manufacturers thoroughly test every batch for proper antigen content, and monitor every step in their storage and shipping processes.
4) Vaccine associated disease is likely the rarest "reaction" and almost never seen today. In this case, the vaccine has not been properly "attenuated" (weakened), or killed. The vaccine contains active disease and instead of preventing an infection, causes the infection. This can be the hardest "reaction" to prove, as it is difficult to determine if the patient was exposed to the disease a few days before the vaccine and happened to be "incubating" an active infection, therefore coincidentally showing up with the disease a few days after the vaccine. Major veterinary vaccine suppliers extensively test their vaccines for appropriate attenuation and use specific strains which can be genetically compared to the infection in suspicious cases. In many cases, vaccine suppliers are switching to recombinant DNA technology so that the vaccines do not contain any of the disease agents that they are designed to prevent.
Finally: not all vaccines trigger the same protective reactions in the body. For reasons that are not easily understood, some vaccines (Rabies, Canine Distemper, Canine Parvo, Feline Panleukopenia, and Feline Leukemia) seem to produce "sterilizing" immunity in the body. With these vaccines, after a successful vaccine series, the disease organisms are not able to produce a persistent infection in the body, and the disease is "thrown off" without any evidence that exposure occurred. Other vaccines, in particular the upper respiratory diseases: Bordetella and Influenza in dogs, Rhinotracheitis and Calici virus in cats, the vaccine stimulates an immune response, which helps minimize or prevent illness, but does not fully prevent infection.