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For many veterinary practitioners canine
vaccination programs have been "practice management tools" rather
than medical procedures. Thus, it is not surprising that attempts to
change the vaccines and vaccination programs based on scientific
information have created great controversy and unique methods of
resistance to the proposed changes have been and are being
developed. For some practitioners the issues are not duration of
immunity for the vaccines, nor which vaccines are needed for the
pet, instead it is felt that every licensed vaccine should be given
to every pet on an annual or more often basis. Ironically this is
fostered by the fact that multivalent products with 7 or more
vaccine components can be purchased for the same price or less than
a product with one or two vaccine components. A "more is better"
philosophy prevails with regard to pet vaccines. On many occasions
practitioners say that "I know many of the vaccines I administer
probably aren't needed but it won't hurt to give them and who knows
the animal may need them some time during their life because of
unknown risk." I have also been told by many practitioners that "I
believe the duration of immunity for some vaccines like distemper,
parvovirus and hepatitis is many years, but until I find another way
to get the client into my office on a regular basis I'm going to
keep recommending vaccines annually." Annual vaccination has been
and remains the single most important reason why most pet owners
bring their pets for an annual or more often "wellness visit." The
importance of these visits for the health of the pet is exceptional.
Therefore, dog owners must understand the vaccines are not the
reason why their dog needs an annual wellness visit. Another reason
for the reluctance to change current vaccination programs is many
practitioners really don't understand the principles of vaccinal
immunity. A significant number of practitioners believe:
1) the annual revaccination
recommendation on the vaccine label is evidence the product provides
immunity for (only) one year. - Not True
2) that they are legally required to
vaccinate annually and if they don't they will not be covered by A
VMA liability insurance if the animal develops a vaccine preventable
disease - Not True. Furthermore, certain companies will not provide
assistance if practitioners don't vaccinate annually with core
vaccines. Not True - In fact most of the companies have now
demonstrated their core products provide at least 3 years of
immunity .
3) that not revaccinating will cause the
animal to become susceptible soon (days or a few weeks) after the
one vear. - Not True
4) if the animal is not revaccinated at
or before one year the "whole vaccination program needs to be
started again". - Not True
5) if they don't continue to revaccinate
annually, diseases like canine distemper, canine parvovirus and
infectious canine hepatitis (CA V-I) will "reappear and cause
widespread disease similar to what was seen prior to the development
of vaccines for these diseases." - Not True
6) that if the revaccination "doesn't
help, it won't hurt." - Not True
7) that giving a vaccine annually that
has a duration of immunity of 3 or more years provides much better
immunity than if the product is given only once during the three
years. - Not True In fact, there are regional/state rabies programs
that suggest annual rabies vaccination programs provide better
protection than revaccination once every three years regardless of
whether a 1 year or 3 year rabies product is used. - Not True
8) that parvovirus vaccines only provide
six months of immunity, thus they must give them semi- annually and
the CPV -2 vaccines need to be given with coronavirus vaccine to
prevent enteritis. - Not True
9) "It's much cheaper to revaccinate the
pet annually than it is to treat the disease the animal will develop
because it didn't get revaccinated annually." The "better safe than
sorry" philosophy - It is less expensive to prevent disease.
However, if the core vaccines are given as a puppy and again at a
year of age, then annual vaccination is not needed. Furthermore, if
a vaccine is given that is not needed and it causes an adverse
reaction that is unacceptable and very expensive.
10) they need to revaccinate all new
dogs/cats coming to their clinic irrespective of vaccination history
even when vaccination records are available from another clinic.
Presumably the "other clinic" used the wrong vaccine or didn't know
how to vaccinate. - Not True
11) "Dogs need to be revaccinated
annually up to 5 to 7 years of age, then and only then would
vaccination every three years be okay.." - Not True
12) "Surgical procedures, including
anesthesia, are immunosuppressive thus dogs should be vaccinated
prior to or shortly after surgery." - Not True
13) "Because boarding kennels require
annual or more often (kennel cough every 3 to 6 months) vaccination,
practitioners must continue vaccinating annually with all vaccines."
- Not True- help change the kennel rules through education and just
use the vaccines that need to be given (eg Kennel Cough.)
Note: There are kennels that require
every licensed vaccine and the vaccines must have been given within
1 year or less prior to admission - help change these rules! Those
kennels that are members of the American Kennel Association should
be following the AAHA Guidelines, but many kennels do not belong to
this association.
It will be necessary to correct many of
these and additional misunderstandings by providing education to
veterinary practitioners, kennel owners and pet owners before
significant changes in vaccination programs can or will occur to
reduce the over-vaccination of both cats and dogs. However it is
equally important that we don't, in our efforts to prevent
over-vaccination, fail to vaccinate often enough, fail to vaccinate
all or as many pups with the core vaccines, fail to use products
that are necessary, or to use products that don't provide protection
in our pets.
I believe every practitioner, kennel
owner and dog owner should know the following general information
about canine vaccines and vaccination programs. What vaccines are
needed for all puppies? I do mean all pups, as we only
vaccinate 50% of dogs. If we could increase this percentage to 75%,
we would be able to eliminate many of the diseases prevented by core
vaccines. The "core vaccines," those that every pup should receive
and identified as core by most canine vaccine experts in the United
States, include: 1) Canine Parvovirus type 2 (CPV -2), 2) Canine
Distemper virus (CDV), 3) Canine Adenovirus type 2 (CA V-2), 4)
Rabies Virus (RV). When do the core vaccines need to be given?
As a minimum, puppies should be given at least one dose at 16
weeks of age or older. Preferably, they should be given three or
more times starting at 6 to 9 weeks then at an interval of 2 to 4
weeks revaccinate 9 to 12 weeks then again at 14 to 16 weeks. It is
critical that the last dose be given at 14 to 16 or more weeks of
age. It is important not to give them earlier than 6 weeks unless
there is a significant risk of a specific disease, then give only
the vaccine for the disease you want to prevent (e.g. CPV -2). Never
vaccinate a pup less than 4 weeks of age. The most effective canine
core products currently include modified live and recombinant
vaccines alone or in combination. The combination products with
CPV-2, CDV and CAV -2 currently often include canine parainfluenza
(CPI) virus. New "core only" products have been and are being
developed that don't have CPI, however, the CPI will not cause a
problem if and when used as a parenteral 5 way combination product.
After the puppy series is completed,
revaccination is recommended again at one year of age or one year
after the last puppy vaccination. Rabies must be given again at 1
year, then every 3 years, whereas, the other core vaccines need not
be given again for at least 3 or more years. There is no benefit
from annual rabies vaccination and most one year rabies products are
similar or identical to the 3-year products with regard to duration
of immunity and effectiveness. However, if they are 1 year rabies
vaccines, they must be legally given annually! Rabies vaccine is the
only canine vaccine requiring a minimum duration of immunity study.
However, revaccination annually does not necessarily improve
immunity. However, annual vaccination does significantly increase
the risk for an adverse reaction in the dog. I would recommend, if
you really want to be sure the puppy vaccination program was
successful, that a CDV and CPV- 2 antibody titer be performed 2 or
more weeks after the last puppy vaccination. Laboratory tests as
well as "in-office test" for CDV and CPV-2 tests are available. If
there is no antibody, revaccinate and perform a test two or more
weeks after revaccination. If you still don't have antibody, change
the product and vaccinate again. Antibody tests (titers) are very
useful at these times to ensure the animal is immunized. The problem
with antibody tests is they are very expensive, thus in general,
these tests won't be used. As an alternative to revaccinating at one
year for CD V, CPV -2 and CA V -2, I would revaccinate at 6 months
to ensure the animal has responded rather than waiting until 1 year.
Then, revaccinate not more often than every 3 years. The minimum
duration of immunity for the core vaccines except rabies is at least
7 years based on challenge and/or titers (Table 1). Thus
revaccinating annually will not improve protection. Ironically "the
better safe than sorry philosophy" can be equally applied to less
vaccination, since the animal that develops an adverse reaction
(e.g. hives, facial edema, anaphylaxis) from a vaccine that wasn't
needed is an example of "being sorry, not safe!"
What about all the other vaccines
currently available for the dog? They are non-core or optional
vaccines that should only be given to animals that need them and
only as often as needed. There are also some vaccines that are
not recommended for any dogs. The duration of immunity is not
known for certain non-core products, the efficacy is limited or not
known and the risk vs. benefit factors are not always well
established nor understood. The minimum duration of immunity for
Leptospira vaccines is probably less than one year, thus if
required for a high risk dog, they may need to be given as often as
semi-annually. Considering the low efficacy, the adverse event rate
and the minimal risk for leptospirosis in many regions of the US,
certain practitioners are not using the current products. However if
an animal is in a high-risk environment for leptospirosis, the
product to use should contain the 4 serovars (there is no
significant cross protection among the 4 current serovars) and the
animal should be vaccinated starting not earlier than 12 weeks of
age, revaccinate in 2 to 4 weeks, revaccinate at 6 months of age,
revaccinate at a year of age and then you may have to revaccinate as
often as every 6 to 9 months for optimal protection. Using this
program the animal should not develop clinical disease but it can
get infected and shed organisms in its urine. Bordetella immunity
may be less than one year and the efficacy for the products is not
well established. Many animals receive "kennel cough" vaccines that
include Bordetella and CPI and/or CAV-2 every 6 to 9 months without
evidence that this frequency of vaccination is necessary or
beneficial. In contrast, other dogs are never vaccinated for kennel
cough and disease is not seen. CPI immunity lasts at least 3 years
when given intranasally, and CAV -2 immunity lasts a minimum of 7
years parenterally for CAV-I. These two viruses in combination with
Bordetella bronchiseptica are the agents most often
associated with kennel cough, however, other factors play an
important role in disease (e.g. stress, dust, humidity, molds,
mycoplasma, etc.), thus kennel cough is not a vaccine preventable
disease because of the complex factors associated with this disease.
Furthermore, this is often a mild to moderate self limiting disease.
I refer to it as the "Canine Cold." My preference when a kennel
cough vaccine is used is that it should be the intranasal rather
than the parenteral, but some dogs will not allow someone to
administer the vaccine intranasally.
There is a new virus of dogs, an
"equine-like influenza virus," that first infected greyhounds in
Florida in 2004 that caused respiratory disease. At this time it is
not known whether this virus, referred to as canine influenza virus
(CIV), is an important cause of canine respiratory disease, nor if
it will be an emerging disease of dogs. Questions about the role of
influenza virus or for that matter, viruses other than CPI and CAV -
2, bacteria other than Bordetella bronchiseptica, various
mycoplasmas and other factors causing kennel cough, which I refer to
as "Canine Respiratory Disease Complex," exist and must be answered.
The geographic distribution of Lyme
disease would suggest vaccination would only be of benefit in
certain regions of the US, thus widespread use of this product is
neither necessary nor desired. Although Wisconsin is an endemic area
for Lyme disease, we have used very few doses of Lyme vaccines in
our VMTH and we have not seen significant numbers of cases of Lyme
disease. However in certain areas of western and northwestern
Wisconsin and eastern Minnesota, many cases of confirmed Lyme
disease are seen in both vaccinated and unvaccinated dogs. Tick
control for prevention and antibiotics for treatment must be used in
high risk areas. Immunity to Lyme vaccines have been shown
experimentally to last up to one year. Giardia is a new vaccine that
may be of value in certain circumstances, but there have not been
adequate field studies to demonstrate the need nor the benefit of
this vaccine. To date no one has demonstrated a benefit for
coronavirus vaccine. In the vaccination guidelines from the American
Animal Hospital Association, neither Giardia nor Coronavirus
vaccines are recommended unless they can be proven to be beneficial
for a specific animal. There are also new vaccines for snakebites
(Crotalus sp.) and for periodontal disease (Porphyrius sp.)
and a therapeutic vaccine for treatment of canine melanomas.
At present most canine core vaccines are
given more often than needed, but a few non-core vaccines probably
not often enough to be of benefit. Also, many vaccines are given
that are not needed or that cannot be shown to provide a benefit for
the specific animal. Vaccines are medical products that should only
be given if needed and only as often as is necessary to provide
protection from diseases that are a risk to the health of the
animal. If a vaccine that is not necessary causes an adverse
reaction that would be considered an unacceptable medical procedure,
thus use only those vaccines that are needed and use them only as
often as needed.
Vaccination programs are changing and
they will continue to change. The vaccination program must be
tailored to the individual animal. Vaccines are medical products
that should not be used as practice management tools. My general
philosophy is to vaccinate more animals in the population, but
vaccinate with only those vaccines that the animal needs and only as
often as required to maintain protective immunity. For some products
vaccination may occur once or twice in a life time, whereas for
other products it may be every 6 to 9 months.
Be wise and immunize, but immunize
wisely!
|
Table 1: Minimum Duration of Immunity for
Canine Vaccines |
|
Vaccine |
Minimum Duration
of Immunity |
Methods Used to
Determine Immunity |
|
CORE VACCINES |
|
Canine Distemper Virus (CDV) |
|
|
|
Rock born Strain |
7 yrs/15 yrs |
challenge/serology |
|
Onderstepoort Strain |
5 yrs/9 yrs |
challenge/serology |
|
Canarypox Vectored rCDV |
3 yrs/4 yrs |
challenge/serology |
|
Canine Adenovirus-2 (CAV -2) |
7 yrs/9 yrs |
challenge-CAV-l/serology |
|
Canine Parvovirus-2 (CPV
-2) |
7 yrs/10 yrs |
challenge/serology |
|
Canine Rabies |
3 yrs/5 yrs |
challenge/serology |
Why Vaccination Programs are Changing
Why, when you know from personal
experience that life-long immunity exists for many human vaccines,
do you have great difficulty believing a canine vaccine can provide
life-long immunity? Perhaps I and my colleagues that teach
immunology to veterinary medical students have failed to explain the
basics of vaccine induced "immunologic memory." Immunologic memory
is as the term implies the immune system's ability to remember the
vaccine antigens that it has seen at an earlier time in life,
allowing the immune system to respond in a manner that will protect
you or your dog from specific infections and/or diseases.(1,2)
Immunologic memory is responsible for
the duration of immunity that develops after recovery from natural
infection/disease and after vaccination with modified live virus (ML
V) or killed virus (KV) vaccines. Similarly bacterial infections and
vaccines or bacterins (killed bacterial vaccines) provide
immunologic memory. However, in general, immunologic memory to
killed viral vaccines and to bacterial vaccines (or bacterins) is
not as long lived as it is to ML V vaccines. The duration of
immunity or length of immunologic memory varies among the agents
causing the diseases. For example, our immunologic memory for
measles virus is life-long. How do we know that it is lifelong? No
one has published any controlled studies, but we know after
recovering from measles infection and/or vaccination with a ML V
vaccine, immunity is life-long because people rarely get measles
even though they rarely receive another dose of vaccine. In contrast
to the ML V vaccine, the killed measles vaccines that were used for
a short period of time about 25 years ago failed to give life-long
immunity. Many individuals receiving killed vaccines were either
inadvertently infected or had to be revaccinated with a ML V when
they were 15 to 20 years of age to provide life long immunity. How
many people do you know that were vaccinated with the modified live
measles virus product, in use for approximately 40 years, or that
had measles as a child, then developed measles later in their life?
I'm sure your answer must be very few or none!
A very similar story to measles can be
told for canine distemper virus (CDV) in the dog. CDV is in the same
virus family as measles virus and it shares many similarities with
MV. As you may know, MV vaccines have been and were available until
recently for dogs to prevent disease (not infection) caused by CDV.
Those of you over the age of 50, may remember canine distemper when
it was a devastating disease killing many animals with more than 50%
of infected puppies often dying from the disease. If you are old
enough, were observant enough and had an opportunity to follow dogs
that recovered from natural infection with CDV you know that dogs
recovering from CDV, like their human counterpart recovering from
measles, rarely, if ever, developed acute distemper during the rest
of life, even when not revaccinated. Like measles immunity in
humans, immunity from canine distemper infection confers immunologic
memory resulting in life- long immunity. How do I and my older,
wiser and now retired colleagues and canine infectious disease
experts, Dr. Max Appel, Dr. L.E. (Skip) Carmichael, and Dr. Larry
Swango know that distemper immunity is life long? We know because we
had the opportunity to follow dogs that recovered from infection
with CDV or puppies that were vaccinated once or twice with MLV CDV
and lived for 7 or more years and never developed disease even
though they were exposed to CDV via natural outbreaks or
experimental challenge with CDV. We also know the vaccinated or
recovered dogs had life long immunity because we and others
performed antibody titer tests for years on the dogs after they
recovered from infection or after puppy vaccination. These dogs all
had titers showing that immunologic memory was present. Most of the
dogs had titers that provide sterile immunity (protection from
infection) much like the measles titers found years later in many
vaccinated or naturally infected people. However even if the dogs
didn't have sterile immunity but still had antibody, they had
immunologic memory. An antibody titer no matter how low shows the
animal has immun9logic memory since memory effector B cells must be
present to produce that antibody. Some dogs without antibody are
protected from disease because they have T cell memory, that will
provide cell mediated immunity (CMI). CMI will not protect from
reinfection, but it will prevent disease. When an animal is antibody
negative it may have T cell immunologic memory, but I generally
consider a CDV antibody negative dog not to be protected, therefore,
I recommend revaccination!. Some researchers, including myself, have
had the opportunity to follow the duration of immunity for dogs
living in natural or experimental environments that are free of CDV
and CPV-2 (6). Why is it important that observations are made on
dogs and cats that are not exposed to the virus? Because in those
environments it is possible to demonstrate that immunologic memory
is independent of natural or overt stimulation with the wild type
virus or the vaccine virus. However, in a normal environment where
infection occurs, "natural vaccination" or exposure
and infection with the specific agent
can and does occur at least for certain agents and in certain
animals, but the infected animals do not get sick. Ironically when
animals have "sterile immunity" their immune system is rarely
boosted by natural exposure since infection does not occur. If
infection does not occur, there is no stimulation of the specific
memory T or B cells, thus the antibody titer does not increase. A
severe outbreak ofCPV-2 occurred in a large commercial breeding
kennel, where more than 90% of puppies got sick and 50% of puppies
from 4 weeks to 24 weeks of age died. However, none of more than 50
dams with sick and dying puppies had a significant increase in
antibody titer, none had virus in their feces and none showed
clinical signs of CPV -2 disease, all excellent indicators the dams
had sterile immunity (did not get infected)!
Is immunologic memory and duration of
immunity to all human viruses life-long? The answer is NO! Natural
infection with many human viruses and the vaccines for those viruses
provide life- long immunity (e.g. measles, mumps, rubella), whereas
other viruses and/or the vaccines for them provide short duration of
immunity (e.g. human cold viruses, influenza virus) and for
additional viruses there is no immunity from infection or
experimental vaccines (e.g. HIV).
The three most important viral
infections of dogs all provide life-long immunity, they are CDV,
CPV-2, and CAV-I. If a puppy is immunized with the three MLV
vaccines used to prevent these diseases, there is every reason to
believe the vaccinated animal will have up to life-long immunity!
The vaccines that prevent the diseases caused by these 3 viruses
plus rabies vaccine are the "Canine Core Vaccines" or those vaccines
that every puppy should receive. My own dogs, those of my children
and grandchildren are vaccinated with ML V CDV, CPV-2, CPI, and
CAV-2 vaccines once as puppies after the age of 12 weeks. An
antibody titer is performed two or more weeks later and if found
positive our dogs are never again vaccinated. I have used this
vaccination program with modifications (CAV-2 replaced CAV-I
vaccines in 1970's and CPV-2 vaccines were first used in 1980) since
1974! I have never had one of our dogs develop CDV, CAV-1 or CPV-2
even though they have had exposure to many dogs, wildlife and to
virulent CPV-2 virus. You may say that I have been lucky, but it is
not luck that protects my dogs, it is immunologic memory.
An important factor contributing to life
long immunity in addition to the memory T and B cells and the
"memory effector B cells" (long lived plasma cells) of the specific
(adaptive) immune system is the innate immune resistance associated
with age. It is well known in all species that the young animal is
more susceptible to infection and disease than a mature animal. In
the case of human infections that period of increased susceptibility
is often 'the first few years of life, and especially the first
year. In the puppy and the kitten it is often the first 3 to 6
months of life, but it can be up to 1 year of age that the animal is
more susceptible to disease. For example, dogs less than a year of
age are much more likely to develop severe parvoviral disease than
susceptible (immunologically naive) dogs over one year of age even
though at both ages the animals are very susceptible to infection
with CPV -2. Similarly a susceptible cat less than one year of age
and especially cats less than 3 months of age are at much greater
risk of becoming persistently infected with feline leukemia virus
than a susceptible cat that is greater than one year of age at the
time of infection. Thus innate as well as specific immune factors
contribute to age- related resistance and these factors are highly
complex and not completely understood. However, age related
resistance plays a critical role in life-long or long term immunity.
This does not imply that older dogs and cats cannot get infected and
develop disease, it is that they are much less likely to get disease
when compared to the younger animal.
I and my colleague, Dr. Fred Scott,
first proposed a three year revaccination program for dogs and cats
more than 25 years ago, when we published an article in Veterinary
Clinics of North America 8(4) 755-768, 1978. Today, a three year
revaccination program has been recommended in the AAHA Canine
Vaccination Guidelines and the American Association of Feline
Practitioners Vaccine Guidelines for Cats. The proposed change for
revaccination with "Core Vaccines" from annual to triennial
revaccination has been very controversial for many reasons, however,
the reasons have little or nothing to do with "immunologic memory"
or duration of immunity. No one has nor can anyone in the future,
show that there is any immunologic benefit from annual revaccination
with MLV CDV, CAV or CPV-2. In fact, it may even be difficult to
show an immunologic benefit for revaccination at three year
intervals since most animals have long term immunity for CDV, CAV-1
and CPV-2. Some among you are probably convinced that there is life
long immunity to certain vaccines used in dogs and cats, but few of
you after many years of performing annual revaccination are willing
to take the risk, however small it may be, to adopt the puppy
vaccination program. However, you should feel confident that
adopting, a three year revaccination program for CDV, CAV and CPV-2,
will not increase the risk for diseases caused by these 3 viruses,
just as a once every three year revaccination, rather than annual
revaccination, with the killed rabies vaccines does not increase the
animal's risk for rabies.
You and your veterinarian will need to
determine what vaccines and vaccination program is best for your pet
and their patient respectively. The program selected may only
include core vaccines that are given once in the lifetime of the dog
or the program may include all vaccines with revaccination on an
annual or more often basis, or it may be a vaccination program in
between these two extremes depending on what your pet's needs are
and what, in the medical judgment of your veterinarian, is best for
their patients. Furthermore, it is likely your decision depend on
the life style of your pet, its medical history, health status, age,
pregnancy status and other important factors.
FREQUENTLY ASKED QUESTIONS (FAQ)
1. Is there a risk of
over-vaccinating a pet (e.g. injecting it too often, or using
vaccines that are not required for the specific pet)?
Yes - Vaccines should not be given
needlessly, as they may cause adverse reactions. Vaccines are
medical products that should be tailored to the needs of the
individual animal.
2. May I mix different types of
vaccines in the syringe?
No - One should never mix different
vaccine preparations in the syringe unless specified by the data
sheet.
3. May I co-inject different vaccines
(not part of a single commercial product) into the same animal?
Yes - but different vaccines should be
injected into separate sites that are drained by different lymph
nodes.
4. May I use smaller vaccine doses in
small breeds to reduce the risk of adverse reactions?
No - The volume (e.g. 1.0 ml) as
recommended by the manufacturer generally represents the minimum
immunizing dose, therefore the total amount must be given.
5. Should the large dog (Great Dane)
be injected with the same volume of vaccine as the small dog
(Chihuahua)?
Yes - Unlike pharmaceuticals that are
dose-dependent, vaccines are not based on volume per body mass
(size), but rather on the minimum immunizing dose.
6. May I vaccinate the anaesthetized
patient?
It is best not to do this if possible -
the patient may develop a hypersensitivity reaction and vomit,
leading to an increased risk of aspiration. Also, anaesthetic agents
may be immunomodulatory .
7. May I vaccinate pregnant pets?
No - Vaccination with ML V and killed
products during pregnancy should be avoided, if at all possible.
8. May I vaccinate pets that are on
immunosuppressive or cytotoxic therapy (e.g. for cancer or
immune-mediated diseases, such as those with an autoimmune or
hypersensitivity pathogenesis)?
No - Vaccination especially with ML V
products should be avoided as they may cause disease; vaccination
with killed products may not be effective or may aggravate the
immune-mediated disease.
9. How long after stopping
immunosuppressive therapy do I wait before vaccinating a pet?
A minimum of 2 weeks.
10. May I vaccinate every week if an
animal is at high risk of disease?
No - Vaccines should not be given more
often than every other week, even when different vaccines are being
given.
11. When should the last vaccine dose
be given in the puppy and kitten vaccine series?
The last dose of vaccine should be given
at around 16 weeks of age.
12. May I inject a killed vaccine,
followed at a later time with a ML V for the same disease?
No - The killed vaccine may induce an
effective antibody response that will neutralize the ML V in the
vaccine, thereby preventing immunization. It would be preferable to
give the ML V vaccine first and if/when needed, revaccinate with the
killed vaccine preparation.
13. May I inject a modified live
intranasal Bordetella vaccine?
No - The vaccine can cause a severe
local reaction and may even kill the pet.
14. May I give a killed Bordetella
vaccine destined for parenteral use intranasally?
No - This will not stimulate a specific
response to the Bordetella; you should give a live vaccine
via the intranasal route, as specified by the data sheet.
15. Are precautions necessary when
using MLV FHV-I/FCV parenteral vaccines in cats?
Yes - Mucosal (e.g. conjunctival and
nasal) contact with the preparation must be avoided, because the
vaccine virus can cause disease.
16. Can nosodes (holistic
preparations) be used to immunize pets?
No - Nosodes
cannot be used for the prevention of any disease. They do not
immunize because they do not contain antigen.
17. Should dogs and cats with a
history of adverse reaction or immune-mediated diseases (hives,
facial oedema, anaphylaxis, injection site sarcoma, autoimmune
disease, etc.) be vaccinated?
If the vaccine suggested to cause the
adverse reaction is a core vaccine, a serological test can be
perfonned, and if the animal is found seropositive (antibody to CDV,
CPV-2, FPV) revaccination is not necessary. If the vaccine is an
optional non-core vaccine (e.g. Leptospira bacterin)
revaccination is discouraged. For rabies, the local authorities must
be consulted to detennine whether the rabies vaccine is to be
administered by law or whether antibody titre may be detennined as
an alternative.
18. May I use different vaccine
brands (manufacturers) during the vaccination program?
Yes - It may even be desirable to use
vaccines from different manufacturers during the life of an animal,
because different products may contain different serotypes (e.g. of
feline calicivirus).
19. Should I use a disinfectant (e.g.
alcohol) on the injection site?
No -
The disinfectant might inactivate an ML V product, and it is not
known to provide a benefit.
20. Can vaccines cause autoimmune
diseases?
Vaccines themselves do not cause
autoimmune disease, but in genetically predisposed animals they may
trigger autoimmune responses followed by disease - as can any
infection, drug, or a variety of other factors.
21. May I split vaccines in
combination products?
Yes -
For example, Leptospira bacterins are often the diluent for
the viral antigen combination. The "viral cake" may be resuspended
in sterile water, and the Leptospira bacterin be given
separately at another site or time, or discarded.
22. Will a single vaccine dose
provide any benefit to the dog or cat? Will it benefit the canine
and feline populations?
Yes -
One dose ofa MLV canine core vaccine (CDV, CPV-2 CAV-2) or a feline
core vaccine (FPV, FCV, FHV-1) should provide long term immunity
when given to animals at or after 16 weeks of age. Every puppy and
kitten 16 weeks of age or older must receive at least one dose of
the MLV core vaccines.
If that were done, herd (population)
immunity would be significantly improved. Even in the USA with its
good vaccination record, probably <50% of all puppies and <25% of
all kittens ever receive a vaccine. We must vaccinate more animals
in the population with core vaccines to achieve herd immunity (e.g.
75% or higher) and prevent epidemic outbreaks.
23. When an animal first receives a
vaccine that requires two doses to immunize (e.g. killed vaccines
like Leptospira bacterins or feline leukemia virus), and it
does not return for the second dose within ~6 weeks, is there any
immunity?
No - A single dose ofa two-dose vaccine
does not provide immunity. The first dose is for priming the immune
system, the second for boosting. If a second dose is not given
within 6 weeks of the first, the regime must start again, making
sure the two doses are given within 2 to 6 weeks. After those two
doses, revaccination with a single dose can be done at any time.
24. May I give a MLV product to a
wild, exotic species or to a domestic species other than to the ones
which the vaccine was licensed to protect?
No - Never. Many MLV vaccines have
caused disease in animal species other than those for which they had
been licensed. Even worse: the vaccine could be shed from those
animals, regain virulence through multiple passages and cause
disease even in the target species for which it had been developed.
The consequences could be catastrophic!
A highly effective and very safe vaccine
for species that are susceptible to CDV is a canary
poxvirus-vectored recombinant CDV vaccine that is available as a
monovalent product for ferrets or a combination product for dogs.
The monovalent vaccine is being used in many wild and exotic species
susceptible to CDV.
25. May I vaccinate a puppy that is
at high risk of getting CDV with a human measles vaccine?
No - Due to an insufficient amount of
virus, the human MV vaccine is not immunogenic in the puppy. Measles
virus vaccines made specifically for the dog (sometimes combined
with CDV) will give temporary protection at an earlier age than a
CDV vaccine. At 16 weeks or older, the puppy must be vaccinated with
a CDV vaccine, to achieve permanent immunity.
26. I know that maternally
derived antibodies (MDA) can prevent active immunization with MLV
vaccines - but can they also block immunity to killed vaccines?
Yes - MDA can indeed block
certain killed vaccines. If the killed product requires two doses,
as is often the case, and the first dose is blocked by MDA, then the
second dose will not immunize. In this circumstance, the second dose
will prime (if not blocked), and a third dose is required to boost
and immunize.
This is not true for MLV,
where - in the
absence of MDA -
it only takes a single dose to prime, immunize, and boost.
Nevertheless two doses are often recommended, particularly in young
animals, to be sure one is given when MDA cannot block. That is why
in the puppy or kitten series, the last dose should be given
at around 16 weeks of age or later.
27. I have been told that certain
canine MLV combination core products need only be given twice, with
the last dose at an age as young as 10 weeks. Is that accurate?
No - it is not. No combination core
product currently available will immunize an acceptable percentage
of puppies when the last dose is given at 10 weeks of age. The last
dose should be given at around 16 weeks of age, regardless of the
number of doses given earlier.
In the presence of MDA, MLV vaccines
either immunize or they don't, and the animal will be either immune
or not immune - there is nothing in between. MLV vaccines do not
give a little immunity with any dose when blocked by MDA.
28. For how long can a reconstituted
MLV vaccine sit at room temperature without losing activity?
At room temperature, some of the more
sensitive vaccines (e.g. CDV, FHV-1) will lose their ability to
immunize in 2 to 3 hours, whereas other components will remain
immunogenic for several days (e.g. CPV, FPV).
29. May I give the same type of
vaccine parenterally and intranasally, for example the canine and
feline vaccines used to prevent respiratory diseases ('kennel cough'
and feline upper respiratory disease)?
Yes -
But be sure to give the product approved for that route. If you use
the parenteral MLV vaccines containing FCV and FHV-1 locally, you
could cause disease in the cat. If you use the killed FCV and FHV-1
vaccines locally, you would not get any immunity and might cause
significant adverse reactions. If you gave the intranasal live
'kennel cough' vaccine parenterally, you could cause a severe
necrotizing local reaction and even kill the dog, whereas giving the
parenteral killed Bordetella vaccine intranasally will not
immunize and may cause a hypersensitivity reaction.
However, both types of products can be
given at the same time or at various times in the life of the
animal. Vaccinating both parenterally and intranasally may actually
provide better immunity than vaccinating at only one site. Thus
parenteral vaccination provides protection in the lung but little or
no immunity in the upper respiratory tract (especially local
secretory IgA and CMI), whereas intranasal vaccination will engender
good secretory IgA and local CMI and non-specific immunity (e.g.
type I interferons), but will not always provide immunity in the
lung.
30. Are there dogs and cats that
cannot develop an immune response to vaccines?
Yes -
This is a genetic characteristic seen particularly in some breeds,
and these animals are called 'non-responders'. Genetically related
(same family or same breed) animals will often share this
non-responsiveness. If the animal is a non-responder to a highly
pathogenic agent, like canine parvovirus or feline panleukopenia
virus, the infected animal will die if infected. If it is a
non-responder to a pathogen that rarely causes death, it may become
very sick but will survive (e.g. after a Bordetella
bronchiseptica infection).
31. Are there mutants (biotypes or
genotypes) of CDV or CPV-2 in the field that the current vaccines
cannot provide protective immunity against?
No. - All the current CDV and CPV-2
vaccines provide protection from all the known isolates of CDV or
CPV-2, respectively, when tested experimentally as well as in the
field.
32. How long after vaccination does
it take for the dog to develop immunity that will prevent severe
disease when the core vaccines are used?
This is dependent on the animal, the
vaccine, and the disease.
-
The fastest immunity is provided by
CDV vaccines - MLV and recombinant canarypox virus vectored. The
immune response starts within minutes to hours and provides
protection within a day to animals without interfering levels of
MDA and dogs that are not severely immunosuppressed.
-
Immunity to CPV-2 and FPV develops
after as few as 3 days and is usually present by 5 days when an
effective ML V yaccine is used. In contrast, the killed CPV-2 and
FPV-2 vaccines often take 2 to 3 weeks or longer to provide
protective immunity.
-
CAV-2 MLV given parenterally would
provide immunity against CAV-1 in 5 to 7 days; when given
intranasally, however, the same level of immunity to CAV-1 is not
present until after 2 or more weeks.
-
Time from vaccination to immunity is
difficult to determine for FCV and FHV-1 because some animals will
not develop any immunity.
33. Will the current 'kennel cough'
vaccines provide any protection from disease caused by the new
canine influenza virus?
No -
The racing greyhounds that have been found infected and that
developed disease had been routinely vaccinated 3 or more times a
year with commercial 'kennel cough' vaccines. Canine influenza virus
is antigenically unrelated to any other virus of dogs, but related
to Equine Influenza Virus.
34. If an animal has gone beyond the
time that is generally considered to be the maximum DOl for the
vaccine (7 to 9 years for CDV, CPV-2, CAV-2; >1 year for
Leptospira, Bordetella bronchiseptica; >3 years for rabies), do
I have to start the series of vaccinations again (multiple doses 2
to 4 weeks apart)?
No -
For MLV vaccines, multiple doses are only required at the puppy or
kitten age, when an animal has MDA.
35. What can I expect from the core
vaccines in terms of efficacy in the properly vaccinated puppy/dog
and kitten/cat?
-
Dogs properly vaccinated with MLV or
recombinant CDV, CPV-2 and CAV-2 would have ≥98% protection from
disease. Similarly we would expect a very high protection from
infection.
-
For the properly vaccinated cat that
had received ML V vaccines, we would estimate that ≥98% would be
protected from disease and infection with FPV.
-
In contrast, we can expect FCV and
FHV-1 vaccines, at best, to protect from disease, especially in a
highly contaminated environment (e.g. shelter) and protection
would be seen in 60 to 70% in a high risk environment and higher
in the household pet cat.
36. Are serum antibody titres useful
in determining vaccine immunity?
Yes -
Especially for CDV, CPV-2 and CAV-1 in the dog, FPV in the cat and
rabies virus in the cat and dog. Serum antibody titres are of
limited or no value for the other vaccines. Assays for CMI are of
little or-no value for any of the vaccines for various technical and
biological reasons. Such factors are less of an issue for
serological tests where it is much easier to control many of the
variables. However, discrepant results are still obtained, depending
on the quality assurance program of the given laboratory.
37. Do puppies develop
immunosuppression after the initial series of core vaccines?
Yes - If a combination product
containing MLV-CDV and MLV-CAV-2 with other components is used, a
period of immunosuppression lasting approximately 1 week develops,
beginning 3 days after vaccination. If the combination vaccine does
not contain either MLV-CDV or MLV- CAV-2, then such suppression does
not occur.
Biographical Profile
Dr. Ron Schultz earned his BS
degree (1966), MS (1967) and PhD in Immunology and Veterinary
Pathology (1970) from the Pennsylvania State University. From 1970
to 1978 he was an Assistant then Associate Professor at NY State
College of Veterinary Medicine, James A. Baker Institute, Cornell
University. He established the first Veterinary Clinical Immunology
Laboratory in the US while on the faculty at Cornell. He also served
as Associate Director of the Human Health Service Laboratory at
Cornell University. From 1978 to 1982 he was a Professor and
Director of the Veterinary Clinical Immunology Laboratory that he
established in the School of Veterinary Medicine, Auburn University.
He accepted his current position as Professor and Chair of the
Department of Pathobiological Sciences, School of Veterinary
Medicine, UW- Madison in 1982. At the time he accepted this position
he was the only member of the department which now has many faculty,
staff and students, including faculty in the Wisconsin Veterinary
Diagnostic Laboratory. He is an honorary diplomate of the American
College of Veterinary Microbiologists. Dr. Schultz has won several
awards, is a member of numerous professional organizations and
served or serves on numerous Editorial Boards and National and
International advisory panels He is on the AAHA Canine Vaccine Task
Force, the AAFP Feline Vaccine Task Force that provide Guidelines
for Canine and Feline Vaccines and Vaccination Programs as well as
the Vaccine Guideline Group for the World Small Animal Veterinary
Association. He has served on National Academy of Science panel to
review USDA Grants Programs and was recently invited to be a Member
of the Assessment Panel to review research programs of the USDA's
Agriculture Research Service Laboratories throughout the US. He was
the first president of the American Association of Veterinary
Immunologists and has been president of the Conference of Research
Workers in Animal Disease. He has published more than 200 papers on
the immunology and microbiology of animal disease, clinical
immunology and vaccinology and has edited several books and holds
multiple patents. He has trained more than 50 graduate students and
postdoctoral fellows in his laboratories at Cornell, Auburn and
Wisconsin. He has received millions of dollars in extramural
research funds for research primarily to study diseases of dogs,
cats and cattle and also received funding for instructional training
programs.
See page 58 on
this web site for more detail:
http://www.akcchf.org/pdfs/whitepapers/CHFSummaryReport2007.pdf
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