The American Animal Hospital Association (AAHA) recently issued its 2011 Canine Vaccination Guidelines. The 2003 report, revised in 2006 and 2007, caused quite a stir. Many veterinarians and pet parents didn’t trust the findings –and still don’t – even though the report was backed by scientific studies and written by 14 well-respected experts. Change can be scary.
The report’s recommendation to eliminate or limit many unnecessary and/or dangerous vaccines, and to give the important “core vaccines” no more often than every three years (NOT annually!), was and is unpalatable to many practices. It could represent a huge drop in income.
Though veterinary organizations and every North American vet school changed their vaccination protocols to accommodate the report’s findings, most clinics continue to over-vaccinate. Pet guardians still overpay for shots their pets don’t need and too many pets (and pocketbooks) suffer from the subsequent vaccine reactions.
The AAHA report contains good information and acts as a resource for pet guardians wanting to stand up to vets pushing shots their pets don’t really need. But this report is very conservative — with decisions made by committee. It doesn’t go as far as many of us would like. Important note: do not presume that your veterinarian abides by the report’s recommendations or that he/she has even read it.
Possible problems with the report
When reading any study, see who sponsored it and then look for possible conflicts of interest. This particular study was sponsored by four vaccine manufacturers: Merck, Merial, Pfizer and Boehringer Ingelheim. In addition, the AAHA has close financial ties to both veterinarians and sponsors. I am not suggesting bias, but in a perfect world, studies would be funded by disinterested parties, not by parties with a financial interest in decisions.
To arrive at a consensus, and to accommodate readers with the least vaccination expertise, individual taskforce members had to compromise. The consensus may or may not represent the personal view of any individual member.
For example, in 2003 task force member Dr. Richard Ford, Professor of Medicine, North Carolina State University, said that the decision to recommend a 3-year revaccination schedule for core vaccines was a compromise. “It’s completely arbitrary…,” he said. “I will say there is no science behind the three-year recommendation…”
Several committee members have personally told me this was a “political” decision, meant to ruffle the fewest veterinary feathers. (Read about vaccine duration of immunity at Vaccinating Dogs: 10 Steps to Eliminating Unnecessary Shots.)
I would have liked a section showing how taskforce members vaccinate their own dogs, just as the Supreme Court publishes ”dissenting opinions,” although this might have presented legal problems and required endless caveats.
Outside the report, renowned expert and taskforce member Dr. Ronald Schultz has a very different puppy vaccination protocol for his own family’s dogs. He uses only the three core vaccines: parvovirus, distemper and adenovirus-2 (hepatitis). He does not revaccinate every three years. He runs antibody titers on the pups to know exactly when is the best time to effectively vaccinate. Then, 2 to 3 weeks or more after vaccination, he titers (tests the blood of) the offspring. If there is ANY positive antibody response, he doesn’t revaccinate for the reminder of the pet’s life. (Before doing this yourself, listen to what he says during this YouTube video and consult your veterinarian. Advance 8 1/2 minutes into the video. Also find his cat vaccination advice there.)
Notable quotes from the report
My dear friend Kris Christine read this report and pulled out the following quotations of note. Kris is the founder of the Rabies Challenge Fund and a tireless activist who was largely responsible for helping every US state to switch from 1- and 2-year rabies vaccination schedules to 3 year (though sadly not all local laws have followed suit). Kris is currently working with other activists and state legislators to provide rabies vaccination exemptions for dogs with health problems. The fight goes on.
Note from Jan: I highlighted the important topics in the quotes below.
Don’t vaccinate dogs with health problems:
>p. 21 ”It is reasonable to avoid administration of any vaccine to patients with a history of systemic disease suspected to be associated with previous vaccination (e.g., immune-mediated hemolytic anemia, immune-mediated thrombocytopenia) or known to be caused by vaccine (vaccination-site cutaneous ischemic vasculitis after administration of rabies vaccine).
p. 28 ”As with pregnant dogs, veterinary medicine has advised against vaccination during illness, due to concerns about suboptimal protection, or worse, vaccine-induced illness.”
p. 29 “Manufacturers only recommend administration of vaccine to healthy dogs. Dogs receiving immunosuppressive chemotherapy should not be vaccinated. Doing so may result in a suboptimal immune response or may aggravate (reactivate) an immune-mediated illness.”
(Also read my article Vaccinating Unhealthy Pets: Beware Reactions & Vaccine Failure)
The difference between noninfectious (“killed” vaccines like rabies) and infectious vaccines (“modified live” vaccines like parvovirus and distemper):>
p. 3 ”When compared with infectious (attenuated, avirulent, modified live, recombinant viral vectored) vaccines, noninfectious vaccines are more likely to produce local and systemic adverse reactions in some dogs.”
p.10 ”Most noninfectious vaccines require at least two initial doses to immunize, regardless of the dog’s age. The first dose of a noninfectious vaccine generally primes the immune response and the second dose, which should be administered 2-6 weeks later, provides the protective immune response. Immunity typically develops approximately 7 days after the second dose. Therefore, the minimum time for onset of immunity is approximately 3 wk after administration of the first dose of a noninfectious vaccine”
p. 12 “Because dogs older than 14-16 wk of age are not likely to have interfering levels of MDA [maternally derived antibodies], administration of a single initial dose of an infectious vaccine to an adult dog can be expected to induce a protective immune response. ….. MDA is the most common reason early vaccination fails to immunize.”
p. 12 “The onset of immunity after administration of a single dose of infectious core vaccine is approximately 4±3 days in the absence of MDA [maternally derived antibodies].”
p.13 ”Infectious core vaccines are not only highly effective, they also provide the longest DOI [duration of immunity], extending from 5 yr up to the life of the dog.”
Note: see Box 1 beginning on page 14 of the report for more info.
Antibody titer testing (blood testing) to prove immunity
p. 17 ”Despite the confusion and controversy surrounding antibody testing, these serologic tests are useful for monitoring immunity to CDV, CPV-2, CAV-1, and RV. …..On completion of the puppy core vaccination series with the last dose given at 14-16 wk of age, a dog can be expected to have an antibody titer or positive test result, regardless of the serologic test performed, provided the serum sample is collected > 2 wks after the last dose of vaccine.” (CDV=distemper, CPV-2 = parvovirus, CAV-1 hepatitis, RV= rabies)
p. 18 “….the last dose of CDV and CPV should be administered at 14-16 wk of age. At this age, MDA should be at a level that will not block active immunity in most puppies (>98%) when a combination MLV vaccine is administered.”
p. 18 ”In a study reported in 1997, dogs vaccinated with a product containing CDV (canine distemper virus) and then placed in an environment without CDV maintained antibody titers for at least 10 yr.”
Adverse reactions:
p. 20 ”…the list that follows includes categories of adverse reactions that have been attributed to vaccine administration.
- Injection-site reactions: lumps (abscess, granuloma, seroma), pain, swelling, hair loss associated with ischemic vasculitis
- Transient postvaccinal nonspecific illness: lethargy, anorexia, fever, regional lymphadenomegaly, soreness, abortion, encephalitis, polyneuritis, arthritis, seizures, behavioral changes, hair loss or color change at the injection site, respiratory disease
- Allergic (hypersensitivity) and immune-mediated reactions: Type 1 (acute anaphylaxis): angiodema (especially the head), anaphylaxis (shock) and death; Type 2 (cytolytic): immune-mediated hemolytic anemia, immune-mediated thrombocytopenia (suspected only; causality has not been confirmed); Type 3 (immune-complex): cutaneous ischemic vasculopathy associated with rabies vaccine, corneal edema (‘blue-eye’) associated with CAV-1 vaccine, immune-mediated disease.
- Tumorigenesis: vaccine-associated sarcoma or other tumors
- Multisystemic infectious/inflammatory disorder of young Weimaraner dogs
- Vaccine-induced immunosuppression: associated with first or second dose of combination MLV vaccines containing CDV and CAV-1 or CAV-2 with or without other vaccines (e.g., CPV-2, CPI). Immunosuppression begins 3 days after vaccination and persists for 7-10 days. The suppression may be associated with increased susceptibility to other diseases.
p.33 ”Vaccine adverse events are significantly underreported in veterinary medicine.”
Minimal vaccination protocols
In answer to the question: “Is there a vaccination program that could be recommended for those owners only wanting the least number of vaccines possible or for those dogs that are not likely to be seen again by a veterinarian?”
p. 34 ”The vaccination protocol that includes the minimum number of vaccines yet still provides a reasonable opportunity to immunize the dog would be: a single dose of combined infectious (attenuated, avirulent, modified live, recombinant viral vectored) CDV, MLV CPV-2, with MLV CAV-2, administered at 16 wk of age or older, plus a rabies shot at the same time (but inoculated at a separate site on the body).
Note from Jan: It is important NOT to give the rabies vaccine with other vaccines or medications if at all possible. Renowned rabies vaccine experts and principals of the Rabies Challenge Fund, Drs. Ron Schultz (a member of the AAHA taskforce) and Jean Dodds both agree on this. The protocol above is for dogs not likely to be seen again by a veterinarian.” Both have also told me, and the AAHA report warns as well, about the dangers of adverse reactions for multiple vaccines given at once, especially for smaller and medium-sized breeds. Please read Vaccinating Small Dogs: Risks Vets Aren’t Revealing for the particular risks of giving multiple vaccines to small dogs.
Links of interest:
- A DVD: world-renowned scientists W. Jean Dodds, DVM and Ronald D. Schultz, PhD spoke at our Safer Pet Vaccination Benefit Seminar in March 2010. A 2-hour DVD of the event, along with articles by the speakers, is available here. Or learn more about it at http://www.dogs4dogs.com/saferpet. All proceeds less actual shipping costs benefit the study of the rabies vaccine.
- Learn more about rabies vaccination and about canine vaccination in general and read articles elsewhere on this blog.
- Read the 2011 AAHA Canine Vaccination Guidelines
- Read the World Small Animal Veterinary Association Guidelines for Vaccinating Dogs and Cats. This report addressed to a worldwide audience prepared by a small academic panel. Dr. Schultz sits on this panel in addition to the AAHA task force. Intervet-Schering Plough Animal Health sponsored the report.
As long as our regulatory bodies allow the pharmaceutical companies to licence their vaccines as a yearly vaccine, vets will be able to USE them as a yearly vaccine. That’s the bottom line. If vaccines show a DOI of a longer period and the labelling reflects that (I have one in front of me that SAYS…revaccinate annually with a single 1 ml dose), then vets will NOT be able to use them indiscriminately because that would be “off label” use. Vets are very big on not using things off label..and the labelling on the packaging – even when the companies have FUNDED studies that indicate a longer DOI..is a scapegoat for the vets to use them as a practice management tool to get people in the door. “I have to recommend yearly vaccination because that’s how the product is labelled, therefore…excess vaccination is not MY fault..I’m required to use product as labelled!”
The label is no excuse any more. EVERY vet school in North America, the AVMA, the AAHA and WSAVA — that is, ALL the recognized authorities, recommend vaccinating with core vaccines no more often than every three years. If you’re worried about liability, you can always get a letter of informed consent from your clients. There will come a time in the near future when the “label excuse” will backfire. Please read this from a vet who is also an attorney. http://www.dogs4dogs.com/vaccination-informed-consent
The real problem lies with not one entity of regulatory veterinary medicine taking a stand to provide science based vaccine protocols. The only one coming close to performing the necessary work to establish these protocols is Dr. Ron Schultz and like Jan said, he has been saying for over 30 years now that repeating the vaccines is not necessary.
Dr. Ford and Dr. Schultz have both made comments that the AVMA needs to do more, to step up to the plate. However, the AVMA nor the AAHA really has any policing powers over the vets. As Dr. Schultz has stated, the vets do not have to listen to me or take my recommendations. I know that only the individual state veterinary medical boards have the power to enforce vaccination protocols.Dr. Ford has pointed out that corporate veterinary businesses were highly unlikely to embrace new vaccination recommendations due to lost revenue. It really is all about the bottom line is business.
Over servicing clients with veterinary vaccines for their pets, this really is a matter of deception, as it is deceiving to the public to solicite for a vaccine the client doesn’t need for their companion animal. The only mandated vaccine is for rabies, so all the others, there is no mandate for despite what clients are often lead to believe otherwise.
Over servicing of the veterinary clients with vaccines for their pets, using the vaccines as a profit center is a nonhealing wound on the profession. Dr. Alice Wolf calls it unethical. Dr. Bernard Rollins calls it “abased practice”. When the over servicing fills the practice coffers then with vaccine induced disease, as repeating vaccines will do as warned by Dr. Schultz, I believe the extortion of money to treat those vaccine induced diseases is now a criminal act and called “extortion”.
Many of the veterinarians recognize this “addiction to vaccines” and one Orange County Veterinarian who has a 2 million dollar a year vaccine based practice was “afraid it was going to be taken away from him”.
The very sad truth is these vaccines are not safe, they are not necessary and most never even proven effective in affecting infectious disease rates in the first place.
This sounds “scandalous” at first, but is quickly confirmed once due diligence is preformed on the subject. Problem is there is little time available for due diligence by the profession when there is so much vaccinating into disease taking place.
This is the INCONVENIENT TRUTH about medicine in general and veterinary medicine is no different.
Sincerely,
Dr. Jordan
I think the real problem lies with the pharmaceutical companies, who really do have a strong profit motive. They rate the vaccines for 1 year immunization, and the vets just do what any sensible doctor would do in order to protect him/herself from possible lawsuits – they recommend yearly vaccines. As a breeder, I’ve worked out a sensible solution with my vet – she recommends the vaccines every year and sends me a reminder card, and I administer the vaccines myself every 3 years. That way, she has covered herself by recommending what the pharmaceutical companies rate the drugs at, but I do what I feel is best for my dogs. I think that most vets really do put the interest of the animal first, but they are all small business people, and thus have to do whatever they can to prevent a financial/legal crisis. Imagine, though, what would happen to Pfizer’s profit line if, all of a sudden, vets could safely go from recommending yearly vaccines to every 3 years.
I am interested, though, in the comments about puppy shots. I’ve always believed that puppies need the series of 3 shots, followed by one more a year later, before beginning the 3-year regimen. Is there really research to show that only one shot is necessary? If so, what is the recommended regimen from birth through adulthood?
Charlie, there is plenty of research showing only one puppy shot is necessary. Vaccinations do not have to be boosted – one is enough to protect. Noted immunologist Dr. Ronald Schultz vaccinated puppies for distemper just once and merely a few hours before placing them in a room with distemper infected dogs and 100% of the puppies were protected. As long as maternal antibodies do not block the vaccine, the puppy will be protected – most likely for life.
You might want to read this for more information: http://www.dogsnaturallymagazine.com/taking-the-risk-out-of-puppy-shots/
My point was simply that your article is painting all Veterinarians with the same brush. As well as you go as far to say that their not reading or “staying abreast of the research”.
Everyone in our clinic, including our receptionists have read the New AAHA Vaccine Recommendations. I don’t know of any clinic in our area that has not received/read the report.
Our vets recommend titres if dosing >3 year intervals, with our results ranging from non protective levels to levels lasting anywhere from 3-6 years. Without titre measurement you cannot tell which dogs need the more frequent dosing.
Veterinarians have to observe all the research that is available, not just one source.
And I do agree with you immunology is definitely not simply straight forward
I agree with the 3 year core vaccinations, that’s what our clinic does. But highly disagree with the comment that vets are pushing vaccines…due to we don’t want to lose income.
When and where did it come from that Veterinarians are just out for money/income. The Veterinarians I’ve worked with/know are mostly concerned with the welfare and health of the pet…not the money…
Again like everything else you get a few bad apples and the world paints everyone else with the same brush.
Due to articles like this, people will believe that Veterinarians have a secret agenda in trying to get you to spend money, whether or not it will harm your pet.
Really?
How many people vaccinate they children? Its the same thing…you just don’t get a bill at the end…the government does.
If you don’t agree with vaccines, then welcome back the major disease with open arms!
Thanks for your reply Ashley. Please note that Dogs Naturally works closely with veterinarians who have left practices because many clinics are more concerned with the bottom line than our pets. There are many vets however who do try to do well by our pets. The issue with these vets is that they rely on pharmaceutical companies to make vaccine and immune decisions for them which is a very slippery slope. For example, you are happy with three year core vaccines when newer guidelines recommend five years. Furthermore, Dr. Ronald Schultz pretty much solidified the fact that core vaccines last for at least 7 years and most likely for the life of the animal well over 30 years ago – and still vets advocate vaccines every three years. Not only that, but Dr. Scultz once again proved through challenge studies that puppies that were vaccinated with the distemper vaccine and placed in a room with distemper infected adults within hours were all protected. It is painfully obvious that only one distemper shot is necessary, and this likely applies to all core vaccines, yet vets like those you work for continue to vaccinate puppies three or four times, again at a year and then every three years afterward. This information is out there for all to see and it is what prompts Schultz to state that veterinarians are not educated enough to make even the most basic immunology decisions.
So, whether a vet chooses to vaccinate needlessly either through ignorance or deliberate intentions matters not. If they are putting themselves in the position of protecting our dogs, then they are obligated to stay abreast of the research.
As for welcoming diseases back with open arms, nearly every newly emerging disease (and there is an enormous amount of them) today is due to retroviruses in vaccines. On that note, we would never have had to deal with canine parvovirus if we didn’t vaccinate dogs for distemper – it was a feline retrovirus in the distemper vaccines that caused the parvo break throughout the world. Polio is enjoying a resurgence in Africa, thanks to vaccination with modified live viruses. I’m afraid immunology isn’t as straight forward as most people think.