The
following article is one of the many reasons for our strict Vaccination
Protocol. The article contains a lot of medical terms, which are hard to
understand by someone, who does not have a medical background. The
summary is, it is dangerous to vaccinate breeds that are predisposed to
adverse vaccine reaction, with multiple vaccines at the same time.
We have made our
vaccination schedule part of our contract and if you do not follow our
vaccination protocol,
you will void
the Health Guarantee of your puppy.
Sadly, sometimes people neither listen nor read the contract carefully
to understand each single paragraph of it.
If
your new veterinarian wants to vaccinate your puppy other than according
to our vaccination schedule, please either stand your ground and have
him/her only give the vaccinations indicated above or look for a
different veterinarian.
Vaccination
Protocols for Dogs
Predisposed to
Vaccine Reactions
W. Jean Dodds, DVM
There is increasing evidence in veterinary medicine
that vaccines can trigger immune mediated and other chronic disorders (i.
e., vaccinosis), especially in certain apparently predisposed breeds.
Accordingly, clinicians need to be aware of this potential and offer
alternative approaches for preventing infectious diseases in these
animals. Such alternatives to current vaccine practices include:
measuring serum antibody titers; avoidance
of unnecessary vaccines or
over vaccinating; and using caution in vaccinating ill,
geriatric, debilitated, or febrile individuals,
and animals from breeds or families known to be
at increased risk for immunological reactions.
Fortunately, the most common effect of vaccine administration is the
stimulation of an immune response that conveys protection for that
disease. This outcome has resulted in the widespread reduction in
morbidity and mortality from the many infectious diseases that have
plagued both animals and humans. Despite these intended benefits,
however, vaccination does carry with it attendant risks.
Adverse Effects of Vaccines
As the most commonly recognized adverse effect of vaccination is an
immediate hypersensitivity or anaphylactic reaction, practitioners are
less familiar with the more rare but equally serious acute or chronic
immune mediated syndromes that can occur. The veterinary profession and
vaccine industry have traditionally emphasized the importance of giving
a series of vaccinations to young animals to prevent infectious
diseases, to the extent that this practice is considered routine and is
generally safe for the majority of animals. Few clinicians are prepared,
therefore, for encountering an adverse event and may overlook or even
deny the possibility. Beyond the immediate hypersensitivity reactions,
other acute events tend to occur 24 to 72
hours afterward, or 7 to 45
days later in a delayed type immunological response.
Even
more delayed adverse effects include mortality from canine distemper
antibodies in joint diseases of dogs. The increasing antigenic
load presented to the host individual by modified live virus (MLV)
vaccines is presumed to be responsible for the immunological challenge
that can result in a delayed hypersensitivity reaction. The clinical
signs associated with non-anaphylactic vaccine reactions typically
include fever, stiffness, sore joints and abdominal tenderness,
susceptibility to infections, neurological disorders and encephalitis,
autoimmune hemolytic anemia (AIHA) resulting in icterus, or immune
mediated thrombocytopenia (ITP) resulting in petechiae and ecchymotic
hemorrhage. Hepatic enzymes may be markedly elevated, and liver or
kidney failure may occur by itself or accompany bone marrow suppression.
Furthermore, MLV vaccination has been associated with the development of
transient seizures in puppies and adult dogs of breeds or crossbreeds
susceptible to immune mediated diseases, especially those involving
hematological or endocrine tissues (e. g., AIHA, ITP, autoimmune
thyroiditis). Postvaccinal polyneuropathy is a recognized entity
associated occasionally with the use of distemper, parvovirus, rabies,
and possibly other vaccines. This can result in various clinical signs,
including muscular atrophy, inhibition or interruption of neuronal
control of tissue and organ function, incoordination, and weakness.
Therefore, we have the responsibility to advise companion animal
breeders and caregivers of the potential for genetically susceptible
littermates and relatives that are at increased risk for similar adverse
vaccine reactions.
Commercial vaccines, on rare occasion, can also be
contaminated with other adventitious viral agents, which can produce
significant untoward effects such as occurred when a commercial canine
parvovirus vaccine was contaminated by blue tongue virus. It produced
abortion and death when given to pregnant dogs and was linked causally
to the ill advised but all too common practice of vaccinating pregnant
animals. Hepatic enzymes may be markedly elevated, and liver or kidney
failure may occur by itself or accompany bone marrow suppression.
Furthermore, MLV vaccination has been associated with the development of
transient seizures in puppies and adult dogs of breeds or crossbreeds
susceptible to immune mediated diseases, especially those involving
hematological or endocrine tissues (e. g., AIHA, ITP, autoimmune
thyroiditis). Postvaccinal polyneuropathy is a recognized entity
associated occasionally with the use of distemper, parvovirus, rabies,
and possibly other vaccines. This can result in various clinical
signs, including muscular atrophy, inhibition or interruption of
neuronal control of tissue and organ function, in-coordination, and
weakness.
Therefore, we have the responsibility to advise companion
animal breeders and caregivers of the potential for genetically
susceptible littermates and relatives that are at increased risk for
similar adverse vaccine reactions. Commercial vaccines, on rare
occasion, can also be contaminated with other adventitious viral agents,
which can produce significant untoward effects such as occurred
when a commercial canine parvovirus vaccine was contaminated by blue
tongue virus. It produced abortion and death when given to pregnant dogs
16 and was linked causally to the ill advised but all too common
practice of vaccinating pregnant animals. The potential for side
effects such as promotion of chronic disease states in male and non
pregnant female dogs receiving this lot of vaccine remains in question,
although there have been anecdotal reports of reduced stamina and renal
dysfunction in performance sled dogs.
Recently, a vaccine manufacturer
had to recall all biological products containing a distemper component,
because they were associated with a higher than expected rate of central
nervous system postvaccinal reactions 1 to 2
weeks following administration.
If, as a profession, we
conclude that we are over vaccinating, other issues come to bare, such
as the needless client dollars spent on vaccines, despite the well
intentioned solicitation of clients to encourage annual booster
vaccinations so that pets also can receive a wellness examination.
Giving annual boosters when they are not necessary has the client paying
for a service which is likely to be of little benefit to the pet’s
existing level of protection against these infectious diseases. It also
increases the risk of adverse reactions from the repeated exposure to
foreign substances.
Polyvalent MLV vaccines, which multiply in the host, elicit a stronger
antigenic challenge to the animal and should mount a more effective and
sustained immune response. However, this can overwhelm the immune
compromised or even healthy host that has ongoing exposure to other
environmental stimuli as well as a genetic predisposition that promotes
adverse response to viral challenge.
The recently weaned young
puppy or kitten being placed in a new environment may be at particular
risk.
Furthermore, while the
frequency of vaccinations is usually spaced
2 to 3 weeks apart, some veterinarians have advocated vaccination once a
week in stressful situations. This practice makes little sense,
scientifically or medically. An augmented immune response to
vaccination is seen in dogs with preexisting inhalant allergies (i. e.,
atopy) to pollens. Furthermore, the increasing current problems with
allergic and immunological diseases have been linked to the introduction
of MLV vaccines more than 20 years ago. While other environmental
factors no doubt have a contributing role, the introduction of these
vaccine antigens and their environmental shedding may provide the final
insult that exceeds the immunological tolerance threshold of some
individuals in the pet population.
Predisposed Breeds
Twenty years ago, this author began studying families of dogs with an
apparent increased frequency of immune mediated hematological disease (i.
e., AIHA, ITP, or both).
Among the more commonly recognized predisposed breeds were the Akita,
American cocker spaniel, German Shepherd Dog, Golden Retriever, Irish
setter, Great Dane, Kerry blue terrier, and all
Dachshund and Poodle
varieties; but predisposition was found especially in the Standard
Poodle, longhaired Dachshund, Old English Sheepdog, Scottish Terrier,
Shetland Sheepdog, Shih Tzu, Vizsla, and Weimaraner, as well as breeds
of white or predominantly white coat color or with coat color dilution
(e. g., blue and fawn Doberman pinschers, the merle Collie, Australian
Shepherd, Shetland Sheepdog, and harlequin Great Dane). Recently,
other investigators have noted the relatively high frequency of AIHA,
ITP, or both in American Cocker Spaniels and Old English Sheepdogs.
A significant proportion of these animals had been vaccinated with monovalent or polyvalent vaccines within the 30 to 45 day period prior to
the onset of their autoimmune disease. Furthermore, the same
breeds listed above appear to be more susceptible to other adverse
vaccine reactions, particularly postvaccinal seizures, high fevers,
and painful episodes of hypertrophic osteodystrophy (HOD).
For animals
that have experienced an adverse vaccine reaction, the recommendation is
often to refrain from vaccinating these animals until at least after
puberty, and instead to measure serological antibody titers against the
various diseases for which vaccination has been given. This
recommendation raises an issue with the legal requirement for rabies
vaccination.
As rabies vaccines are strongly immunogenic and are
known to elicit adverse neurological reactions, 3,5 it would be
advisable to postpone rabies vaccination for such cases. A letter from
the primary care veterinarian stating the reason for requesting a waiver
of rabies vaccination for puppies or adults with documented serious
adverse vaccine reactions should suffice.
Recommendations
Practitioners should be encouraged during
the initial visit with a new puppy owner or breeder to review current
information about the breed’s known congenital and heritable traits.
Several databases, veterinary textbooks, and review articles contain the
relevant information to assist here. For those breeds at increased risk,
the potential for adverse reactions to routine vaccinations should be
discussed as part of this wellness program. Because breeders of at risk
breeds have likely alerted the new puppy buyer to this possibility, we
should be mindful and respectful of their viewpoint, which may be more
informed than ours about a specific breed or family issue. To ignore or
dismiss these issues can jeopardize the client patient relationship and
result in the client going elsewhere for veterinary services or even
turning away from seeking professional care for these preventive health
measures. As a minimum, if we are unaware of the particular concern
expressed, we can research the matter or ask the client for any relevant
scientific or medical documentation. The accumulated evidence indicates
that vaccination protocols should no longer be considered as a “one size
fits all” program.
For these special cases, appropriate
alternatives to current vaccine practices include: measuring serum
antibody titers; avoidance of unnecessary vaccines or over vaccinating;
using caution in vaccinating sick, very old, debilitated, or febrile
individuals; and tailoring a specific minimal vaccination protocol for
dogs of breeds or families known to be at increased risk for adverse
reactions. Considerations include starting the vaccination series later,
such as at 9 or 10 weeks of age, when the immune system is more able to
handle antigenic challenge; alerting the caregiver to pay particular
attention to the puppy’s behavior and overall health after the second or
subsequent boosters; and avoiding revaccination of individuals already
experiencing a significant adverse event. Littermates of affected
puppies should be closely monitored after receiving additional vaccines
in a puppy series, as they, too, are at higher risk. Altering the puppy
vaccination protocol, as suggested previously for the Weimaraner, is
also advisable.
Following these
recommendations may be a prudent way for our profession to balance the
need for individual patient disease prevention with the age old
physician’s adage, forwarded by Hippocrates, of
“to help, or at least do no harm.”
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