Introduction
As part of my effort to practice medicine based solidly in scientific evidence, I regularly review my own practices and recommendations and make adjustments as seems indicated by new evidence. The quantity and quality of scientific research in veterinary medicine is often less than ideal, so absolute right or wrong answers are seldom clear. But over time changes in the available evidence sometimes justify changes in practice. One area in which this has been particularly true in the more than 15 years since I started in vet school is the subject of vaccinations for dogs and cats.
Unfortunately, the vaccination issue is all too often taken out of the realm of rational, science-based discussion and made part of ideological battles over different approaches to medicine that have little to do with a sound assessment of the risks and benefits of vaccines. This is unfortunate and unnecessary, but given the politicized nature of this topic, I will begin by stating my basic perspective before getting into the details.
I believe vaccines are one of the most successful and beneficial healthcare interventions ever developed. Like any real medicine, vaccines have risks as well as benefits, but history is unequivocal that vaccines have saved and improved the lives of humans and animals to a degree that dramatically overshadows any harm they have done. Most of the opposition to vaccination in the last decade, for children as well as for pets, has been irrational, unscientific, and pretty thoroughly baseless. The kinds of dangerously misguided and misinformed anti-vaccine positions of all too many proponents of alternative medicine are not based in science and represent a serious threat to the health of our pets.
With all of that said, the mainstream veterinary approach to vaccination has often not been soundly based in science either. Habit, inertia, and economic considerations have led some vets to ignore growing scientific evidence and continue giving some vaccines more frequently than necessary. The latest data I have been able to find, which is from 2006, suggests up to a third of small animal vets give certain core vaccines more often than is recommended (I’ll get into the details in a bit). This is far fewer than the majority sometimes claimed by critics of science-based medicine, but it is still an illustration of the resistance to change in routine practices even when good evidence supports the change.
So what does the evidence say about vaccinations for dogs and cats? What should they be vaccinated for? With which vaccines? How often? Not surprisingly, these are complicated questions with complicated, nuanced answers. Simple, one-size-fits-all rules may be convenient, but they don’t reflect the complex nature of biology. The best review so far of vaccination research concerning dogs is the 2011 American Animal Hospital Association Guidelines on Canine Vaccinations. For cats, the 2013 American Association of Feline Practitioners Vaccination Advisory Panel Report is a useful document. Both of these are consensus statements issued by a limited group of experts, and they don’t meet the standards of a fully transparent, systematic review of the evidence. But they do provide a good summary of existing research and a reasonable interpretation of the how the research might translate in vaccination practices.
Vaccination, like any medical therapy, needs to address the specific needs of the individual patient. One cannot make a decision about which diseases to vaccinate against until one has some understanding of which diseases a patient is at risk of getting. This involves considerations such as age, exposure to other animals, general health, and so on. Unfortunately, the specific risk of a particular disease in a given setting is not always known since there are no regular, systematic or comprehensive surveys of how common most cat and dog diseases are everywhere in the country. However, some general guidelines and the experience of practitioners in a given area can help give a crude idea of whether a particular patient is likely to be at risk for a particular disease and to benefit from vaccination for it.
Dogs
The AAHA guidelines for dogs categorizes vaccines as core, those that are most likely to be widely beneficial, because the diseases they protect against are common, and non-core, those which are only appropriate for dogs with specific know risk factors for a particular disease. The guidelines also assess the general efficacy and safety of particular vaccines and the available information on duration of protection, which helps us decide how often to repeat particular vaccines.
Based on this information, most puppies should have a series of vaccinations for canine distemper and parvovirus every 3-4 weeks from about 6 weeks of age to 16-18 weeks of age, one rabies vaccination after 12 weeks of age and boosters for these one year after the last in the puppy series.
Duration of protection is at least 3 years for most licensed canine rabies vaccines, and they are legally required in most places every three years for life. From a medical point of view, a reasonable argument can be made for less frequent rabies vaccination or for alternatives, such as monitoring antibody titers. But in most cases these alternatives are not legally permitted. This is a function of the fact that rabies is widely present in wildlife and nearly 100% fatal for humans (and all other mammals) who catch it, so the public health authorities choose to err on the side of caution when using vaccines to prevent transmission from dogs to humans.
Some research efforts are under way to try and support changes in these laws, so these rules may be altered at some point. However, it is important to remember that while the evidence suggests less frequent vaccination for rabies might be effective in protecting dogs (and humans), it also suggests that the current guidelines of revaccination every three years is safe and very, very unlikely to harm most dogs. While I would welcome an evidence-based change in the rules regarding rabies vaccination intervals, I do not think there are risks that justify defying the rules in the meantime.
For distemper and parvovirus, the other core vaccines, there is strong evidence that protection for most dogs lasts at least 5 years, and pretty good evidence for longer duration of immunity. The guidelines recommend repeating vaccination no more than every 3 years, and 3 years is the interval most commonly used today. However, longer intervals are probably justified. There is certainly no need for annual boosters, and this is a practice that really isn’t defensible scientifically.
Antibody titers can be useful in some cases, since a high titer does indicate a dog is protected and does not require additional vaccination. However, a low titer does not necessarily mean a dog is susceptible, so it is less useful in trying to decide when to revaccinate.
Given the length of protection, and some evidence that susceptibility to parvovirus is low in older dogs, most probably do not need to be vaccinated after about 8-10 years of age. There is clear evidence that older dogs do respond appropriately to vaccinations, and there is not evidence that they are more likely to be harmed by vaccines than younger dogs, so continuing to vaccinate after this age is not likely to be harmful, but it is probably unnecessary. In humans, there is evidence that older people may be more susceptible to some diseases than younger adults, and thus may be more in need of vaccination, but this hasn’t yet been demonstrated in dogs.
Given the degree of safety for most of these vaccines, if there is significant uncertainty about whether a given dog is protected or has had appropriate vaccination for these diseases, giving the vaccine is safer than not giving it.
The AAHA guidelines cover in detail many of the other available vaccines. Most are not regularly recommended, usually because the diseases they protect against are mild or uncommon or because the vaccines are of poor or uncertain effectiveness. Some are quite controversial, such as that for Lyme Disease. Most are only appropriate for dogs with particular risk factors, not for routine use on all dogs.
Cats
The AAFP guidelines for cats are similar to the AAHA canine recommendations, identifying core and non-core vaccines and providing general guidelines for use of these as well as suggestions for how to develop individualized vaccination recommendations. Most cats should have a series of vaccines for feline herpes virus (FHV) and calicivirus (FCV) and panleukopenia (FPV) between 6 and 20 weeks of age and boosters for this one year later. Thereafter, 3-year intervals are recommended for life, though there are a variety of factors that may alter this plan.
Feline leukemia vaccination is also recommended for most cats. While many indoor only cats may not be exposed to this disease, the recommendation is for all cats to have an initial vaccine and one year booster because it is not always possible to predict future lifestyle or exposure status for kittens. Boosters are recommended every 1-2 years depending on risk of exposure. Recommendations for other vaccines depend on the needs of individual cats. Other vaccines are assessed on a case-by-case basis.
In general, I recommend following these guidelines for the initial vaccine series and the one year booster. I often cease vaccination for strictly indoor cats after that, however this involves a thorough discussion of the possible risks. If a cat escapes every once in a while, for example, they should certainly be kept current on rabies vaccination. And, of course, if there are legal requirements for rabies vaccination, these should be followed. Cats that visit other cats or have visitors or new cats come into the household, cats who attend shows or are boarded, and cats with owners who interact with cats outside the household may benefit from vaccination even if they are strictly indoors.
The risks of vaccination are generally similar in cats as in dogs, and very small, with one significant exception. The evidence is stronger for the development of a very serious kind of cancer, called a sarcoma, associated with some vaccines in some cats. The risk of this is still very low (reported to occur following as few as 1/10,000 doses of vaccine to as high as 36/10,000 doses), but it is a very dangerous and often fatal disease. Changes have been made in the vaccine used in cats to try and reduce this risk, but it isn’t absolutely clear if these changes have lowered the risk. This disease needs to be considered when making vaccination decisions for individual cats, and certainly we need to make a serious effort to avoid unnecessary vaccination. However, irrational fear of this disease is not a good reason to subject cats to unnecessary risk from equally serious infectious diseases by avoiding appropriate vaccinations.
Conclusions
Because the scientific evidence is never perfect or complete, it is not unusual for different individuals to have different interpretations of it, and more than one of these may well be reasonable and appropriate. For example, I tend to recommend distemper and parvo boosters every five years, but there is nothing wrong with recommending these every three years.
On the other hand, the evidence is often sufficient to make some interpretation unreasonable. Annual boosters for these vaccines are almost never justified, and complete avoidance of them, or refusal to vaccinate adult dogs is not sound medical practice. The evidence may not always provide a single right answer, but it can help establish a range of reasonable options from which to choose.
My own vaccination practices have changed significantly during my career as a result of both changes in the evidence and new assessments of existing studies. The practice of evidence-based medicine requires regular re-assessment of the interventions we offer. Unlike in some domains, such as politics, changing one’s mind in science is understood to be a good sign, and indication that a good clinician is committed to providing the best science-based care possible. I always emphasize in this blog that our patients and clients deserve the best care, and that care is going to be treatments for which we have as much scientific evidence as possible to understand the real risks and benefits.
This applies to all veterinary interventions, conventional as well as alternative. I tend to focus on alternative therapies here partly because there is so little skeptical, critical information about them available to help pet owners make informed decisions and also because, frankly, they are quite often far less founded in science-based theory and evidence than conventional approaches. However, the same scientific standards of evidence should apply to all treatments regardless of their provenance. Accepted conventional practices need to be scrutinized as closely as alternative therapies. When there is some uncertainty about the evidence, I endeavor to apply this scrutiny just as I do for unconventional treatments. My articles concerning neutering, cruciate ligament disease, and stem cell therapy, in addition to this and previous discussions of vaccination, are examples of this.
Since my position on vaccines tends to be very similar to that of many proponents of alternative therapies, I thought it would be useful to discuss it explicitly here. There is a tendency to caricature and demonize those with whom we disagree on issues we feel strongly about. It is often assumed, for example, that I blindly give all dogs annual vaccinations because this is a stereotype image of veterinarians who are critical of alternative therapies. But of course a science-based evaluation of an intervention like vaccination can and should be every bit as thoughtful and focused on the needs of the individual and the risks and benefits of the intervention as alternative practitioners claim they are. I believe the science does not support annual boosters for core canine vaccines, so I no longer recommend them.
Similarly, it is tempting to assume all proponents of alternative therapies hold the most extreme anti-vaccine views espoused by members of their community, but that is likely inaccurate and unfair also. I see no reason to shy away from points of agreement with folks on some issues even when one has serious disagreement with them on others. Hopefully, such points of agreement might even act as bridges to allow more realistic and respectful communication and disagreement, though my experiences in this area haven’t led me to be very optimistic about that.
In any case, it happens that I often agree with the criticism of vaccination practices put forward by proponents of alternative medicine, if not always on the basis of the same reasoning or evidence. This will likely neither tarnish my credibility with skeptics nor improve it with proponents of alternative medicine, but hopefully it will illustrate that I am committed to following the evidence over ideology as best I can.
Another excellent article. I have a question about a non core vaccine; leptospirosis.
I live on Long Island. That’s in the southeastern portion of New York. I live in the suburbs and I know that wild critters run through my back yard at night; raccoons, opossums. We also have foxes in the neighborhood that I know have been in my front yard.
I have been getting the leptospirosis vaccine every year because of the wild critters that run through my property. I asked one of the vet techs if they had gotten lepto cases and she told me they have had a few. She said a few definites, some suspected, and some dogs didn’t leave the hospital alive.
My dog also has the disgusting habit of tasting foreign urine. Yuck! Sorry I had to say that. Please forgive me, but I wanted to give full details of facts that may be pertinent to my forthcoming question!
So, my question: under the aforementioned circumstances, would you recommend that I continue to get the yearly lepto shot, or not. Just for the record, I don’t think any of my neighbors are getting it. Oh, and one more thing; my dog is 6 years old and has handled the vaccine well without any reactions whatsoever.
Thanks, Skeptvet. You’re the best!
Good article on a subject that needs a realistic approach. The anti-vaxers jump on the common claims of yearly boosters as evidence that vaccinations are unnecessary and just a vets money making con to justify more general doubt in vaccinations.
I don’t know much about the prevalence of leptospirosis in your area, but if the local vets say that it is endemic in the wildlife in that area, then it certainly sounds like keeping your dog up to date on the vaccine is a good idea. We used to think it was mostly rural and hunting dogs who were at risk, but because of the intersection between wildlife and pets in suburban areas, this is actually one of the most common settings for lepto exposure, which fits your situation perfectly.
What is the best injection site location for vaccines? I’ve seen some vets do them all SQ behind the shoulders, and some do vaccines IM in the rear legs or lumbar muscles. I gather that many vets now do SQ injections for rabies on the right rear leg, and the combo vaccine SQ on the right front. I’ve been told we do this method at my local shelter just in case an injection site sarcoma does develop, you can easily amputate a limb. (I’m still pro-vaccination despite having a senior cat who developed – but survived – an injection site sarcoma on his back.)
Of the states that have rabies vaccine laws about 20 of them allow vets to write waivers to avoid revaccinating fully immunized pets.
See
Vaccinations can have adverse effects, studies show
By Rhonda L. Rundle
THE WALL STREET JOURNAL
July 31
After receiving a reminder in the mail from his veterinarian, Jim Schwartz took his 11-year-old poodle, Moolah, for her annual rabies shot. A few weeks later she fell ill and was diagnosed with an autoimmune disease. As her suffering worsened, Mr. Schwartz put her down.
THERE’S NO PROOF that the rabies shot killed Moolah and Mr. Schwartz didn’t immediately suspect any link. But when the retired financial planner learned that some veterinarians are vaccinating pets less frequently because of possible fatal side effects, he was furious. “No dog should have
to go through what Moolah did,” he says. Evidence is building that annual vaccination of dogs and
cats performed for diseases such as rabies, distemper and parvovirus may not be necessary and could even be harmful. Vaccines licensed by the U.S. Department of Agriculture are tested to ensure they protect pets against disease, usually for one year. But the tests don’t detect long-term side effects, or measure the duration of a vaccine’s effectiveness. Recent and continuing studies at several universities suggest that protection from vaccines may last for years, which would make annual shots for some diseases a waste of money at the very least.
Fears of vaccine-induced diseases date back more than 40 years. But a sharp increase during the past decade in cancerous tumors among cats, between the shoulder blades where vaccines typically are injected, has spurred studies. Some have found a higher-than-expected incidence of side effects. “We see health problems in dogs for which we have no explanation. The classic one
is autoimmune disease,” says Larry Glickman, professor of epidemiology at Purdue University’s School of Veterinary Medicine in West Lafayette, Ind., who is studying possible links with vaccinations. “We see an epidemic of hyperthyroidism in cats today, and we suspect that these are happening because we’re over-vaccinating our pets.”
ACCUMULATIONS ARE THE DANGER
Dr. Glickman and his colleagues theorize that repeated vaccination causes dogs to produce antibodies against their own tissue. The antibodies are caused by contaminants in the vaccine introduced in the manufacturing process. While the amounts are minuscule, they gradually accumulate with repeated vaccinations over the years. But Dr. Glickman cautions that more
research is needed before a clear link can be established between antibody levels and autoimmune disease.
Vaccination recommendations for cats and dogs vary around the country. Most states require rabies vaccinations every three years, while a handful of states as well as some individual cities and counties have mandated annual shots due to local problems with rabies in wild animals. Some other vaccinations are given only when a pet’s lifestyle or environment exposes it to a particular risk, such as Lyme disease.
Pet diseases other than rabies aren’t a threat to people, thus vaccinations aren’t required by law. But veterinarians and vaccine makers have traditionally recommended annual booster shots against potentially fatal diseases such as distemper and parvovirus in dogs and herpesvirus in cats.
In a policy statement last year, the American Veterinary Medical Association acknowledged that the practice of annual vaccinations is based on “historical precedent” and “not on scientific data.”
The emerging evidence of health risks is prompting some vets to change their practices. “We’re now doing 40% less vaccinations than five years ago,” says Kathleen Neuhoff, a veterinarian in Mishawaka, Ind., and president of the American Animal Hospital Association, Lakewood, Colo.
FINANCIAL REASONS?
“My own pets are vaccinated once or twice as pups and kittens, then never again except for rabies,” Ronald D. Schultz, chairman of the University of Wisconsin’s Department of Pathobiological Sciences, wrote in the March 1998 issue of Veterinary Medicine.
Some critics of annual shots accuse some vets of ignoring research about vaccine risks for financial reasons. “Vets are afraid they will go broke” without regular vaccines, which account for about 20% of their practice income, says Bob Rogers, a Spring, Texas, veterinarian and
outspoken critic of current practices. Other vets deny that financial motives are involved. (“No one who is motivated by money would ever become a veterinarian,” Dr. Neuhoff says.) “The concern is that if we move too quickly to decrease vaccine frequency across the board, we may be opening the door for some animals to become infected when we could have prevented the problem,” says Todd R. Tams, chief medical officer of VCA Antech Inc.,in Los Angeles, the nation’s largest owner of veterinary hospitals.” No one truly knows how long protection from vaccines lasts. Vaccine
makers say that proving their duration would be expensive and would require large numbers of animals to be isolated for years. One company, Pfizer Inc., decided to test its one-year rabies
vaccine on live animals and discovered it lasted for at least three years. It sells the identical formula simply packaged under different labels Defensor 1 and Defensor 3 to satisfy different state vaccination requirements.
Yes, vaccines can have adverse effects. However, decades of extensive research has found little evidence to support, for example, that the kind of fatal autoimmune disease used as an attention grabber at the start of this article is actually due to vaccination. Some studies are suggestive of a link and others are not. So while the issue needs to be investigated carefully, the kind of irrational anti-vaccine panic that often arises from stories like this isn’t justified, and it causes harm by frightening people into not giving their pets appropriate vaccinations. I would think the resurgence of measles and whooping cough in children due to similarly irrational fears leading parents to avoid vaccinations would be adequate illustration of why it is vital that vets give science-based advice about vaccines and discourage both unnecessary vaccination and unnecessary fear of vaccines.
There is no “best” site in the sense that the location itself has much effect on the safety or efficacy of the vaccine. However, the issue of injection-site sarcomas in cats has led to the practice of giving specific vaccines in specific locations, so we are better able to track if certain vaccines are more likely than others to cause a local reaction or problem. It is also a practice to give vaccines as far down the limb as possible in cats with, as you say, the idea that if a tumor develops it is more likely to be removable surgically. That seems reasonable, though again the incidence of these tumors is likely fewer than 10 out of every 10,000 vaccinations, so it’s not clear that this is going to help very any cats. And there is the concern that this location is more difficult to vaccinate in, and I sometimes wonder how many cats don’t get properly vaccinated because of the technical difficulty of using this spot.
Intramuscular vaccinations aren’t generally recommended for core vaccines since they seem to hurt more and don’t, as far as we know, induce better protection than SQ vaccines.
I may have been hospitalized as a child for IMT from vaccination right before starting school. There is remarkably little hard information in dogs other than Extrapolation from similar viral- or vaccine-induced IMHA and IMT in children. Getting a viral disease can cause the same problem. Here is the study that makes a temporal link between vaccination and autoimmune disease in the dog.
Vaccine-associated immune-mediated hemolytic anemia in the dog.
J Vet Intern Med 10[5]:290-5 1996 Sep-Oct
Duval D ; Giger U
Vaccination has been incriminated as a trigger of immune-mediated hemolytic anemia (IMHA) in dogs and in people, but evidence to support this association is lacking. In a controlled retrospective study, idiopathic IMHA was identified in 58 dogs over a 27-month period. When compared with a randomly selected control group of 70 dogs (presented for reasons other than IMHA) over the same period, the distribution of cases versus time since vaccination was different (P < .05). Fifteen of the dogs (26%) had been vaccinated within 1 month (mean, 13 days; median, 14 days; range, 1 to 27 days) of developing IMHA (P < .0001), whereas in the control group no marked increase in frequency of presentation was seen in the first month after vaccination. The dogs with IMHA were divided into 2 groups based on time since vaccination: the vaccine IMHA group included dogs vaccinated within 1 month of developing IMHA; the nonvaccine IMHA group included dogs that developed IMHA more than 1 month after vaccination. The recently vaccinated dogs with IMHA (vaccine IMHA group) had significantly lower platelet counts (P 75%) occurring in the first 3 weeks after presentation. Persistent autoagglutination was a negative prognostic indicator for survival in both groups (P < .05). Presence of icterus and hyperbilirubinemia were negative prognostic indicators for survival in the nonvaccine IMHA group (P < .0001 and P < .01, respectively) but not in the vaccine IMHA group. In the recently vaccinated dogs, combination vaccines from various manufacturers against canine distemper, adenovirus type 2, leptospirosis, parainfluenza, and parvovirus (DHLPP) were involved in each case. Vaccines against rabies virus, Bordetella spp, coronavirus, and Lyme Borrelia were administrated concomitantly to some dogs. This study provides the first clinical evidence for a temporal relationship of vaccine-associated IMHA in the dog.
As I said, there are studies that suggest a link between vaccines and these diseases. However, there are also studies that don’t find such a link, and overall the evidence is poor. While the link is plausible, it isn’t clearly established, whereas the link between vaccination and the prevention of disease is. The decision to vaccinate a particular dog should be based on what is known about the risks and benefits and the risk profile for that dog. Unfortunately, all too many of my clients have the misconception that there is a significant and well-established link between vaccination and these autoimmune disease, and this discourages them from accepting appropriate vaccination.
Here is a nice review of the evidence, specifically for IMHA and ITP.
And here are a few of the studies that do not support a link:
A.A. Huang; J. Coe; G.E. Moore; J.C. Scott-MoncrieffApparent Lack of Association between Primary Immune-Mediated Thrombocytopenia and Recent Vaccination in Dogs
This study looked for an association between vaccination and immune-mediated thromboctopenia (ITP, the destruction of platelets, necessary for blood clotting). Looking back through medical records at dogs diagnosed with ITP and then comparing them to dogs of similar age, sex, and breed with other diseases, the authors did not find that vaccination increased the odds of developing ITP.
Carr AP, Panciera DL, Kidd L. Prognostic factors for mortality and thromboembolism in canine immune-mediated hemolytic anemia: A retrospective study of 72 dogs. J Vet Internal Med 2002;16:504-509.
Davidow EB, and A Oncken. Risk factors for development of IMHA-A prospective case-control study. Abstract. VECCS 2004.
Reimer ME, Troy GC, Warnick LD. Immune-mediated hemolytic anemia: 70 cases (1988-1996). J Am Anim Hosp Assoc 1999;35:384-391.
Klag AR, Giger U, Shofer FS. Idiopathic immune-mediated hemolytic anemia in dogs: 42 cases (1986-1990). J Am Vet Med Assoc. 1993;202:783-788.
Klotins KC, Martin SW, Kruth S. Vaccination as a risk factor for immune mediated anemia in dogs: a multi-centre case-control study. Proceedings of the 3rd International Veterinary Vaccines and Diagnostics Conference. Guelph, Ontario (Canada), July 13–18, 2003.
I’ve researched the topic of pet vaccination over the past more than five years (i.e. after one of my dogs became very ill and was subsequently put down after unnecessary revaccination in 2008).
It’s my opinion that the veterinary industry is grossly over-vaccinating and over-servicing our pets. You can see the extensive correspondence I’ve undertaken on this matter on my pet vax webpage: “Over-vaccination of pets – an unethical practice”:
The veterinary industry continues to be obfuscatory on this matter. However, I suggest a careful reading of this document from the WSAVA Vaccination Guidelines Group, which is as good as it gets at the moment…. http://users.on.net/~peter.hart/WSAVA%20Puppy%20Vax%20Guidelines%20May%202013.pdf
FYI, our remaining dog, Coco, a 12 year old Maltese x Shih Tzu, who weighs just over four kilos, has not been revaccinated with either live or inactivated vaccine products since 2008. Neither does she receive any other medical interventions, i.e. no heartworm treatments, no flea treatments nor worming treatments.
We live in South Australia and I am not convinced that heartworm is a problem in the southern states. Certainly I would not have Coco injected with the annual heartworm product. If I thought heartworm was a problem I would go with the tablets instead, for the minimal period. Coco hasn’t got fleas. She did have some fleas for a brief period, but I picked them off her, and this no longer seems to be a problem. I had one of her stools tested for worms a couple of years ago, and as she was clear, I could see no reason to give her worming products. Coco doesn’t mix much with other dogs, so this also probably helps to keep her clear of problems.
Coco does not have processed foods. She is on a raw food diet, consisting of a mix I make up with lamb and chicken mince, chopped up lamb steaks (including the fat rind), some organ meats, i.e. kidney or liver, grated carrot, and chopped spinach, plus a sprinkling of kelp powder. She gets some of this mix every day. (I freeze it in small portions and defrost it on the day). She also has raw chicken necks and chicken wings, plus the occasional piece of lamb shank. No cooked bones of course.
As she’s a small dog she doesn’t eat massive quantities, so this diet is quite economical, certainly I reckon it’s much better value and safer than processed pet foods.
Compared to other 12 year old dogs I’m familiar with Coco seems to be in pretty good shape, still very nimble and active. So many dogs are sickly these days don’t you think? And cancer appears to be quite common…. I wonder if it can be anything to do with the way dogs’ immune systems are damaged with excessive use of vaccine products?
In the end you need to make a decision in the best interests of your own pets. Unfortunately, it has been my experience that you cannot rely on financially conflicted veterinarians’ advice in this regard….
Elizabeth Hart
Of course, there are many kinds of bias that influence our thinking besides financial motives. The evidence is, for example, overwhelming that vaccines do not cause autism in children. Yet, you will never convince a mother of an autistic child of that if she believes already that vaccines are responsible. Similarly, it seems likely the painful experience you had with your own dog might color your interpretation of the scientific evidence. The claim that vaccines damage the immune system, which you make, has even less evidence behind it than many of the vaccination practices veterinarians have been so reluctant to give up, yet you give it credence because it fits your beliefs.
Everyone does, indeed, have to make their own decisions for their pets, and fortunately there are lots of sources of information available. Every source has its limitations and caveats, but I hope people understand that advocacy web sites set up by individuals with bad personal experiences with vaccines are not somehow more objective or reliable sources of information than doctors and scientists. The tired notion that we only make recommendations that serve our personal financial interests really doesn’t hold much water
I think it’s an excellent and informative article. I have indoor only cats who had their kitten vaccines. I plan to do boosters in one year, and then only do Rabies as mandated by law in this area. This is pretty much what we did with my previous cat.
At the same time, I do think that “fewer than 10 out of every 10,000 vaccinations” is not such a small risk considering a number of vaccines an average cat gets. Also, one needs to do the math and estimate lifetime risk after a number of vaccinations, and the resulting cumulative risk is considerably higher.
A question. Has there been any studies comparing incidence of VAS after Purevax vs adjuvanted Rabies?
Great question, with a complicated answer.
One argument in favor of Purevax is the basic pathophysiologic rationale. Chronic inflammation appears to be a clear risk factor for cancer. Adjuvanted vaccines clearly cause more inflammation than non-adjuvanted vaccines. Ergo, it is reasonable the non-adjuvanted vaccines might lead to fewer sarcomas. Of course reasonable only means it might be true, not that it is true.
There have been no direct comparisons between adjuvanted and non-adjuvanted vaccines because this would be almost impossible to do. You would have to find groups of cats who had received only one or the other and then follow them for 20 years. With an incidence of 10/10,000 or less, you would probably need tens, maybe hundreds of thousands of cats to see a clear difference. So this won’t happen.
There are, however, a couple of studies which do address the question in other ways.
The first one looked at cats with sarcomas and with other tumors and compared how many had been exposed to different kinds of vaccines. They basically found that cats who had sarcomas were 10 times more likely to have been exposed to adjuvanted rabies vaccines than cats who did not have sarcomas. Note, this does NOT mean cats are 10 times more likely to get a sarcoma if they get an adjuvanted vaccines (the statistics of case-control studies don’t work that way). However, it does suggest the vaccines were a significant risk factor for sarcomas.
The study also found sarcomas associated with many other injectable products, and it did find sarcomas in cats who had gotten Purevax, so once again the risk pattern is more complicated than just adjuvanted=bad, non-adjuvanted=good.
The second study looked at the rate of sarcomas diagnosed, and it found no change in the rate since the introduction of non-adjuvanted vaccines. However, once again this isn’t a direct comparison of cats who received one type of vaccine only and cats who only received the other. It suggests we haven’t fixed the sarcoma problem by changing vaccines, but it doesn’t tell us the real role of the adjuvanted vaccines in the problem.
So, at this point we can’t say with certainty that changing vaccines will reduce a given cat’s risk of sarcomas. But, there is pretty good reason to believe there is an association between the adjuvanted vaccines and sarcomas, and there is no reason (other than cost) not to give the non-adjuvanted vaccines. So I use only the Purevax for now, but I don’t assume there is no risk with this or any other injection.
So I use only the Purevax for now,>>>> Purevac every year ?
Skeptvet, (August 8, 2014 at 5:55 am) interesting that you raise children’s vaccination. I suggest there are interesting parallels between human vaccination and companion animal vaccination, as I discuss on the Home Page of my website: over-vaccination.net
Also, FYI, here’s a link to my letter to John McConnell, editor of The Lancet Infectious Diseases, in which I challenge a systematic review prepared by members of the Cochrane Vaccines Field, i.e. “Adverse events after immunisation with aluminium-containing DTP vaccines: systematic review of the evidence”: http://users.on.net/~peter.hart/Letter_to_Lancet_Infect_Dis_re_Cochrane_aluminium_review.pdf
As companion animals are also often given aluminium-adjuvanted vaccines (e.g. inactivated bordetella bronchiseptica) this is also relevant to veterinary vaccination practice.
Elizabeth Hart
The most important parallel is, of course, that fear on the part of parents and pet owners, leads to poor decisions on vaccination. Fear and personal experience sadly trump science even though it they are unquestionably less reliable. Your web site exemplifies this problem as a classic example of ideology-driven reasoning which rejects any scientific evidence that conflicts with your pre-existing beliefs and cherry-picks or spins science to support a point of view that is actually incompatible with the balance of the evidence.
‘skeptvet’, you have cast aspersions on my website without evidence to support your position.
The following posts may be of interest to readers, they can make up their own minds:
UPDATE: Response from Professor Ronald Schultz re vaccination ‘boosters’ for dogs:
More on over-vaccination of pets…
Elizabeth Hart
As you say, people can read your site and make up their own minds. Your posts are the evidence that you take a view of vaccination that is often inconsistent with the scientific evidence.
Can you explain why humans don’t need repeat vaccinations against – say smallpox or hepatitis ? Explain the difference in physiology here, please, skeptvet.
My dog was recently boarded and the holistic vet advised against a repeat distemper vaccination for my 14 + year old city dog due to possible side effects.
Disregarding all but ” scientific evidence ” ignores a valuble source of information ( anecdotal ) that just hasn’t been quantified and vetted by so-called experts with their own biases.
Routine gynecology exams for women aren’t considered necessary any more though ” scientific evidence “never proved that they were in the first place. Un-scientific reporting has a place in this world.
This is a great review of current thought on vaccines. I’m happy to say it meshes well with what we’re doing where I work.
Actually, humans do need repeat vaccinations for many diseases, so you’re simply mistaken there. Our lifespan is far longer than our pets, so the intervals are longer, but boosters are routine. Here are recommended vaccination schedules from the CDC for children, teens, and adults:
As for anecdote, if you can’t see why that is unreliable, and why ever failed medical practice from ritual sacrifice to bloodletting to homeopathy has been supported by anecdotes, then you’ve been denied key tools and knowledge of history that would help you make better healthcare decisions for yourself and your pets. Putting “scientific evidence” in scare quotes just shows that you don’t realize how much we all owe to science or how clearly and drastically anecdote and personal experience have failed us for thousands of years.
Here is the quote (below)from the father of (sackett) at the heart of what I see as the real prevention controversy. It spills over not only annual vaccines but annual check ups.
I “believe” the FDA is doing a good job of following David Sacketts ebm principals for prevention. A good example, Lyme vaccines. When the human lyme vaccines came on the market there was no label directions to revaccinate once fully immunized. When the USDA approved dog Lyme vaccine the vaccine bottle said repeat the vaccine every year.
. I worry people will see how the USDA controls pet vaccine and make the error in assuming the FDA is following the same guides as the USDA. FDA approved vaccinations when I look for efficacy has at least one randomized controlled trial. All the USDA approved labels for pet vaccines recommending revaccinating fully immunized pets right on the bottle with no RCT as support. The USDA is not as consumer friendly as the FDA.
Sackett quote
“Although one could level these same accusations against the “curative” medicine delivered to symptomatic patients who seek health care, the 2 disciplines are absolutely and fundamentally different in their obligations and implied promises to the individuals whose lives they modify. When patients sought me out for help with their established, symptomatic diseases, I promised them only to do my best and never guaranteed that my interventions would make them better. Although many of my interventions had been validated in randomized trials,1 the need to intervene in rapidly advancing, life-threatening disorders forced me to use treatments justified only on the basis of past experience, expert advice, and the first principles of physiology and pharmacology.
But surely the fundamental promise we make when we actively solicit individuals and exhort them to accept preventive interventions must be that, on average, they will be the better for it.2 Accordingly, the presumption that justifies the aggressive assertiveness with which we go after the unsuspecting healthy must be based on the highest level of randomized evidence that our preventive manoeuvre will, in fact, do more good than harm. Without evidence from positive randomized trials (and, better still, systematic reviews of randomized trials) we cannot justify soliciting the well to accept any personal health intervention. There are simply too many examples of the disastrous inadequacy of lesser evidence as a basis for individual interventions among the well: supplemental oxygen for healthy premies (causing retrolental fibroplasia), healthy babies sleeping face down (causing SIDS), thymic irradiation in healthy children, and the list goes on.”
“Without evidence from positive randomized trials (and, better still, systematic reviews of randomized trials) we cannot justify soliciting the well to accept any personal health intervention. There are simply too many examples of the disastrous inadequacy of lesser evidence as a basis for individual interventions among the well: ”
Have the SBM guys written anything about this sackett prevention quote?
I absolutely agree with Sackett that the standard of evidence must be higher for interventions involving the healthy, such as screening tests and therapies for primary prevention, than for therapeutic interventions. Now whether RCT evidence is appropriate or necessary to meet this standard, however, is a different issue. It is not easy to design an ethical RCT in which a variety of different vaccination protocols are employed and then the incidence of disease in the different groups is compared, and such prospective trials necessarily take years and, if the prevalence of the disease at issue is low, must involved many thousands of participants to distinguish the effects of the different protocols. So in the real world, we may not always have such evidence, and we may have to make decisions informed by the best available evidence rather than the optimal evidence.
And protocols need to be flexible so they can be altered when new evidence emerges. The movement away from annual vaccinations towards ever lengthening intervals for core cat and dog vaccines reflects this. A survey last week on VIN (granted with significant selection bias) found 70% of respondents booster core feline vaccines every 3 years or more rather than annually, which may still be too much but is a significant improvement. This is not based on a lengthy, large RCT since no such study has been conducted, but on other kinds of evidence.
Similarly, epidemiological evidence showed that while the MMR vaccination protocols had changed in the mid 90s, from a single dose to two doses based on evidence that a single dose was not generating adequate protection in a high-enough proportion of the population, this change left a cohort vulnerable. This was exacerbated by the success of vaccination, which had so reduced the number of cases that “natural” boosting of immunity through exposure to the disease was not occurring. The recommendation then was made to add a “catchup” booster for people of a certain age. This was clearly an evidence-based decision, and driven by the very real occurrence of outbreaks of disease, but again not one based on a prospective RCT in healthy people.
So while I agree we need stronger evidence to justify preventative interventions in the healthy that might cause unintended harm that to justify therapy for the seriously ill, I think we have to be sophisticated in our use of evidence and not fall prey to the cliché critique of EBM that it ignores all relevant information other than RCTs. That is precisely the trap that has led some to argue for a distinction between EBM and Science-based medicine, which incorporates other kinds of evidence and prior probability in a more Bayesian method of assessing the effects of interventions.
Great comment, so thanks for sharing it!
Not that I know of. Sackett has been out of the EBM game for quite a while, so I’m not sure when he said this, but it doesn’t seem the sort of thing the SBM folks tend to respond to with posts.
They have talked a lot about preventative care, especially Harriett Hall. She has been quite critical of the annual exam, for example. And I believe they have promoted Choosing Wisely, which is an effort by a number of specialty boards to discourage unnecessary diagnostic and therapeutic interventions.
‘skeptvet’, I quote David Sackett on the Home Page of my website, and include the reference (see ref. no. 16). You must have missed this when you reviewed my website…
In regards to MMR vaccination, there are serious problems in regards to a lack of informed consent re this vaccine, similar to companion animal vaccination.
Sero-negative subjects are likely to be immune after the first dose of this ‘live’ vaccine, particularly the measles and rubella components. This can be verified by serological testing.
See for instance my letters to:
– Paul Offit:
– US ACIP:
and my webpage on MMR vaccination: Elizabeth Hart
Re: vaccination sites in cats–A study at the University of Florida looked into the tip of the tail as a possible injection site, and the results seem to be promising. http://news.ufl.edu/archive/2013/10/uf-researchers-tail-vaccinations-in-cats-could-save-lives.html
http://www.cmaj.ca/content/167/4/363.full sackett article
http://www.cmaj.ca/content/167/4/363/reply to sackett article comments
“Sackettization” prevention quote
“Without evidence from positive randomized trials (and, better still, systematic reviews of randomized trials) we cannot justify soliciting the well to accept any personal health intervention. There are simply too many examples of the disastrous inadequacy of lesser evidence as a basis for individual interventions among the well: ”
HH has been critical of annual exam>>>
We need more Skeptdoc . I’m not allowed to post on vin. So I guess the annual exams promoted by the” experts” at vet schools will continue to go unchallenged behind closed doors.
See
http://news.vin.com/VINNews.aspx?articleId=33363
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Skeptvet, re your sentence “I believe the science does not support annual boosters for core canine vaccines, so I no longer recommend them”, can I take it then that previously the science did support annual boosters for core canine vaccines, and that once you did recommend them?
I ask this question because like you I see this as a tricky issue and, unlike you, I’m not yet sure which side to lean towards. So I’m trying to get an idea of the credibility of your position here – no disrespect intended.
Skeptvet, still on the same subject – my trying to get a feel for the reliability of what you say about this subject, and others:
I read in your article in Jan 31 2010 on
http://skeptvet.com/Blog/2010/01/wootag-uh-i-mean-shootag-pest-control-device/
“Anaglyph over at Tetherd Cow has written about the shooTAG pest repellant device, and has posted a follow-up response to a comment from the company CEO. I have little to add to his comments.”
I read Anaglyph’s comments and came away with the view that I would not want to afford any credence to his or her views on health matters. No offence to him, I just didn’t find his comments convincing. ‘not saying anything about the product he was critiquing mind.
You read his comments and saw fit to include his link on your site. Can I take it that you found his comments convincing? that you thought he might be worth listening to in making a science-based determination?
Tony,
I find it interesting that you are trying to assess my credibility based on your impression of the credibility of someone whose comments I agree with on a particular subject. That seems dicey way to proceed. If I agree with Adolf Hitler when he said “Make the lie big, make it simple, keep saying it, and eventually they will believe it,” does that make me a no longer credible source because Hitler was evil and arguably insane? I think such an approach to assessing my credibility is pretty problematic.
And I will also say concern with my personal credibility rather than the credibility of the arguments and evidence I present seems misplaced. Who I am and what my credentials are has less relevance in evaluating the claims I make than the evidence and arguments I present in support of those claims. While I could, perhaps legitimately, claim the status of “expert” in some of the matters I discuss based on my education or experience, I think that would be distracting from the purpose of my articles, which is to critique claims from the perspective of science and evidence. Similarly, people like to identify my personal potential biases based on education and experience and use those to dismiss the arguments I make, but that is simply a way of not dealing with the substance of the critique.
In any case, to answer your question, I agree with the substance of Anaglyph’s argument, though I prefer a less sarcastic, emotional tone and greater reference to the scientific details that inform such a critique. The basic argument he makes is that the claims for this product made by the company are buttressed by pseudoscience and appeals to personal experience rather than scientific evidence. The CEO, in her rebuttal to the first post, actually tells him to try the product for himself as if that were real evidence for its efficacy. So, I my own inspection of the claims and evidence provided on the ShooTag site lead me to agree with Anaglyph’s assessment that the product is pseudoscientific “snake oil” not worth taking seriously until the company is willing to conduct legitimate scientific research to back up their claims.
I was trained to give annual boosters because that was the dominant practice when I went to vet school. The evidence provided at the time was the USDA licensing clinical trials, which only examined efficacy up to one year. Once in practice, I developed the practice of evidence-based medicine (not yet widely taught in vet schools), which entails examining the literature for myself and evaluating it critically. Additional literature also became available, which has been summarized in the AAHA guidelines. Over time, this led to a change in my practices, roughly 10 years ago, to giving 3-year boosters, and more recently to recommending 5-year boosters or titer testing. I think the ambiguity in the evidence supports a range of legitimate practices, so this article was not intended to give a definitive recommendation but to illustrate how I use examination of the evidence to inform and alter my own practices.
Thanks for the prompt replies Skeptvet. If I can follow up on the 2nd one for now, would it be fair to say that at the time you were giving annual boosters for core vaccines, you would have been similarly dismissive of any opposition to that practice, as you were of the bio-energetic flea&tick tag in that entertaining article you wrote back in 2010?
I should say that I agree with a lot of the things you said in that article, but not with the conclusion that I can rest assured the device definitely couldn’t work.
I came across your material yesterday when I was looking for stuff that might help me make a decision on whether to buy one of them. Like you I’m sceptical of claims made by people marketing devices like this. But I have a pressing need to keep alive, in a place where ticks abound seemingly all year round, a certain kelpie-cross that is important to the emotional well-being of one of my children.
A friend recommended the tag to me and told me it worked for his dogs. To me that’s evidence. It’s not proof, but I can’t just dismiss it without counter-evidence. Which is what I’m looking for here. I’m also surveying my neighbours and asking the opinions of other vets who I’ve found are open to treatments like homoeopathy (but let’s not get you started on that one :).
My personal bias says it’s quite possibly a mixture of chance and self-deception on the part of my friend, but my own experience, firstly as a government researcher and later as a nutrition therapist (long story) has also lead me to be open to questioning claims that science presents as God’s Truth.
So getting back to the question in my first paragraph …..
Not at all. I believe substantive critique is integral to the process of science, and I accept seriously any challenge to any practice, whether I employ it or not, so long as appropriate evidence and arguments are offered for it. If someone had said, “You shouldn’t boost annually because vaccines cause autism in children,” I would dismiss that as nonsense. But when, in fact, I was presented with evidence that annual boosters were unnecessary because the duration of immunity of the core vaccines was longer, I did not dismiss it. I investigated, verified that the evidence seemed reliable, and adjusted my practices. That’s how medicine should work and how I try to practice.
I never said the device “definitely couldn’t work.” I said that the rationale offered for how it worked was pseudoscientific nonsense and no reliable evidence that it does work has been presented. The burden is not on me to prove it doesn’t work but on those claiming it does, and making money off those claims, to prove it does, and they have not done so.
As for what constitutes evidence, that’s an entire discipline of philosophy (epistemology), so we aren’t going to be able to work through all the issue here. I would never say science is “God’s Truth” because that misses the entire point of the enterprise. Science is about generating a degree of confidence in hypotheses through the accumulation of evidence, with all conclusions provisional to some degree. Now I think the evidence of history is unequivocal that it is far better at generating reliable knowledge than any other system we have come up with, and certainly better than uncontrolled individual observation (aka anecdote) which has supported every failed and rejected medical therapy ever employed. But perfect, no.
Thanks Skeptvet, ‘appreciate the time you’ve taken to reply.
Hi Skeptvet
I tried to post a message but got this back:
“Hmmm, your comment seems a bit spammy. We’re not real big on spam around here.”
So I’ll try again but leave out all the links and replace them with google suggestions. Here goes:
Re what you wrote in http://skeptvet.com/Blog/2010/01/wootag-uh-i-mean-shootag-pest-control-device/
– the first 6 or so paragraphs ending with
“…..but it’s just a bit of vacuous pseudoscientific gibberish designed to obscure the lack of a real mechanism of action.”
I emailed the people at Pet Protector – (google Pet Protector) – asking them if they could tell me how they make the PP discs, and why a price of $70+ is warranted. Also how they’ve been able to create a scalar wave generator and install it in a circular brass/alloy disc.
They replied today:
“The Pet Protector disc is made out of high quality alloys of steel and charged with specific frequencies of magnetic scalar waves. There are 2 scalar waves generators in the world, and one of them is located in Austria and this facility is where we charge our discs.
The specific frequencies we use are very low. The magnetic field ranges between 200-700 mt which is 2000 less than the frequencies emitted by a mobile phone. This is why animal and people can’t detect these frequencies but they are enough to be detected by external parasites.
For more information about the Scalar Waves, please visit our website (Home page), scroll down, and click on “Scalar Waves” tab. ”
I went to their website and followed the link labelled “Scalar Waves”, which took me to a copy of this document: (google Prof. Dr.-Ing. Konstantin Meyl – New Hydrogen Technologies and Space Drives, Congress Center Thurgauerhof,)
I’m not a scientist (I used to be a clinical nutrition therapist and before that an economist, government statistician, systems analyst, and senior research advisor for the Qld Cabinet, and in that last job they classified me as a scientist for pay-scale purposes but that’s as far as it goes), but what I read there looks like hard science to me.
Would you please take a look at it when you get time and let me know what you think.
For more information on the guy giving the lecture, Prof. Dr.-Ing. Konstantin Meyl, you can have a quick look at these two – tell me if you think he’s a “snake-oil merchant”:
(google “Prof. Dr.-Ing Konstantin Meyl teaches the subjects power electronics and alternative”)
(google “Prof. Dr.-Ing. Konstantin Meyl Potential vortex, newly discovered properties of the electric field”)
Thanks Skeptvet, I’d appreciate your opinion as someone with far greater knowledge in this area than myself.
I’ve just read the paper you mentioned (on scalar waves) and it’s funny how it mentions absolutely nothing about pest repellent.
Someone saying it worked for their dogs isn’t really evidence. I know people who’ve used nothing on their dogs, and most of them haven’t had problems with fleas and ticks- even if there’s as high as a 50% chance of a noticeable infestation, that’s still a flip of the coin that your friend will be the one who gets lucky.
I notice that none of Professor Konstantin’s papers appear to be in the field of veterinary medicine. It would not be the first time that an expert strayed out of their field of expertise, and got things very wrong. Even the most intelligent of us can do it- see Arthur Conan Doyle and his fairies. His papers would not lead me to ask him about pest repellent, or accept him as any kind of authority in that area.
What double-blind controlled studies have the Pet Protector people done on their product? Because I have read about their ‘experiment’, and that is incredibly poorly designed. It seems almost engineered to prove nothing.
No details on how it was assessed that the animals had no parasites, no control group, therefore no blinding at all, nothing. Anything, given that testing protocol, could be shown to be effective. For example it assumes that an animal not getting a parasite, shows that the tag offered effective protection- what if the animal wasn’t going to get a parasite anyway (environment, chance, etc). It looks to me like it’s designed to look like science, to people who don’t know what they’re looking for when they read a study. Not to mention it doesn’t seem to have been published in the scientific literature, or independently replicated- it wouldn’t be the first time someone’s made up data wholesale to sell a product. Companies conducting research on things they sell are notoriously more likely to come up with positive results.
http://www.petprotector.org/pdf/The_Official_Product_Testing.pdf
If anything, the study, and their website, would make me pretty certain the product doesn’t work, even though I wasn’t hugely leaning one way or the other before I read them. It reads like a scam.
Is it a multi-level marketing scheme? I can’t see anything there about having to recruit people beneath you, but the whole ‘not available in retail stores’ and the hard sell of ‘join us now’ is raising red flags for me.
http://www.petprotector.org/AboutGoldstar
In years past I ran a boarding kennel. The core vaccine issues seem relatively cut and dry. Liability concerns demand three year schedule at minimum. Bordetella decisions were much more problematic. The vet I used at the time said she, personally, didn’t vaccinate her dogs for Bordetella because the disease wasn’t that serious and the efficacy of the vaccinations wasn’t that great. If she did vaccinate, she said she would do so two weeks before putting the dogs in the kennel. I had kennel cough go through the kennel a few times, and many vaccinated dogs got sick, while my own unvaccinated dogs did not. This is a bit stronger than anecdotal evidence, cause the sample size was a few dozen, but lacked any sort of statistical control. Can you recommend any literature on the issue of Bordatella?
The guidelines I link to discuss bordatella as well, so you should be able to find a review of the evidence there. Generally, the vaccine has about 80% efficacy, but duration of immunity is short, maybe 4-6 months at this level and then less as time goes by. The disease is caused by a constellation of factors, which is why vaccination against the Bordatella bacterium alone isn’t a perfect preventative. It is VERY unlikely that the vaccine made the dogs you describe more susceptible, so I think that is an observation inconsistent with the better controlled scientific evidence.
For healthy adult dogs, the disease usually is self-limiting, so it’s not much worse than having a cold or sore throat. That said, young, old, and immunocompromised dogs can develop pneumonia associated with kennel cough, so it can’t always be taken lightly.
There are different forms of vaccine (injectable intranasal, and now oral), and lots of arguments about the relative merits of these. I haven’t reviewed the literature lately, but in general the intranasal probably provides quicker protection than the injectable and may have some other advantages in terms of efficacy, though it is also be more likely to cause mild upper respiratory symptoms than the injectable.
I generally recommend the vaccine only for regular or close-quarters exposure to lots of other dogs, though I only think it is important for dogs who might be at increased risk due to age, health condition, medications, and so on.
Thanks for the reply. I’ll have a look at the 2011 report. Sorry, didn’t mean to imply that the vaccine made the dogs more susceptible, just that they got sick despite having been vaccinated within the last year. (Clubs and kennels have tended to write rules requiring annual vaccination . . . so dogs end out under-treated for Bordetella and over-treated for the core vaccines. The management software we used didn’t allow for different vaccination intervals for different vaccines. )
As for my own dogs not getting sick, maybe they were exposed often enough that they developed immunity: maybe they got very light cases and I didn’t notice. Who knows. They were able to get pretty close to the outdoor runs, and three of our neighbors also had boarding kennels.
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Vets on vin.com who have been to Ron Shultz vaccine lectures say he has a unpublished study showing no significant decrease in kennel cough disease using bordetella vaccines.
Like other bacteria, there are different strains of the same organism that are somewhat antigenically different. The relevant antigens on Bordetella are the fimbrial antigens that affect adhesion to the mucosa. What vaccines (both IN and parenteral) are designed in part to do is to develop antibodies against these fimbrial antigens to prevent the bacteria from adhering, colonizing the mucosa and causing disease. Researchers at K. State presented data at ACVIM in 2000 demonstrating that the fimbrial antigens on bacteria isolated from clinical cases are significantly different from those on the strain used in the vaccine. This is not surprising since bacteria in the “wild” are mutating all the time and the vaccine strains were put on “hold” years ago and have continued to be used today. This drift away from the antigenic types in the vaccines has allowed the bacteria to “escape” and cause clinical disease in spite of vaccination.
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Vaccinosis can be inherited? Just read this on one of the homeopathic sites. That’s not true. Is it?
I know, I have to stop going to those places…..