In previous discussions of vaccination recommendations, I have referenced several clinical guidelines that review the existing evidence and provide recommendations for vaccination. The American Animal Hospital Association (AAHA) and American Association of Feline Practitioners (AAFP) guidelines are quite extensive and useful documents in making decisions about vaccination. AAHA guidelines are, unfortunately, usually prepared by small groups of experts with little transparency, and they are not always a model of evidence-based guideline development (for a great model, see the RECOVER guidelines for small animal CPR). That said, the vaccination guidelines do a good job of summarizing the complex and sometimes contradictory evidence and making reasonable recommendations.
AAHA has update the canine vaccination guidelines, and has presented them in a new form. The 2017 AAHA Canine Vaccination Guidelines are now primarily an online document divided into sections that make finding the answer to specific vaccination questions quite easy. In terms of providing a summary of existing vaccine science and giving a general overview of the issues, the web-based format is clunky and harder to use than a traditional journal article. But in terms of giving direct answers to questions vets and dog owners typically have about when and how to use specific vaccines, the format works well.
The new guidelines also add detail to subjects only lightly discussed in the previous version, including the use of antibody titers to guide vaccination and how to handle animals with uncertain vaccine histories or overdue for boosters of vaccines given previously.
There is nothing revolutionary or earth-shattering in the new guidelines, and they will undoubtedly not satisfy the concerns of those with deep anxieties or objections to routine vaccination practices. The recommendations are very similar to previous versions, and there will be few changes for those of us who have been following these guidelines in the past. Thorny questions like how often, or if, boosters of core vaccines should be given are not always directly answered.
The previous guidelines summarized the evidence that, for example, vaccination for canine parvovirus (CPV) and canine distemper (CDV) should provide immunity for a minimum of three years and likely protects most dogs for at least 5-7 years and possibly longer (when given properly as a series to puppies with a booster at about one year). The currently guidelines recommend intervals for these vaccines of “three years or longer”, which leaves the exact interval to the discretion of vets in practice. This makes sense in many ways, since the risks and benefits of vaccination for individual animals depends on exposure risk, lifestyle, health, medical treatment, and many other variables. Ultimately, there is no single right answer for every dog.
Unfortunately, it is easier for most vets to choose an arbitrary recommendation to make for all their patients. Right now, many choose three year intervals for these vaccinations because that number was specifically suggested in the AAHA guidelines. When I have suggested longer intervals might be appropriate, many of my colleagues are understandably wary of deviating from what all the major veterinary schools and most other practices are doing for fear of being blamed for any failure of protection that might occur. And, of course, none of this will satisfy those who think little or no vaccination is necessary at all.
Despite the inevitable compromises and limitations in the evidence, however, the AAHA guidelines are an excellent resource for vets and dog owners wishing to make rational, science-based decisions about how best to protect dogs from vaccine-preventable disease.