Tuesday, May 19, 2009

Too Many Vaccines?

A woman from Australia posted a lengthy comment regarding my post about vaccine reactions on Thursday, May 14th. She makes many interesting points and after I got over my initial delight that someone on the other side of the world is reading my blog I decided to post an entry with my opinion on the topic of over-vaccination of dogs and cats. Below is Friendship’s official statement on this issue:

The decision to vaccinate your dog is not one the doctors at Friendship make lightly. There has been much debate over the risks and benefits associated with vaccination over the last decade. There is no doubt that vaccines have played a significant role in enabling people and animals to live longer and healthier lives in this world filled with microbial pathogens. Yet, as the risks of some infectious diseases have been reduced more attention has been focused on the risks of vaccination in both human and veterinary medicine. Adverse effects, including some that are potentially serious, can be unintended consequences of vaccination. These reactions are fortunately rare, but are unpredictable. The reported incidence of adverse reactions to vaccines varies. Despite this, it is safe to say less than 1% of vaccinated pets experience an adverse reaction. Not vaccinating for fear of an adverse effect is not the answer. As vaccination in the general population wanes, re-emergence of these diseases is certain and the diseases we do vaccinate against are very serious or even fatal. There has been a benefit of this focus on adverse effects; increased research into vaccine safely, efficacy and duration of immunity. Using the information generated by these studies, vaccines and vaccine protocols can be made safer for our furry family members.

The short answer to this controversial issue is we don’t definitively know the length of protection offered by any given vaccine. Some may offer lifelong immunity while others such as the Leptospirosis vaccine are thought to protect for less than one year. Vaccine protocols are something we spend quite a bit of time discussing at Friendship to ensure we are recommending the best course of preventative medicine for our patients. We were ahead of the curve and went to a three year vaccination schedule before the drug companies produced a product specifically labeled for administration every three years.

In addition, we make every effort to inform our clients of the facts associated with vaccinating their pets. Before I give vaccines I always discuss the possibility of a reaction and advise my clients on the clinical signs to look for. We also take time at Friendship to discuss the patient’s lifestyle with their owner. If it is an indoor only cat then the feline leukemia vaccine is unnecessary. If the dog never goes to the kennel or groomers then a Bordetella vaccine is probably not needed. Another way to decrease the chance of vaccine reactions is to only administer one vaccine at each visit. Clients usually do not choose to do this as it is more expensive and requires multiple trips to the hospital which may cause unnecessary stress for their pet.

I encourage clients discuss vaccine protocols with their veterinarian so they can be informed and confident that they are providing their pets the best possible care. This topic is currently undergoing further scientific investigation in veterinary research as well as by drug companies and it will continue to evolve so that we may understand how to best protect our pets. The ultimate goal of veterinarians and owners must be to work together in order to give our furry pals a long, happy and healthy life.

1 comment:

  1. Dr Hughes, I forwarded you my report on over-vaccination so you know I have researched this issue quite thoroughly.

    What concerns me greatly is that pet owners are not being informed about duration of immunity (probably lifelong) for MLV core vaccines for canine parvovirus, canine adenovirus and canine distemper virus (e.g. the 2003 AAHA guidelines note: "When MLV vaccines are used to immunize a dog, memory cells develop and likely persist for the life of the animal.")

    I appreciate this remains a controversial issue in the veterinary community, but pet owners must be informed of both sides of the argument. Pet owners must be fully informed before they make a decision to revaccinate their pets. It should be their informed decision…

    Pet owners should be informed that there is no scientific basis for either annual or triennial revaccination with MLV core vaccines. These are arbitrary recommendations, they are not evidence-based.

    Pet owners should also be warned that vaccine product labels do not record the possible range of adverse reactions. The World Small Animal Veterinary Association Dog and Cat Vaccination Guidelines note: “there is gross under-reporting of adverse events which impedes knowledge of the ongoing safety of these products”. These guidelines stress the need to "reduce the 'vaccine load' on individual animals in order to minimise the potential for adverse reactions to vaccine products." http://www.wsava.org/PDF/Misc/VGG_09_2007.pdf

    I have been researching this issue for the past eight months and I am appalled that information on duration of immunity has been withheld from pet owners. Pet owners are encouraged to “discuss vaccine protocols with their veterinarian”. Well the sad fact is, not all vets are as forthcoming as those at Friendship…

    In Australia we are in a dire situation. Annual revaccination (with MLV core vaccines) is still accepted practice in the veterinary profession here. Why is Australia ignoring information coming out of the US? Science isn’t confined by international borders, why aren’t pet owners in Australia being informed of the latest international information on vaccination?

    If I knew in September 2008 what I know now, my dogs would not have been revaccinated with MLV core vaccines, because they simply did not need them. Neither did they need non-core vaccines, they weren't boarded out.

    The vet sent me a reminder letter saying my pets needed revaccination to “stay healthy”. I now know this was not true. In fact, this intervention provided them with no benefit and needlessly put them at risk of an adverse reaction. Who in their right mind would knowingly choose to have a possibly harmful intervention that provides no benefit? Why wasn’t I allowed to make an “informed choice”?

    I feel I was made an unknowing accomplice in putting my dogs in harm’s way – and I am extremely unhappy about it.

    My experiences over the past eight months have been a shocking revelation. I have met with much resistance in investigating this issue in Australia.

    There is no protection for pet owners – we are dealing with a self-regulating profession, and there appears to be little accountability.

    This isn’t just about revaccination. I have broader concerns about veterinary ethics, general lack of “informed consent”, reluctance to report adverse reactions, and questions about professional responsibility and integrity, transparency, abuse of power and authority, and abuse of trust. These are issues I will be exploring further.

    I suggest concerned pet owners do their own research before revaccinating their dogs, and before they have any interventions for their pets, including heartworm and flea treatments etc.

    As a start, here’s a link to the World Small Animal Veterinary Association's Dog and Cat Vaccination Guidelines: http://www.wsava.org/PDF/Misc/VGG_09_2007.pdf

    Thanks for the opportunity to comment Dr Hughes. It’s difficult to find a veterinary forum to air these concerns in Australia.