When & Why to Vaccinate or Titer Test Your Patient?

Summary on Vaccine Policy

AAHA 2003 –  Current knowledge supports the statement that

• No vaccine is always safe, no vaccine is always protective and no vaccine is always indicated
• Misunderstanding, misinformation and the conservative nature of our profession have largely slowed adoption of protocols advocating decreased frequency of vaccination

WSAVA 2015-2017

From Prof. Michael J. Day

• Vaccination should be just one part of a holistic preventive healthcare program for pets that is most simply delivered within the framework of an annual health check consultation
• Vaccination is an act of veterinary science that should be considered as individualized medicine, tailored for the needs of the individual pet, and delivered as one part of a preventive medicine program in an annual health check visit

Importantly, pet caregivers should understand that the act of giving a vaccine may not equate to immunization of that animal. Vaccines may not always produce the needed or desired immune protective response, not only if the vaccine itself was inadequately prepared (very rare) but also if the pet is a genetic low or non-responder to that vaccine (quite common in certain breeds of dogs and their families).  In the latter case, that pet will be susceptible lifelong to the disease of concern and revaccination will not help and could even be harmful.

New protocols for dogs and cats

In response to issues raised above, vaccine experts recently have recommended new protocols for dogs and cats. These include:

1. Giving the puppy or kitten vaccine series later (starting not before 8 weeks of age, except in the cases of outbreaks of virulent viral disease or in orphans or those that never received colostrum from their dams) followed by a booster at one year of age
2. Administering further boosters in a combination vaccine every three years or as split components alternating every other year until
3. The pet reaches geriatric age, at which time booster vaccination is likely to be unnecessary and can be unsafe for those with aging-related or immunologic disorders.

Antibody titer testing

In the intervening years between booster vaccinations, and in the case of geriatric pets, circulating humoral immunity can be evaluated by measuring serum vaccine antibody titers as an indication of the presence of immune memory (e.g. VacciCheck). Titers do not distinguish between immunity generated by vaccination and/or exposure to the disease, although the magnitude of immunity produced just by vaccination is usually lower.

When to Vaccinate Puppies & Kittens? Which Vaccines are Needed? What About Socialization?

Puppies

• Should receive MLV or recombinant “Core” vaccines (canine distemper, parvovirus and hepatitis/adenovirus) preferably either at 9-10 and 14-16 weeks of age (minimum protocol), or, at 9, 12 and 16-18 weeks of age
• Rabies vaccines are all adjuvanted killed products and are given as required by law, preferably always given separately from other vaccines, and as late as legally allowed – e.g. 20-24 weeks of age. Thimerosal (mercury) – free rabies vaccines are preferred and safer
• Other vaccines are optional, and depend upon circumstances and disease risk in the area
• For the optional Bordetella or kennel cough vaccines, the oral version is preferred over the intranasal although both offer better protection than the injectable version
• Leptospirosis vaccines protect against only 4 serovars of the organism and are second to rabies vaccines in risk of hypersensitivity and other adverse effects. Use if endemic in the area of concern
• While canine influenza viruses (2 strains; H3N2 and H3N8) are highly contagious, most infected dogs have mild to no clinical issues, unless they develop a high fever and are at risk for secondary pneumonia. Vaccination, while being widely promoted, is still optional
• Three or more days after the last round of puppy vaccines, they can be out and about to be socialized. In the interim period, between 10-14 weeks of age, socialization can take place in the back yard or at puppy training classes with known friends and healthy dogs
• Until fully vaccinated, puppies should not walk on unfamiliar or public grounds; they can be carried about, when needed to travel
• If Titer testing is desired, instead of giving another vaccine after 12 weeks of age, wait until at least 16 weeks of age to avoid measuring residual maternal immunity

Kittens

• Core vaccines (feline panleukopenia, feline calicivirus, feline rhinotracheitis/herpes) given as MLV or killed, inactivated or intranasal products are started in a 2 or three-dose series beginning for example at 7-9 weeks of age and 12-16 weeks, or at 7, 11 and 16 weeks
• Rabies vaccines if legally required are recommended as for puppies, although cats can receive a recombinant non-adjuvanted rabies vaccine which is preferred over the adjuvanted killed rabies vaccines given to dogs. This non-adjuvanted rabies vaccine is not yet available for dogs
• Some people consider feline leukemia virus (FeLV) vaccine as important for cats, especially those that live outdoors or are indoor/outdoor. Options are a recombinant non-adjuvanted or a killed adjuvanted vaccine
• Feline immune deficiency virus (FIV) vaccine is available in an adjuvanted killed virus vaccine for those cats at similar exposure risk to FeLV.
• Other vaccines (Chlamydia, FIP) are generally not recommended or are optional, and depend upon circumstances and disease risk in the area
• Socialization and Vaccine Titer testing options are as for puppies

*WSAVA-World Small Animal Veterinary Association; AVM A- American Veterinary Medical Association; AAHA-, American Animal Hospital Association; BVA-  British Veterinary Association