Vaccinations for Your Dog: A Complex Issue, by Nancy Kay, DVM

Today I am delighted to have a guest post from Dr. Nancy Kay, a veterinary internist and author of the must-have guide for being a good health advocate for your pet, Speaking for Spot. In today’s post, Dr. Kay gives some tips for how to wade through the complex issue of pet vaccination and what you can do to make the decisions that are right for you and your pet. Thank you so much Dr. Kay!

During my last year of veterinary school, I recall how scary it was when a new canine virus—parvovirus—seemed to appear out of nowhere. Highly contagious, it spread like wildfire throughout the United States, causing severe illness and often death. It was a downright frightening time for veterinarians and the clients they served. Fortunately, an effective vaccine was rapidly developed, and this horrible new virus was downgraded from a rampant deadly infection to a preventable disease. Thank goodness for vaccines! They provide a remarkable means of preventive health care for dogs.

As invaluable as vaccinations are for protecting canine health, determining which vaccines are appropriate and how frequently they should be administered are no longer simple decisions. In my book, vaccinations are no different than any other medical procedure. They should not be administered without individualized discussion and consideration of the potential risks and benefits.

Gone are the days of behaving like a “Stepford wife” when it comes to your dog’s vaccinations — it’s no longer necessarily in his best interest to vaccinate simply because a reminder postcard has arrived in the mailbox.

Consider the following:

• There are currently 14 canine vaccinations to choose from! Back in the days when I was just a pup there were only five, and decision-making regarding vaccine selection for an individual dog was far less complicated.

• Over the past decade we’ve learned that, for some vaccines, the duration of protection is far longer than previously recognized. In the past we vaccinated for the core diseases (distemper, parvovirus, and rabies) annually. We now know that these vaccinations, when given to adult dogs, provide protection for a minimum of three years and, in some cases protection is life-long.

• The duration and degree of immune protection triggered by a vaccine is variable, not only based on manufacturer, but from dog to dog as well.

• Other than for rabies (state mandated), vaccination protocols are anything but standardized. There are no set rules veterinarians must follow when determining which vaccines to give and how often they are administered. Unfortunately, some vets continue to vaccinate for distemper and parvovirus annually even though we know that these adult vaccines provide protection for a minimum of three years. Some vets give multiple inoculations at once, others administer just one at a time.

• Increasingly clear-cut documentation shows that vaccines have the potential to cause many side effects. While vaccine reactions/complications are still considered to be infrequent, they can be life threatening.

What you can do:

So, as your dog’s savvy and courageous medical advocate, what can you do to be sure that he is neither under or overvaccinated? Here are some guidelines for making wise vaccine choices for your best buddy:

1. Educate yourself about available canine vaccinations and the diseases they are capable of preventing (in some cases treating the disease, should it arise, might be preferable to the risks and expense associated with vaccination). Learn about duration of vaccine protection and potential side effects. Talk with a trusted veterinarian and read the chapter called “The Vaccination Conundrum” in Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life. It provides detailed discussion about all aspects of canine vaccinations including the diseases they prevent, adverse vaccination reactions, and vaccine serology (blood testing that helps determine if your dog is truly in need of another vaccine). The American Animal Hospital Association’s “Canine Vaccine Guidelines” is also an excellent source of information.

2. Figure out which diseases your dog has potential exposure to. A miniature poodle who rarely leaves his Manhattan penthouse likely has no exposure to Lyme disease (spread by ticks); however a Lab that goes camping and duck hunting may have significant exposure.

3. Alert your veterinarian to any symptoms or medical issues your dog is experiencing. It is almost always best to avoid vaccinating a sick dog — better to let his immune system concentrate on getting rid of a current illness rather than creating a vaccine “distraction.” If your dog has a history of autoimmune (immune-mediated) disease, it may be advisable to alter his vaccine protocol or even forego ongoing vaccinations — be sure to discuss this with your vet.

4. Let your vet know if your dog has had vaccine side effects in the past. If the reaction was quite serious, she may recommend that you forego future vaccinations, necessitating an official letter to your local government agency excusing your pup from rabies• related requirements.

5. Consider vaccine serology for your dog. This involves testing a blood sample from your dog to determine if adequate vaccine protection still exists (remember, vaccine protection for the core diseases lasts a minimum of three years). While such testing isn’t perfect, in general if the blood test indicates active and adequate protection, there is no need to vaccinate. Serology may make more sense than simply vaccinating at set intervals.

6. Ask your veterinarian about the potential side effects of proposed vaccinations, what you should be watching for, and whether or not there are any restrictions for your dog in the days immediately following vaccination.

Vaccine Clinics

I will tell you right up front that I am not a fan of vaccine clinics – a “factory line” approach to vaccinating dogs. Their only redeeming quality seems to be their low cost that makes it possible for some dogs to be vaccinated that otherwise wouldn’t be. Know that, if you choose to use a vaccination clinic you may be sacrificing quality of care for your dog in the following ways:

• You may not receive adequate counseling about which vaccinations are appropriate for your dog based on his age and lifestyle.

• Serologic testing will not be an option.

• A thorough physical examination will not be performed prior to vaccination administration. Abnormalities such as a fever, irregular heart rhythm, or abdominal mass will go unnoticed. Not only might the vaccination do more harm than good in a dog that is sick, but a golden window of opportunity for early disease detection and treatment will be missed.

• Records pertaining to prior adverse vaccination reactions may not be available.

• The vaccination clinic veterinarian may not be available to tend to your dog should he experience an adverse reaction, especially one that occurs hours to days later.

Have you had difficulty figuring out which vaccines your dog really needs and how often they should be administered? If so, please share your story with me.
Now, here’s wishing you and your four-legged best friend abundant good health!
Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook
Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

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  • Tonya

    Thank you for this post! My vet has stopped giving all vaccines annually, and I was happy about that. But I’ve always been of the opinion that my vet knows more than I do about this type of thing, so I’ve deferred to his opinion on it. It’s so helpful to have this easy-to-understand article and the links you’ve provided to further my education on the topic!

  • http://somethingwagging.wordpress.com Pamela

    I really appreciated the emphasis on what’s right for your particular dog. I think that’s key. In one situation (16 year old dog with Cushing’s) I got a rabies exemption letter from my vet. Fortunately, that sufficed for every situation we had to provide proof of rabies vaccination.

  • http://aboutvetmed.com AboutVetMed

    Great post – I ♥ Dr Kay.
    See you both at Blogpaws West!

  • Diane N

    Very timely article – I just had this discussion with my vet, who is moving toward this stance but isn’t quite there yet. He’s done the serology tests on a few dogs, and found that in those cases they needed boosters, so for those who don’t regularly have their dogs examined otherwise, he still recommends annual vaccinations. For those who do at-home routine examinations AND regular vet exams, he is willing, if not eager, to test first. And he DID give me the exemption letter for rabies in my dog with cancer – we simply stopped all shots for several years (and managed 5 years of “extra” time with chemo and love). Thank you for expressing this information so clearly.

  • Chile

    Luckily the county that my primary vet is in does 3 year rabies vaccines. But the other vaccines are annually (distemper & parvovirus and I think maybe one other? I’d have to check her records). Thanks for the advice on how to see if it’s truly necessary each year. I’ll talk to my vet regarding vaccine serology. :) My rottiegirl does well with vaccines, hasn’t had any side effects but she just hates going to the vet and freaks out. The more I can cut down on that, the better!

  • Dr. Sarah

    I’ve found a lot of owners are hesitant to do the serology due to the cost factor, although this is the approach that I advocate as well. However, *full disclosure* I do a vaccine clinic as a side job, and I have such mixed feelings about it. I see so many animals that are completely lacking in vet care and whose owners come for the cheap vaccines. Particularly for those cases I do my best to do a more thorough physical exam prior to vaccination so I can point out issues that need to be addressed by their regular veterinarian.

    There have been a couple of cases where I turned animals away; last week we had a dog that had obviously entered congestive heart failure, and I told the owner I would not administer a kennel cough vaccine until she had it worked up and treated at her regular vet. She seemed appreciative that I’d taken the time to talk that over with her.

    But you are absolutely right — these are assembly-line clinics where things will frequently be missed, especially when there is a line out the door and I am trying to get everyone serviced quickly. This clinic also does annual vaccines for everything but rabies; however, it seems as though most clinics in the San Diego area are still doing that, from what I’ve observed. Change sure is slow, isn’t it?

    • http://www.pawcurious.com Dr. V

      I think you are doing a much better job than most who have that role- from what I have heard from techs who worked the clinics. I’m sure the owners appreciate it.

      As practitioners in an area with a huge parvo problem in the middle of tough economic times, I agree that I prefer vaccine clinics to no care at all for those who can’t afford regular veterinary care. But I also think what you are doing, ie thorough exams, is showing the owners the value of the veterinarian’s involvement. :)

      • Dr. Sarah

        Well, the way I see it, if I’m not taking the time to do an exam and talk over the health of their animals with them, then why does a vet even need to be there? They might as well have a tech running the thing.

        Of course, that could end up being lawsuit city, but it also can when there’s a vet on the premises that’s neglecting to examine the animals prior to vaccination.

  • Leigh

    At our hospital, I also refer clients to the AVMA Vaccine Associated Feline Sarcoma Task Force page. It outlines many vaccine issues, and how you can be an advocate for your cat regarding which type of vaccines your vet uses.
    http://www.avma.org/vafstf/
    My vet heard one of the members speak at a conference, and immediately changed to the least-risk vaccines. Good info to know! :)

  • http://dawgbusiness.blogspot.com/ Jana Rade

    This surely is one of the hot topics, so many experts preach about over-vaccinating and the potential issues that stem from that…

    As with everything, I believe that this is about the lesser of the evils. What is the lesser of the evils? That is the question.

    Right now we vaccinate as we always used to, but I am particularly wondering about the statements that vaccines do last substantially longer than one year – what is your opinion on that?

    Is there a substantial benefit to vaccinating for one thing at the time rather than combo vaccines? Personally I can see pros and cons to both …

    What is your opinion on the efficiency of titering?

    • http://www.pawcurious.com Dr. V

      I think, as in all things, you have to make your decisions based on your own lifestyle and that of your pet.

      I believe enough evidence is out there that the core vaccinations (distemper, parvo, and rabies) last at least 3 years that I am satisfied with that. Keep in mind this does not apply to other vaccinations, such as leptospirosis and bordetella, though not all dogs need those.

      I prefer to vaccinate for one thing at a time, because of the risk of vaccination reactions and overloading the system with antigens. However, I will vaccinate for more than one thing at a time if the pet is healthy, has no history of reactions, and the owner clearly understands my preference and the risk.

      As for titers, imo the jury is still out. Dr Khuly at PetMD had a great post about this a while back: http://www.petmd.com/blogs/fullyvetted/2008/october/titers-versus-vaccines-pets-vaccine-safety-and-what-titers-really-mean

      • Dr. Sarah

        That’s exactly what I’ve always been wondering… whether titers were really a true reflection of immunity since they are ignoring the entire cell-mediated branch of immunity.

        I asked this question about rabies titers at the AVMA convention last year and was told that it had been determined for rabies that titers were an effective measure of immunity. But then, I had been taught the exact opposite in vet school, so frankly I’m a bit confused on the issue. I guess I need to peruse the literature for myself and come to my own conclusion.

  • elizabeth

    I was curious if the 3 year core vaccines were identical to the core vaccines that would be given annually or if the dosage amounts were different? I ask because we recently switched vets and had always done 3 years and our new vet does annual core vaccinations. One of my dogs had the annual and I’m wondering if I can discuss waiting on doing boosters until 3 years instead of every year. Or, if I’ll need to have boosters done in a year and at that time request 3 year.

    I really appreciate all the info you provided for us pet owners to make more informed decisions.

    Thanks!

  • http://canisbonus.com/canis-blogus/ Laure-Anne

    Great article! I was looking for a short article giving me the low down on vaccinations as I am getting really confused, and this is just the thing. I also went on Amazon to get myself a copy of Dr Kay’s book. If you’re interested in the subject, there’s also a great chapter on this in Linda Case’s classic book “The Dog”. A true must-read for dog professionals.