Monday, February 7, 2011

Overvaccination: Is This Really Happening?

Sorry, vaccinarians, I just have to write about this.

Do know that sash of bullets that Rambo wore? I always imagine a vaccinarian should have a similar sash, except it would be lined with vaccines instead of bullets. One day when I’m hosting Saturday Night Live, I promise to have a skit about it.

Anyway, I recently saw two back-to-back appointments that were oddly linked to each other. The first was an annual exam for a 10 year old, indoor-only cat, who was "due" for the gamut of vaccines - FVRCP, rabies and feline leukemia. This particular senior cat had never had bloodwork, a urinalysis or screens performed on it. However like many other clients, the cat's person was concerned that the most important reason for her cat’s vet visit was its vaccines. The next appointment I saw was another indoor only cat, 4 years old, with a nasty, festering, baseball-sized malignant fibrosarcoma on its left hindlimb, a finding that is almost always associated with the feline leukemia vaccination.

Obviously, most cats vaccinated with the rabies and feline leukemia vaccines never develop these tumors, but it is estimated that as many as 1 in 1000 do. Ever since vaccine-associated sarcomas were first elucidated in the early 1990’s, practitioner associations and task forces have recommended limiting the feline leukemia vaccine to high-risk cats only – as in, those who roam outdoors and are likely to contact or fight with other cats. In determining risk, it’s also important to remember that susceptibility to the virus declines considerably with age. In other words, it is a practical impossibility for an indoor-only, 10 year old cat to contract feline leukemia virus.

In short, lifelong vaccine-centric medicine is not good medicine. In all honesty, only a fraction of vaccines given to your pet in its lifetime are, in general, crucial to its health. For dogs, this includes the first DAP (distemper, adenovirus-2, parvovirus) “puppy series” and rabies vaccine. If you saw the movie Old Yeller as a kid and/or need to comply with state laws, your dog needs to also have repeat rabies vaccines every 3 years of its life after the 1 year booster. For cats, it is important to complete a FVRCP “kitten series.” Feline rabies vaccine mandates vary from state to state; I seldom gave them to indoor cats in California, but NY requires it.

Do not assume that because vaccines can occasionally cause adverse reactions that your puppy or kitten should not have its puppy/kitten series. This is a big mistake. Parvovirus is everywhere, I see it all the time, and it is hell on Earth for a baby dog to spend time during its first few months of life flat-out, depressed and dehydrated in a pool of bloody diarrhea and vomit. Not to mention that even with expensive, aggressive, often week-long hospital stays, they don’t always survive the disease.

After your puppy or kitten has its series, booster him or her a year later, but after that, repeat DAP or rabies vaccines need not be given more often than every three years. Ideally, a distemper-parvo antibody titer can be performed periodically to ensure persistent immunity. In New York, if you lapse on the rabies vaccine (i.e. return for a booster after the due date) vets are required by law to give another 1 year vaccine instead of a 3 year. So if you're giving your pet a rabies vaccine and your state has an equivalent law, get it in to the vet on time so no one sticks you in a corner.

Annual distemper or rabies vaccines on current, previously vaccinated dogs are not medically functional and confer no "extra" immunity. Antibodies from these vaccines have been repeatedly demonstrated to last much longer than 3 years, and often last the life of the animal.

There are a couple of other vaccines that may be of benefit in certain situations (i.e. Lyme Disease, leptopirosis), depending on your location and possible exposure to wildlife. Vaccine manufacturers market these vaccines zealously in an attempt to bring them up to the same perceived level of necessity as, say, puppy DAP vaccines, but I disagree with how commonly these vaccines are administered. To avoid being altogether contentious, I will simply state that I live in a hotbed of Lyme disease, ticks, deer and rodents, and I still choose not give my dogs either of these vaccines.

In general, here is a short list of vaccines that I definitely do not recommend giving to your animal, either because they target minor, easily treatable illnesses, or because their efficacy has not been sufficiently demonstrated.
Canine porphyromonas
Canine coronavirus
Feline leukemia (unless outdoor cat, and even then consider discontinuing after 5 years of age)
Canine rattlesnake vaccine
FIV (feline immunodeficiency virus)
FIP (feline infectious peritonitis)

I tend to be in agreement with the UC Davis vaccine protocols, which are available for your perusal hereFor your information and/or entertainment, here is a letter written nearly a decade ago by a Texas veterinarian; he filed a complaint against vaccinating veterinarians in the state for: "fraud by misrepresentation, fraud by silence, theft by deception, and undue influence."

Unrelated, but also for your entertainment, is this anecdote: A client recently told me, "When I die, I want to donate my body to Purina, so they can make a cat food out of me." And then, in a justifying, explanatory aside, she said, "I just really love cats." (?!)

 Until next time....please continue to be the supervet that you are: