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Controversy Over Vaccines
Veterinarians divided when it comes to immunity

For years people suspected that pet vaccines didn't need to be administered annually and that immunity was more similar to human shots. Fortunately in the last ten years, veterinary colleges and organizations, such as the American Veterinary Medical Association (AVMA) and the American Animal Hospital Association (AAHA), revisited their guidelines and now recommend administering core vaccines every three years. It's even becoming more common to find veterinarians who measure antibody levels through blood titers instead of defaulting to regular booster shots (this is one of my requirements when choosing a vet).

But even with the AVMA and AAHA constantly revisiting their guidelines, pet vaccines remain a tricky topic. It's further complicated by the fact that many studies are sponsored by vaccine manufacturers, which creates a potential bias. Dr. Richard Ford, a 2003 AAHA Canine Vaccination Guidelines Task Force member, has said that the decision to recommend a three year re-vaccination schedule was an arbitrary compromise that was not based on science.

And frequency isn't the only controversy. Earlier this month, a Connecticut veterinarian had his practice taken away from him after Banfield found out that he had been administering half-dose vaccinations. Dr. John Robb believes that it's not safe to use the same dose for all dogs and cats, particularly for the smaller breeds.  

Dr. Robb bought his Stamford, Conn. Banfield franchise in 2008, a year after the veterinary hospital chain was acquired by Mars and PetSmart. He believes that the corporations are not only unfairly targeting him because they want to ultimately cease franchise ownership for their hospitals, but are jeopardizing the health of his clients' pets.

There are definitely arguments for both sides of the issue, but I can see where profits and insurance risk could create a conflict for a medical organization owned by two big corporations.

AAHA President Dr. Mark Russak believes that Robb is putting pets at risk and creating a potential public health concern with incorrectly administered rabies shots. He says that vaccines are manufactured through scientific trials to determine the correct amount of antigens needed to stimulate the immune system.

But while many veterinarians disagree with Dr. Robb's vaccine protocol, Jean Dodds, a leading expert in this area, says that dosages can be adjusted safely. She has been vaccinating toy breeds with half doses for years and is currently spearheading a campaign to increase the rabies vaccination interval from three to five years with the hope of eventually changing it to seven.  

A 2002 study published in the Journal of the American Veterinary Medical Association showed that there are potential problems with using a universal dosage. The research documented a higher incidence of vaccine-associated adverse events in dogs less than 22 pounds (27 percent versus 12 percent for dogs over 22 pounds with each subsequent shot).  

The fact that there is so much division among veterinarians on this topic just goes to show that more work must be done in this area to develop guidelines we can trust.  

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JoAnna Lou is a New York City-based researcher, writer and agility enthusiast.

Photo by Lindsay Perry.

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Submitted by PBurns | February 22 2013 |

You are missing part of the story: AAHA is a bulk seller to vets and has a monetary interest in upcoding. See >> http://terriermandotcom.blogspot.com/2010/06/payola-and-pushers-in-veter...

If you want to know what do do about vaccines, pay atttention to what the world's authority on vaccines does with his own dogs... and has been doing for 30 years. See >> http://terriermandotcom.blogspot.com/2009/01/billion-dollar-vaccine-scam...

Submitted by desertorange | February 28 2013 |

I don't mean to make generalizations about veterinarians, but I was scammed by my first veterinarian about heart-worm treatment. I live in southern Nevada, we don't have the mosquitoes in the middle of the desert, yet the veterinarian office scared me into treating my dog with heart worm treatment and testing every six months. I went along due to my initial ignorance, first dog, but it got a bit ridiculous when they refused to sell me the heart-worm pills unless the dog had been tested "according to the manufacturer" recommendation. It got me worried that the dog would miss a dose of his medicine, I've been giving him the heart-worm pill religiously every month as they told me to do. This vet office also refused to titer test my dog, insisting in yearly vaccine boost and every 6 months bordatella vaccine; they literally told me titer testing was a waste of money when the booster vaccine was only $30 a year, (titer test starts at $90). Due to their refusal to titer test, I then went to another vet's office where they informed me that my dogs didn't need heart-worm treatment at all unless they traveled to a state with known heart-worm incidents. New vet also does titer test in same office now and subscribe to the every 3 year vaccine testing. The lesson is, we need to trust our health providers and veterinarians, that they are up to date with current accepted research and that they don't scam us or scare us into buying treatments that we don't really need. This office where I was scammed (there is no other way to put it nicer) is run by 6 young female vets, and they are very nice and they talk with great authority and the office is very clean and everything would give you the impression that you should trust them. I happened to come across different information, but they are countless older people who are scared into yearly vaccines, unnecessary hear-worm prevention and unnecessary costs.

Submitted by Debbie Gilbert | February 22 2013 |

In the rural county where I live, we only have one veterinary clinic. I am generally pleased with their service, but we have argued for years about vaccines, which I believe are being administered too frequently. If you want to use their boarding kennel, they require your dog to be vaccinated against parvo and kennel cough every six months. There is no scientific evidence that such frequent shots are necessary -- but if you refuse, they won't let you board your dog.
I had to abide by that rule because there was no other vet in town. But this spring a new animal hospital will be opening, and I am thinking of switching veterinarians. If I do, I will inform my old vet that I am leaving due to their vaccine policy.

Submitted by Anonymous | February 28 2013 |

This is my concern as well. In order to take your dog to a kennel or day care, etc, they require proof of vaccinations. You can either vaccinate your pet and take them or you are out of luck.

Submitted by Anonymous | February 22 2013 |

Medications are prescribed based on weight, so I don't see why vaccines wouldn't account for it as well. There's a big difference in med dosage amounts for a 10lb dog and an 80lb dog!

Submitted by drarnoldlgoldman | February 28 2013 |

“For years people suspected that pet vaccines didn't need to be administered annually and that immunity was more similar to human shots. Fortunately in the last ten years, veterinary colleges and organizations, such as the American Veterinary Medical Association (AVMA) and the American Animal Hospital Association (AAHA), revisited their guidelines”

This didn’t occur because of “people’s suspicions” or internal politics of veterinary organizations, it occurred because new research demonstrated the longer duration of immunity we are now aware of. “People’s suspicions” were anecdotal and often had more to do with reluctance to vaccinate, money or other reasons. Veterinarians followed manufacturer’s recommendations of and at that time, and do so now differently, precisely because those recommendations were able to change, based on the newer research. The implication that immunization was done annually for other than medical reasons as they then existed, i.e. meeting the standard of care of that time, is offensive to conscientious veterinarians.

“becoming more common to find veterinarians who measure antibody levels through blood titers instead of defaulting to regular booster shots (this is one of my requirements when choosing a vet).”

The far greater cost of doing this makes it prohibitive for the vast majority of clients. We offer it, we do it when asked, but the “default” is to the research verified manufacturers recommendations. As every dog and cat is different, many clients choose the now common three year booster, rather than pay more for immunity verification, which may or may not prove that a 4th, 5th or 6th year of immunity still remains.

“Dr. Richard Ford, a 2003 AAHA Canine Vaccination Guidelines Task Force member, has said that the decision to recommend a three year re-vaccination schedule was an arbitrary compromise that was not based on science.”

Dr. Ford is entitled to his opinion, as one individual. As an academician, however, he does not much have to deal with cost conscious clients. The compromise to which the author refers is simply based on a three year duration of immunity proved by scientific research. True, it may be possible to demonstrate a longer duration of immunity through more research, however that science is costly and time consuming. As dogs and cats life spans are commonly 12 to 15 years, rarely to 20, being vaccinated with three year duration vaccines every three years for a total of 5 or 7 times in a lifespan, need not to be considered excessive, especially if one considerss the cost of treating the diseases we vaccinate against. Should research ever be done which conclusively shows a longer duration, then the intervals can be adjusted again. Today’s interval is three years. It's primarily about disease prevention, not vaccine avoidance.

“Earlier this month, a Connecticut veterinarian had his practice taken away from him after Banfield found out that he had been administering half-dose vaccinations. Dr. John Robb believes that it's not safe to use the same dose for all dogs and cats, particularly for the smaller breeds. “

If these allegations are true, Dr. Robb has violated the standard of care. As an ordinary general practitioner, he has no special expertise or training in immunology, and “beliefs” are no substitute for scientifically verified knowledge. Violating the standard of care and manufacturers recommendations is a risky proposition, with all the risk absorbed by patients and clients. His very public campaign to try and get the veterinary establishment to agree that he knows better than everyone else, is therefore destined to fail.

“AAHA President Dr. Mark Russak believes that Robb is putting pets at risk and creating a potential public health concern with incorrectly administered rabies shots.”

Of all the things Dr. Robb has been accused of, this accusation is the most egregious, as Rabies immunization is given to pets to protect the public health, i.e. humans, not the pets themselves. As such, the liability here is huge, and the risk to the public is real. Dr. Russak is absolutely right in his assertion, and the veterinary profession will never stand behind a colleague who would risk Rabies transmission to a human being.

“Jean Dodds, a leading expert in this area, says that dosages can be adjusted safely.”

This may be true, but the research must be done first, not afterwards. While Dr. Dodds may be a researcher, as well an effective advocate for her views, she of all people should council patience to the public, until studies are done which verify her theories.

“The fact that there is so much division among veterinarians on this topic just goes to show that more work must be done in this area to develop guidelines we can trust. “

There is not “so much division” but rather there is the vast majority which seeks to meet the standard of care and use manufactured products as they are intended, and then there is a vocal few who advocate or act on their beliefs far ahead of demonstrable scientific proof that their theories are valid. When debates like this break out into the lay press, into blogs and among ordinary pet owners, it confuses people, sometimes angers them and they are left not fully trusting the veterinary profession. While I do not advocate any sort of scientific censorship, those advocating novel theories and treatments should hold those beliefs in doubt, and communicate them as such, until they are beyond any doubt. That is the ethical way to discuss scientific disagreement with a public not versed in the nuance of scientific debate. Indeed, holding the debate in public is a form of advocacy that has no place in science. Science is about getting as close to the truth as you can, acknowledging what is not known and changing as more becomes known. Recent changes in immunization recommendations demonstrate that process beautifully.

The author is absolutely correct when she asserts “more work must be done in this area” however incorrect when she follows with an expression of a lack of trust in current guidelines. Today’s guidelines are based on today’s science. We can’t wait years to start preventing disease, until the perfect, complete guideline is developed. That will never occur, as new knowledge continuously becomes available and guidelines will continuously change. We must act on what we know now, for now.

Arnold L. Goldman DVM, MPH

Submitted by mirjam | February 28 2013 |

Would you give an infant the same dosage of medicine as a grown person? I am sure medicical science did not research that (maybe after they were dropping dead....).
With common sense you can figure out that for different size dogs the same probably applies.
Besides how good was the research that decided that every dog should get the same?

Submitted by Anonymous | February 28 2013 |

O K , so what do we do about the counties that require us to buy a license for our dogs that is contingent upon rabies vaccines every two years ?

Submitted by drarnoldlgoldman | February 28 2013 |

We obey the law in those counties, and then advocate through your state department of public health, health or agriculture to bring those counties into alignment with state law and manufacturers recommendations. the change won't be quick but over time these things tend to get sorted out. And keep in mind, licensing is about funding, whether for animal control services or just general funds. 2 years between license periods brings in more and more frequent income than three.

Submitted by Anonymous | March 2 2013 |

I have demanded titres with a confirmation letter of the numbers my dogs were recorded at and the recommended levels from the labs testing the blood for almost a decade now. My vet accepts this and agrees that annual vaccinations aren't necessary. He never fusses with me about this. As far as getting licenses from the county I live in, it isn't anything more than a money making deal from the gov't pick pockets. We shouldn't have to pay others extra to do their jobs making up statistical numbers
that are for the most part unnecessary. As long as my dogs are up to date on all their shots with proof of lab tests, I have endangered no one and I never have gotten in trouble for not registering them. They can find their extra dollars elsewhere.

Submitted by Becky | February 28 2013 |

My 10 year old pug had her rabies vaccine just 3 weeks ago and had a reaction to it for the first time. (She gets the 3 year.) She was OK after a benadryl shot and then a cortisone shot, but it was scary. I also had a pug that died 9 years ago after her vaccine, from thrombocytopenia. Terrible.

Submitted by Lorelei | March 1 2013 |

Do consider runing titers before administering more shots. My 7 yr old IG always reacted to innoculations, and the vet never suggested doing this. She, (the dog) developed immune issues that nearly killed her.... 6K later, we run the titers. They're cheaper than the potential alternative!

Submitted by Ana | February 28 2013 |

Thank you for printing this article. Kudos to Drs. Robb and Dodds for the wisdom, courage and insight to administer half-dose vaccines to smaller breeds. My miniature pincher was vaccinated with a 3-year rabies vaccine prior to leaving Hawaii as required by law. Within minutes, she went into anaphylactic shock and barely survived. More people need to come forward to bring this issue to light. We titrate dosages of medications based on weight in humans, why should we treat animals differently?

Submitted by Anonymous | March 4 2013 |

My ex husband and I bought litter mate Shih-tzus. He got a male and I a female. Because of his work schedule, I take both dogs to their well dog visits / vaccinations. When they received their first rabies shots everything went fine with my dog ( aside from the initial ear splitting ki-yi's. she is quite the drama queen my Jasmine) but when Nitro was vaccinated he never calmed down. He whimpered and paced anxiously for about 5 minutes. I then noted eye swelling. Being an RN, I was up and out the door with him looking for help. He received 3 shots of Benedryl over an almost 2 hour period before the allergic reaction was brought under control. The next time, we gave him Benedryl 45 minutes before his apointment as directed by our vet. Again he had a horrible reaction that took several hours plus an IV to control. While I don't agree with my ex, i can understand his decision not to vaccinate Nitro further. I assumed that doses were adjusted for size as it only makes sound medical sense. Finding out that they aren't astounds me. I can only wonder if Nitro had been given a dose properly titrated to his size if he would not have had an reaction at all.

Submitted by John R | July 2 2013 |

Excellent article!

Not only are vaccinations potentially harmful, but the rate at which vets/manufacturers push vaccinations is expensive. To make matters worse states and municipalities are basing their regulations on the manufacturer's guidelines.

I definitely think rabies vaccines are important, but I would rather know that 99% of dogs had only received their first set of vaccines than 70% of dogs are vaccinated yearly. I believe that this black and white view of vaccination is encouraging poorer pet owners to avoid the vaccines all together. Instead we should be trying to make initial vaccinations more affordable and encouraging titering in older vaccinated pets.

Submitted by Terry | January 23 2014 |

I have to wonder about people saying that the titers are more expensive than the vaccinations. We just had titers done for parvo and distemper for our pup, totalling $132 plus taxes. The vaccination would have been $75 plus tax. That doesn't seem like such a huge difference to me when it won't need to be repeated for another 3 years and my pup won't have to undergo a needless vaccination with its potential adverse reactions.

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