2011 Vaccines and Vaccination
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Richard B. Ford, DVM, MSM
Diplomate ACVIM and (Hon) ACVPM
Emeritus Professor of Medicine
North Carolina State University
College of Veterinary Medicine
Raleigh, North Carolina
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Over the past 3 decades, the number of vaccines licensed for use in dogs and cats
has increased significantly. Today, in the United States, the list of companion
animal vaccines (by trade name) numbers about 180. Because of this unprecedented
growth in the vaccine market, scientists, academicians, industry, and practicing
veterinarians have met over the past 10 years with the objective of reviewing the
current scientific literature on vaccines and developing vaccination guidelines
appropriate for use by practicing veterinarians. Those efforts culminated in the
publication of vaccination guidelines. The latest iteration of the canine (2007)
and feline (2006) vaccination guidelines can be accessed at no cost through the
American Animal Hospital Association and the American Association of Feline Practitioners
(AAFP). Updated canine vaccination guidelines will be published in 2011. In 2010,
the Vaccine Guidelines Group (VGG) of the World Small Animal Veterinary Association
(WSAVA) published the canine and feline vaccine guidelines intended for use by veterinarians
in countries outside of North America. The consistency in recommendations advocated
by each of these sets of Guidelines highlights the fact that vaccination is a medical
procedure and that the decision to use, or not to use, a particular vaccine
in an individual patient is the responsibility of the clinician.
For veterinarians who practice in the United States, the decision to implement either
the AAHA or AAFP Vaccine Guidelines is optional...the Guidelines are merely recommendations.
Furthermore, the Vaccine Guidelines are not a universal protocol applicable to all
dogs and all cats. Instead, they are intended to guide decisions leading to the
development of a rational vaccination protocol.
What follows are summary tables of representative vaccination protocols for CORE
and NON-Core vaccines utilized by practices that have adopted AAHA and AAFP vaccination
guidelines. In addition, a number of key issues and frequently asked questions are
addressed, the answers for which are consistent with the current standard of care
in veterinary medicine.
-VACCINATION PROTOCOLS-
A. Canine Vaccination-Initial Series:
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CORE Vaccines
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Administration
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Booster
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MLV or 'r' Distemper +
MLV Parvovirus +
MLV Adenovirus
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8 wks; and 12 wks; and 16 weeks of age
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Not later than 1 year following the last dose in the initial series
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Option:
Parainfluenza virus is often administered in combination with the above vaccines.
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Where parainfluenza virus vaccine is indicated, intranasal vaccination (which is
combined with B. bronchiseptica) is recommended.
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Rabies-1 year (killed)
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Single dose usually given at 12 or 16 weeks (Local or State Statutes apply)
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Single dose of a Rabies 3-year.
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NON-CORE Vaccines
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Administration
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Booster
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B. bronchiseptica + parainfluenza virus (intranasal)
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Single dose (intranasal) at 12 or 16 weeks of age. (some authors recommended 2 doses
at 12 and 16 weeks of age).
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Where risk of exposure exists...administer a single dose 1 year following the last
dose administered.
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Leptospirosis (killed) 4-serovar
[2-way Leptospirosis vaccines are no longer sold nor are they recommended]
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2 initial doses, 2 to 4 weeks apart.
NOTE: do not administer the 1st dose prior to 12 weeks of age.
ALSO: Small Breed dogs: delay initial administration until after completion of
the CORE series.
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Where risk of exposure exists...administer a single dose 1 year following the last
dose administered.
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Lyme disease
(recombinant or killed)
(recombinant Lyme vaccine appears to be less reactive than killed vaccine)
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2 initial doses, 2 to 4 weeks apart.
NOTE: do not administer the 1st dose prior to 12 weeks of age.
ALSO: Small Breed dogs: delay initial administration until after completion of
the CORE series.
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Where risk of exposure exists...administer a single dose 1 year following the last
dose administered.
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Canine Influenza Virus (killed)
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2 initial doses, 2 to 4 weeks apart.
NOTE: do not administer the 1st dose prior to 12 weeks of age.
ALSO: Small Breed dogs: delay initial administration until after completion of
the CORE series.
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- Indication for vaccination depends on individual patient exposure risk.
- Duration of immunity has not been established at this time.
- Manufacturer recommends annual re-vaccination where risk of exposure exists.
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NOTE: Canine Coronavirus Vaccines are Not Recommended.
NOTE: The Western Diamondback Rattlesnake (Crotalus
atrox) vaccine is conditionally licensed as an aid in reducing the severity
of clinical signs associated with envenomation. This vaccine should only be recommended
for use in dogs with a clear risk of exposure.
B. Canine Vaccination-Adult Boosters
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CORE VACCINES (distemper+parvovirus+adenovirus-2): administration of a single dose
every 3 years is recommended. Rabies vaccine should be administered in accordance
with State/local law; where laws are not in effect, administer a single dose every
3 years.
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NON-CORE VACCINES: administer annually where risk of exposure is sustained.
C. Feline Vaccination-Initial Series:
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CORE Vaccines
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Administration
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Booster
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MLV Panleukopenia +
MLV Herpesvirus +
MLV Calicivirus
When feasible, avoid the use killed (adjuvanted) vaccines in cats.
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Single dose at: 8 wks; and 12 wks; and 16 weeks of age.
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Not later than 1 year following the last dose in the initial series
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Rabies (recombinant [is the only non-adjuvanted rabies vaccine]).
Alternative: Rabies (killed-adjuvanted)
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Single dose usually given at 12 or 16 weeks (State or local law applies)
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Administer a single dose of Rabies vaccine within 1 year following administration
of the initial dose.
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NON-CORE Vaccines
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Administration
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Booster
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Feline Leukemia Virus (FeLV)
Recombinant-non-adjuvanted
(Also available as killed-adjuvanted)
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"Highly Recommended" for all kittens: 1 dose at 12 and 16 weeks of
age.
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Where risk of exposure exists...administer a single dose 1 year following completion
of the initial series.
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Feline Immunodeficiency Virus (FIV)
Killed-adjuvanted
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3 initial doses 2 to 4 weeks apart, if indicated. Vaccine is not commonly used.
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NOTE: initial vaccination will cause cats to have a False + FIV test result
on ALL commercial FIV tests for at least 1 year. Kittens having nursed from a vaccinated
cat may also have a False + FIV test.
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Feline Bordetella bronchiseptica
Attenuated Live Intranasal
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A single dose, administered intranasally, as early as 4 weeks of age, if indicated
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Feline Chlamydophila felis
(formerly: Chlamydia psittaci)
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2 initial doses 3 to 4 weeks apart, if indicated. Vaccine is not commonly used.
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Booster annually if risk of exposure is clear. (exposure risk among household cats
is very low).
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Virulent Systemic (VS) Calicivirus
Killed-adjuvanted
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2 initial doses 2 to 4 weeks apart, if indicated. Vaccine is not commonly used.
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Disease prevalence is considered low and limited to cluster environments (esp. shelters).
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NOTE: the Feline Infectious Peritonitis (FIP) vaccine is "Not
Generally Recommended" by the AAFP Vaccine Advisory Panel.
NOTE: the association between vaccine adjuvant (all killed/inactivated
feline vaccines are adjuvanted) and vaccine associated sarcoma has not been definitively
established. The evidence, however, is compelling. When feasible, it is recommended
to avoid use of killed (adjuvanted) vaccine in cats.
D. Feline Vaccination-Adult Boosters:
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CORE Vaccines (MLV panleukopenia+herpesvirus+calicivirus): administer a single
dose every 3 years following completion of the initial kitten series and the first
booster.
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Recombinant (NON-adjuvanted) Rabies: administer a single dose annually in
accordance with State or local law. Where laws are not in effect, administer a single
dose annually.
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Killed (adjuvanted) Rabies: Rabies vaccine should be administered in accordance
with State/local law; where laws are not in effect for cats, administer a single
dose every 3 years.
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Non-CORE Vaccines: (FeLV) recommended annually ONLY if risk is sustained
(ie, outdoor cats with reasonable risk of encounter with other cats). The recombinant
FeLV vaccine (administered transdermally) is not adjuvanted; \all other FeLV vaccines
contain adjuvant.
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Other non-core vaccines are seldom administered and should be considered only after
assessing and defining a clear risk of exposure. All other non-core vaccines are
recommended for annual administration as long as the risk of exposure persists.
Rabies Vaccination
While it is the choice of individual veterinarians whether or not to adopt any of
the current vaccination recommendations, it is important to note that AAHA and AAFP
do not make recommendations regarding Rabies Vaccination. State and/or Local
laws provide specific guidance regarding initial and booster vaccination for rabies
in dogs and cats. Where laws are not in effect, veterinarians are encouraged to
recommend rabies vaccination in accordance with recommendations included in the
tables above.
What NOT to do
Current national and international vaccination guidelines have cited some important
recommendations regarding what to avoid when administering vaccines to dogs
and cats. Five principle recommendations are highlighted below:
Do NOT...
...miss the 14-16 week dose when administering CORE vaccines to puppies and kittens...
veterinarians are encouraged to advise clientele that, during the course of "puppy"/"kitten"
shots, the last dose in the initial series may be the most important. "Don't
miss this dose"...as it may be the first opportunity to immunize without risk
of interference from maternally derived antibody.
...administer any vaccine at an interval of less than 2 weeks. It is possible
that innate immune responses (cytokines, etc.) could interfere with the second dose
of a vaccine administered within a 10-day period following vaccination. This effect
is not antibody-dependent and, therefore, applies to any vaccine.
...reduce the volume of any vaccine as a way to reduce the risk of an adverse reaction.
Doing so may result in sub-optimal, or no, immunization.
...mix vaccines that are not specifically labeled for combination. Doing so may
result in inactivation of one or more antigens. Likewise, it is not recommended
to administer vaccines from different manufacturers into the same site at the same
appointment.
...administer any vaccine licensed for intranasal (IN) administration by the subcutaneous
(SQ) route. Doing so, especially with IN B. bronchiseptica vaccine, may cause
abscess formation or, in some cases, death. Also, oral administration of
a vaccine labeled for IN administration will result in inactivation of the antigen
and failure to immunize.
Frequently Asked Questions
1. In the past, it was common to administer additional doses of parvovirus
vaccine to Doberman's and Rottweiler's. Is this still necessary?
No. The reason for vaccinating "black & tan" breed puppies with parvovirus vaccine
beyond 16 weeks of age (out as far as 20 and 24 weeks) was based on the fact that,
in the 1980s, many of these breeds, despite receiving appropriate doses of parvovirus
vaccine, remained susceptible to exposure and infection. The genetic susceptibility
of dogs not to respond to parvovirus vaccine is not recognized today. Additional
initial doses of parvovirus vaccine, beyond that stipulated in the table above,
are not recommended for any breed.
The same applies to cats. There are no unique feline vaccination requirements based
on breed.
2. Missed Doses...If a dog/cat misses a dose of vaccine, what are the recommendations
for follow-up vaccination?
In general, the answer is based on: 1) the age of the patient and 2) the type of
vaccine.
In Puppies/Kittens: If one of the doses in the initial vaccination series
is missed by more than 6 weeks it is recommended that the patient receive
2 additional doses...at an interval of 2 to 6 weeks apart.
In Adult Dogs/Cats: If an annual dose of an MLV (cat/dog) or recombinant
canine Distemper vaccine is missed, administration of a single vaccine dose, regardless
of the time elapsed since the last dose, will provide a rapid boost of immunity.
However, if the vaccine dose missed is a killed (inactivated) vaccine, the recommendations
are somewhat different. Remember, there are limited data available to validate these
recommendations but, in general, if the interval between doses of a killed vaccine
(especially leptospirosis and Lyme disease) exceeds 2 years, administration of
2 doses is recommended...at an interval of 2 to 6 weeks. Canine influenza
virus vaccine, although inactivated (killed) may be an exception in which a single
dose would be sufficient to boost immunity following an interval of 2 or more years.
There are no firm recommendations regarding FeLV re-vaccination in the event the
interval between doses exceeds 1 year.
3. Adverse Reactions: What are the recommendations for managing acute adverse reactions
that might occur following vaccination?
Remarkably little information is published on this subject. However, a review of
the literature and recent surveys of hundreds of veterinarians have provided some
insight on the prevention and treatment of acute adverse reactions.
NOTE: Vaccines can and do provoke a series of complex immune reactions that
may cause rapid-onset side effects lasting from a few hours to as long as a few
days. Such reactions are typically self-limiting. Treatment is seldom necessary.
For this reason, veterinarians are encouraged to inform clientele that transient
side effects for up to 2, and possibly 3, days following administration of any vaccine
could occur. Acute-onset side effects commonly observed include: reduced or loss
of appetite (lasting for 1 or 2 feedings), pain at the injection side, lethargy
(lack of activity), reluctance to walk/run, and mild fever. Signs persisting beyond
3 days warrant clinical evaluation.
Treatment: Among dogs, significant acute-onset (minutes to hours) signs associated
with vaccine administration typically include angioedema (swollen face/ears) and
(rarely) shock/respiratory distress. Cats tend to manifest acute-onset gastrointestinal
signs (vomiting, diarrhea). Rarely, cats will develop acute hypotension and collapse.
Corticosteroid (methylprednisolone) therapy is indicated in any of these patients.
Intravenous fluids and respiratory support are always indicated in patients that
develop significant hypotension following vaccination.
Prevention: Despite the lack of supporting research, it is customary in veterinary
medicine to administer a single dose of antihistamine (e.g., diphenhydramine, 2-4
mg/kg, orally or 1 mg/kg, parenterally) to a patient with a known, or suspected,
history of having previously had an acute adverse event associated with vaccination.
Antihistamine should be administered approximately 30 minutes prior to vaccination.
Alternatively, some veterinarians will elect to administer vaccine from a different
manufacturer. Neither of these recommendations guarantees that an acute-onset adverse
reaction will be prevented.
4. Small Breed Dogs: Small breed dogs given multiples doses of vaccine at the same
appointment are known to have a greater risk of having an acute-onset adverse reaction.
What recommendations are available for administering vaccines to small breed dogs?
A "small breed" is generally considered to be any dog that has, or is expected to
have, an adult body weight of 20 pounds (approximately 9 kg) or less.
Mitigating the risk of an adverse vaccine reaction by arbitrarily reducing the volume
of the vaccine dose administered is not recommended.
It is generally assumed, although not definitively proven, that inactivated (killed)
vaccines (especially leptospirosis, Lyme, and rabies) may pose a greater risk for
adverse reactions than modified-live or recombinant vaccines. In small breed dogs,
it is reasonable to prioritize administration of the CORE vaccines (distemper, parvovirus,
adenovirus-2, and rabies) and delay, by at least 2 weeks, administration of any
NON-Core vaccines (leptospirosis, Lyme, canine influenza). The decision to further
separate the administration of NON-Core vaccines is left to the discretion of the
clinician. Although doing so increases the number of appointments to complete the
vaccination series, and may inconvenience the client, this extra effort on the part
of the clinician and the client may be an important safety issue for small breed
dogs.
