Today I saw Miss Lola, one of my cutest little Poodle patients. (Why are they all named Lola?) After spending the better part of her first year of life suffering from various and sundry gastrointestinal maladies, she’d finally been free of us for over three months. And so it was that yesterday, during her first annual checkup (technically undertaken at sixteen months of age), Lola seemed in perfect health.
Today, however, is another story.
Last night. ‘round about nine PM, her owner called me frantically, describing symptoms typical of a mild vaccine reaction. No vaccine reaction is ever “mild” from a pet owner’s point of view, but this presupposes that said owner has never witnessed a severe reaction. (Everything’s relative, isn’t it?)
When I saw Lola today she was slightly feverish (102.4) and moderately painful all over—more so at her injection site. It was a classic, mild vaccine reaction for which I prescribed a small dose of Rimadyl after administering subcutaneous fluids. Her owner called later to report that Lola was already feeling better.
Lola’s experience notwithstanding, the lion’s share of vaccines seem to provoke no illness. The pet is vaccinated in hospital and goes home within fifteen minutes where no untoward effects of the vaccine are typically noted.
Most reactions we do see include swelling of the muzzle and face, myalgia (muscle pain) and fever and, less commonly, vomiting. These are often treated with antihistamines and pain relievers. The most severe, life-threatening reactions are very rare indeed. The only one I had the displeasure to attend occurred in vet school when a cat, vaccinated at a nearby hospital, suffered acute respiratory distress almost immediately after a vaccine was administered. The kitty died—very quickly, I might add.
Lest I forget, let me now mention another more common, if controversial, life-threatening reaction: the vaccine-related sarcoma. As the cat people among you probably already know, vaccine-related, highly-malignant tumors are sometimes seen in cats. Although it was difficult to prove, this disease has finally received its due respect as a phenomenon related directy to vaccination. Our hospital has only seen four or five possible cases in over thirty years, but it’s out there as a potential consequence of vaccine administration.
My goal here is not to scare the bejeezus out of you, just to inform you of how we vets think about vaccines. We know they’re potentially dangerous. We all worry about the possibility of a reaction. And that extends to our families, too: I didn’t have my own son vaccinated without trepidation, either, but—believe it or not—I consider it my civic duty to vaccinate myself and my whole family, pets included.
If you want to discuss safety, here’s the reality: In a population where 100% of the individuals are vaccinated, the safest condition is to be the only unvaccinated one. The implication here is that vaccination has its risks. Best not to receive the vaccine. But if everyone opts out, no one’s protected. A conundrum, indeed.
Why else would we have Federal mandates for early vaccination in children? Why is rabies vaccination mandatory for our pets? Because if everyone is given free leeway to eschew vaccines, protection is not possible for the population as a whole.
Opting out is always possible—I, myself, sign “not in best interest” forms (for extreme geriatrics and ill patients) on a regular basis—but the government does everything in its power to thwart these efforts. And it should. Whatever your vaccine politics, it’s hard to deny that without this approach we’d still be suffering from smallpox and polio.
In our highly individualistic society, we’re trained to consider our self-interest in a positive light, regardless of connotation. And science has opened its doors to public scrutiny in ways heretofore unseen by our culture. It stands to reason that we might hesitate to expose our dearest loved ones to newly revealed risks.
With our newfound knowledge comes the need to understand the very real dangers of not vaccinating as well as the responsibility to demand more safety from basic medical products like vaccines. But opting out is no answer to the dilemma—it only puts your child, your pet, yourself and society at large in harm’s way.
Alternatives for the “no vaccine” movement are out there. For example, science demonstrates that antibody titers from vaccines remain active for many years beyond the previously accepted norms. In our hospital, this finding led us to change our vaccine protocols a couple years back:
We vaccinate every three years with few exceptions. We don’t administer vaccines for illnesses our area doesn’t see (however, we do ask about travel plans). We don’t vaccinate for kennel cough unless a dog is at risk due to his habits (puppy park, day care, kennel stays, etc.). We give intranasal vaccines whenever possible. We don’t ever administer feline leukemia to indoor cats (it’s the one vaccine most closely associated with sarcomas). And we vaccinate every cat on its hind limbs (under the skin near the ankle) so that any potential tumors can be removed without removing the whole cat.
You can be sure that the same considerations are taking place in human medicine at all levels. Mercury, autism, cancer and other potentially immune-mediated diseases are too scary for parents to ignore. But what can we do? Failure to vaccinate means a failure to attend to society’s needs because we consider ourselves and our children more important than others.’ Even if that’s how we feel, our understanding of the science of vaccination should let us get past it.
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I have had my opinion vary widely with my knowledge and exposure risk. In my ignorance and access to free-to-me vaccine, while we worked at the shelter all of our pets were vaccinated every three months. This group of pets I now steadfastly refuse to vaccinate unless it's absolutely necessary. That was waaaaay too often and not good. But they didn't come down with anything we brought home, so we felt justified at that time.
With the pets added since then, I'm on a three-year schedule. These were not over vaccinated, and the two cats are indoor only animals. The basset is 12 and goes outdoors, so I try to be much more vigilant with his vaccines than the cats. If the vet prods for any of these to get their vaccinations, they will get them.
I did have a friend whose yorkie died from Rabies vaccination. The first one caused a sore that never healed, even after multiple debridements. The second vaccination killed him within a short span. Now she refuses to let her new yorkie be vaccinated at all. But then, all of her kids reacted badly to the MMR vaccine, and she has refused to let her youngest have that at all. She homeschools to avoid the federal regulations.
georg March 2nd, 2007 10:58:00 AM
What do you have to produce for Dade County in order to only vaccinate every three years for rabies without being fined? My Dane had a reaction to a vaccine (atrophy of the hip muscle he was injected in which recovered in about 1 1/2 years) but I don't want to get notices from animal control that my pet isn't up to date on vaccs. with the threat of fines to be levied.
Carla March 2nd, 2007 11:51:00 AM
For NY and rabies, it's first shot, second one year later, and after that it's three years, with proof of prior vaccination.
georg March 2nd, 2007 12:36:00 PM
At our feline-only hospital, we see about one vaccine-related sarcoma per year. All have been cats vaccinated by someone other than us. All but one were vaccinated with a particular brand of vaccine.
You didn't indicate (or I missed) whether you use only nonadjuvanted vaccines. We've been using the Merial Purevax line. We'd vaccinate for rabies every third year if Merial had a three-year nonadjuvanted rabies vaccine. I've heard they're working on it. We love the new needleless leukemia vaccine and hope Merial develops other transdermal vaccines.
catmanager March 2nd, 2007 03:23:00 PM
Thanks for covering this topic. I'm currently having problems with my cat from a vaccine reaction. She's developed a rather nasty looking sore.
Dana March 2nd, 2007 08:34:00 PM
I worry about vaccines, but I live about a block away from a state park, we get wildlife in our yard all the time, and I worry a lot more about my cat slipping out and trying to get territorial with a raccoon. My understanding is that raccoons carry rabies, and a pet who's been injured by one has to be euthanized unless its owner can prove vaccination.
Diane March 2nd, 2007 09:21:00 PM
The animal hospital I work for is a corporate one (can't say which one, of course, but I'm sure you guys can figure it out!); working for these types of practices has some benefits - better pay, established training protocols, etc. Definitely NOT a benefit is the fact that I'm supposed to inform people that their dog, no matter what its environment, needs to have a distemper/parvo combo, corona, giardia, lyme, leptospirosis, and rabies vx every year - no matter what! - and a bordetella vx every 6 months. As for the kitties, if the owner wants to do "what's best for the animal", it includes yearly FVRCP, FIP, FIV, and FeLV vx. It's disgusting, blatant, over-vaccination contrary to research supported by the AVMA, AAFP, etc. Vaccine markups make up such a huge chunk of the hospital's profit margins, however, that I don't see an end to it anytime soon. Some of the higher-ups argue that it's best just to vx annually w/everything b/c if we try to explain to owners the newer guidelines, most would take it as, "Oh - so these shots are good for 3 years? Great, I don't have to worry about Fido's health until 2010!" While it's true that the company's approach gets the animals in at least yearly (which should be happening anyways for general exams), I can't help but feel sick about the whole thing. The only thing I can do is objectively describe each vx, explain the company's vx "philosophy", and encourage owners to do some research - that is, until I can find comparable employment elsewhere!
anna March 3rd, 2007 03:52:00 AM
Just as a random note to Dr. K - I too, saw a poodle named Lola earlier this week. Her owner had awakened to find Lola munching on a bottle of herbal diet pills imported from South America. I spent the morning on the phone with the manufacturer's Miami office...butchering the Spanish language as I attempted to get information on the ingredients!
anna March 3rd, 2007 03:57:00 AM
I'm sorry, Anna. It must really suck to have to deal with that. I know I would hate it.
I wish they would just go ahead and pull the corona vaccine from the market. Every single piece of research I've read on it says that it's--at best--useless. And yet a lot of the time it's still included in the vaccine combos that puppies get.
Janine March 3rd, 2007 05:09:00 AM
Carla: In Miami-Dade county where you and I both live, every vet should have adopted the three year protocol newly admissible by the county (as of January 1st 2006). One catch--it has to be an approved three-year product. I would recommend, in your case, however, that your pet not receive vaccinations for rabies. To satisfy the county fully, however, an antibody titer performed by the University of Kansas (or Kansas State?--not sure right now) is a perfectly legal option. I wish every vet had gone to the three-year protocol but it looks like we're a lone outpost in the Miami area. Call around, perhaps others have taken the plunge. You can always come see me if your vet won't do if--even if just for the rabies issue (I would definitely not want to "steal" you from your vet. (I'm writing a post about that soon.)
Dr. Patty Khuly March 3rd, 2007 11:39:00 AM
catamanager:
I also realize that I had not mentioned titers as an option. (readers: It's more expensive but worth it--it's what I do for my own creatures now.)
Thanks for reminding me about quality quality and quality in vaccines.
Yes, we love the transdermals and always use nonadjuvenated vaccines.
And none of our sarcomas were vaccinated by us, either.
What a coincidence!
(readers take note: If you worry about vaccine safety, learn to ask for what you want. Your vet will surely accommodate.)
Dr. Patty Khuly March 3rd, 2007 11:46:00 AM
Anna: Our clients have taken to the new vaccine protocol very nicely. Yes, it did take some explaining but so far it seems like no one has failed to report for their annual visit since the change. Perhaps we have a different class of client. In fact--I know we do if you work where I think you work. Hang in there! We all have to spend time practicing in ways we'd prefer not to until we happen upon the right situation.
And yes, we do make less money but not by much. Our emphasis during the yearly visit has always been the physical and the diagnostics--full bloodwork and fecals every year. I've always gone out of my way to say the vaccines are a necessary evil and of secondary imprtance in many ways to the rest of what we do. Maybe it sunk in.
Dr. Patty Khuly March 3rd, 2007 11:51:00 AM
I worry about the vaccination protocol for my Yorkshires. My seven year old male and his 11 year old mother both have little nodules that remain at the site of every vaccination they have ever had. For a long time I lived in a vaccinate every year state and went to a vet who believed in the all vaccinations every year bit.
I wonder how often I need to be vaccinating them now that I live in a three year state, to avoid any future reactions/nodules/possible tumors.
Jenn March 17th, 2007 11:30:00 PM
There is no federal mandate for vaccinating children.
www.thinktwice.com
Vanne March 21st, 2007 12:45:00 AM
My cat died last week from receiving fvrcp, rabies and feleuk vaccines when he was not healthy enough to get them. He had been eating and drinking just fine and acting happy. I took him in for his yearly and they did a CBC and then gave him those vaccinations. I took him home and he immediately started acting ill. They gave me the CBC results the next day--he had serious liver problems and should NEVER have been vaccinated. I tried so hard to save his life, force feeding him several times a day, sub-q fluids twice a day and literally 7 different meds that the vet prescribed. He lasted almost 2 weeks and then it was just too much for his poor old body. I learned a lot with this experience and it broke my heart. I never knew vaccines could harm. I suggested to my vet that they run a CBC and evaluate it before vaccinating geriatric cats. Had they done this, my cat might still be alive.
Laurie Murray April 10th, 2007 05:24:00 PM
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