Vaccinations...Too Many, Too Often?

Vaccinations, vaccinations, vaccinations.  Dog and cat owners have been told by veterinarians and pet health care providers for years that annual vaccinations for Rabies, Distemper, Parvovirus, Feline Leukemia and on and on...are required yearly.  Annual vaccinations, also called annual boosters, have certainly played a major role in disease prevention in dogs and cats.  Nevertheless, the question recently on the the minds of dog and cat owners has been... Do these vaccines have to be given every year?  And a second and equally important questions is... are we vaccinating dogs and cats too much?  Are we actually causing harm by over-vaccinating our pets?

UPDATE! The American Association of Feline Practitioners has recently released a suggested Protocol for veterinarians to consider when vaccinating cats for various diseases.  Visit the AAFP website to see the 29 page report.

This article was developed to shed light on these questions of vaccine use.  Times are changing and vaccine protocols are changing.  But are we being swayed by unproved theories or are our decisions being made based on scientific and statistical evidence? After reading this article on vaccinations in dogs and cats, you, the dog and cat's health care provider, will be better equipped to answer the question: Vaccinations...Too Many, Too Often?

Vaccinations: Too Many, Too Often?
Nothing is sacred. Nothing stays the same. And so it is regarding the present state of affairs in the swirling waters of the pet vaccination world. There are a number of questions that could and should be asked before you allow your dog or cat to be vaccinated. Unfortunately, the answers to your questions will probably be determined not by firmly set scientific standards or universally accepted protocols but rather by the judgment and biases of the person you ask!

There are two major questions that beg for exact answers:

1.) Are multiple agent (multivalent ) vaccines "overloading" the pets immune system?
2.) Are "annual vaccinations" really necessary annually?

Not only are dog and cat owners beginning to ask about the safety and necessity of annual, multivalent vaccines for their pets but the entire veterinary profession is in a state of critical self-examination. From the highly technical research and development laboratories in the giant pharmaceutical corporations right on down to the solo practitioner operating a mobile clinic, the veterinary health care providers are asking:

Too many? Too often?

In an attempt to gather research for this article and to help clear the waters of disparate directives on the vaccination topic, my consensus is that nobody really knows how many or how often! So if the trained professionals disagree whether or not "Laddie" should get a seven-in-one vaccination, plus a Rabies inoculation, and that this schedule should be repeated yearly, how are you as "Laddie's" owner to know what to do?

Let’s take a swim through these turbulent waters and try to make some sense of what is fact and what is conjecture. Discussing the first question of multivalent vaccines and whether or not they are "stressing The Immune System we need to know a little about how an individual (human, dog, cat, mouse ... mammals are quite similar in their defense mechanisms against disease) responds to a pathogen. A pathogen is any agent such as a virus or bacteria or poison that harms the individual. Every minute of every day all individuals are being silently attacked by pathogens from the air, food, water, and contents of our own intestinal tracts. The true miracle is that any of us survive at all!

Through eons of evolutionary trial and error, those species who best defended against pathogens were able to produce similar offspring who were also immune competent, that is, able to fend off those harmful invaders. So we can safely state that, in general, those individuals alive today have healthy Immune Systems, otherwise all those nasty pathogens would have their way with us in short order! But some experts believe the overall state of health in many of the earth's creatures is declining, and that vaccinations are actually contributing to the demise of our immune systems.

The Immune System ... everybody throws this term around with reckless abandon and often the term is totally misunderstood. Here is what you really need to know about The Immune System if you are to have any calm water to swim through in this sea of controversy surrounding vaccination protocols:

The Immune System is really a general term for all of the body's pathogen defense mechanisms. The Immune System is not a single, discrete system, after all. There are a multitude of biochemical and anatomical factors that make up The Immune System but only three aspects that we will refer to in this article. These three active barriers to disease that play a major role in vaccination-induced immunity are the following:

1.) MUCOSAL IMMUNITY ... takes place in the thin mucous lining of the mammary, respiratory, urinary, and digestive tracts. This important barrier to disease often is the first line of defense against viruses and bacteria and the ammunition used against invaders is called "secretary IgA" antibody. This complex protein molecule binds up invaders and prevents their entrance into the body. Vaccine technology has taken advantage of this line of defense through the implementation of intranasal and oral vaccines. Much more emphasis will be placed on MUCOSAL IMMUNITY in the future since there is increasing evidence that human and animal populations are experiencing a measurable decline in IgA immune proteins. Just what is triggering the decline in IgA levels and what role vaccinations may play in this scheme is as yet unknown.

2.) CELL-MEDIATED IMMUNITY ... this refers to individual body cells that have learned by past experience (exposure) what foreign invaders look like and recognizes the invaders whenever they show up again!  So when a cell is exposed to an invader such as Parvovirus, the cell recognizes the virus as an invader and mounts a response by manufacturing immune proteins. If the strength and numbers of the virus attack don't kill the cell, the cell is now educated as to what Parvoviruses look like and becomes better equipped to defend itself from future Parvovirus attacks.

Natural exposure as well as vaccine products which "look like" a natural pathogen but don't present a threat to the cell can induce the cell to remember what the foreign invaders look like. A healthy cell is then prepared to fend off future attacks.

There are lots of body cells whose main job is to fight off disease. Plus, every cell in the body that has a special function... let's say a liver cell that has to store glycogen, make cholesterol, convert protein into building material, plus regulate numerous other chemical reactions...still has the ability to recognize an invader and fight for its life! For the most part, specialized white blood cells play a major role in CELL-MEDIATED IMMUNITY.

3.) HUMORAL IMMUNITY ... works from the body's fluid sources, the blood and lymph. This is where we test for a dog or cat's immune levels (called antibody titers) so that we can get an estimate of how well the body can recognize an invader. If the body has had a previous encounter with a pathogen, just like with CELL-MEDIATED IMMUNITY), the body makes "Opposite Invaders" to circulate in body fluids. The "Opposite Invaders" are called antibodies. These molecules attach to or otherwise disable invaders and prevent them from doing harm to the body. And just like with CELL-MEDIATED IMMUNITY, it is safer for the body to learn to recognize an invader from a crippled or fake invader than to risk learning from an actual natural attack.

There are many other ways a "home-body" wards off disease, but these three major Immune System divisions working together carry the brunt of responsibility for defense against pathogens. Remember that there are no simple blood tests for CELL-MEDIATED IMMUNITY, it can be assessed but it is difficult and expensive to measure.

And each individual is unique as to how tough this line of defense is. HUMORAL IMMUNITY, however, can be measured by checking the levels of circulating "Opposite Invaders" that we call antibodies. Our ability to say that a dog or cat is protected from a disease based solely upon checking for high antibody titers is precarious ... but, from a practical standpoint, it's all we've got! It is very important to keep in mind that we can only assume what titer levels are protective and what levels are not. Antibody titer tests are not absolutely predictive of the individual's ability to fend off disease but rather simply indicate the strength of the immune system's memory of previous exposure to a specific pathogen. So if your dog has a high titer to the Rabies virus...does that mean that if exposed to the virus the dog will absolutely not get the disease? No one can  say absolutely not...we can only sat probably not.

Now that we have a better understanding of what The Immune System refers to and with the knowledge that we can test part of it, we can ask certain questions. The first one is...

"Are multiple agent vaccines overloading The Immune System?"  With your knowledge that every individual is continuously being challenged by invaders, it seems unlikely that "ganging up" on The Immune System is even possible. In fact there is overwhelming scientific evidence that a healthy body can respond with immune defenses to multiple challenges and can make protective levels of antibodies to a number of pathogens at the same time! Remember ... we're talking about normal and healthy individuals here! All bets are off if we are talking about severely stressed or presently sick individuals.  Could it be that the dogs and cats that may have had an adverse reaction to a vaccination were outwardly healthy, but in truth were  suffering from a pre-existing, undetected disorder?  With twenty-seven years of experience in  immunology, Robert Snyder, a Public Health Advisor at the Centers For Disease Control, has stated that there is "evidence that the more you stimulate The Immune System the better it works." This statement may very well be true, unless there is an overwhelming number and virulence of pathogens.

On the other hand there are knowledgeable individuals who would strongly disagree. Veterinarian Christina Chambreau, an holistic practitioner from Sparks, Maryland states that there are "all kinds of problems with vaccinations and they are probably the worst thing that we do for our animals".  Her belief is that by injecting vaccine into an animal we are effectively by-passing the body's normal lines of defenses and presenting to the animal foreign material in an unnatural manner. Repetitive vaccinations, she contends, rather than providing extra assurance that an animal will mount high levels of antibodies, actually has an adverse effect on the animal's overall ability to achieve a healthy balance within its disease fighting talents.

If I, as a small animal practitioner with twenty-eight years of experience, have a hard time reconciling these widely different viewpoints, how is the pet owner to make sense of the present state of affairs? And just to underscore the lack of uniformity of opinion regarding multivalent vaccines, I sent questionnaires to over twenty veterinarians including Dr. Carvel Tiekert, Executive Director of the American Holistic Veterinary Medical Association, seeking evidence that "too many" vaccines were causing harm to our pets. Not a single person I queried would offer any irrefutable evidence that the multivalent vaccines actually harmed pets. There are stories, there are opinions, there are theories, there is conjecture ... even suggestions that veterinarians are knowingly using all those vaccines to further their financial gains! (On this point, you should know that giving a pet a single dose of a single vaccine, then giving subsequent single dose vaccines for different diseases spread out over a period of time could be more expensive for the pet owner and more revenue for the veterinarian than giving a  multivalent vaccine.)

If you choose to believe that multivalent vaccines (such as the DHLPPCv so commonly used in dogs) are harmful to your pet and that only a single antigen (vaccine) should be given at a time, you may encounter difficulty since some vaccines are not available individually.  Keep in mind, though, that there are decades of evidence gathered from millions of individuals including humans, dogs, cats, cattle, horses, chickens etc. that multivalent vaccines are an effective and economical method of protecting individuals from disease.

Balance this, though, with the belief of some holistic practitioners that harmful effects of vaccinating may not be recognizable for several generations and that an individual may not show any signs of vaccine derived diseases in its lifetime. But future generations (offspring of the vaccinated animal) would not have optimum immune fitness because of the previously given vaccines.

Wow! Now we have to factor into the vaccination equation whether or not the pet is spayed/neutered or will be bred in order to make a proper ethical evaluation as to current vaccination requests! The choice is yours because there will always be health care providers who disagree.

The question of whether or not "annual vaccinations" really should be given yearly is a good one. How often is Too Often? The answer is somewhat elusive, too, because the only way we would know if an individual should be vaccinated right now would be to know that the individual is at high risk of getting the disease. In other words, if there was a nice test that would say "Yes, vaccinate immediately! This blood sample indicates that the immune system's mucosal, cellular and humoral immunity is low and needs reeducating!," then the choice to vaccinate would be simpler. (That is if you believed in vaccinating to begin with!) Some types of in-office blood tests are available at this time. However it may be a while before a wide range of simple and inexpensive tests for immunity-status-indicators for a multitude of pet diseases are available.  A complicating factor in duration of immunity after a vaccine is given is the unique character of each individual's Immune System.

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Regarding How Often to vaccinate, let's hear what a few pet health care professionals have to say...

What manufacturers and distributors are saying:

Pet owners should keep in mind that when a laboratory conducts duration of immunity studies the dogs and cats are healthy and kept in clean, parasite free surroundings and are very well provided for. This is done not only for humane reasons but also to be able to evaluate the effectiveness of a vaccination over a period of time without all the other common variables the average dog might face. In reality it happens that dogs are vaccinated who have just been released from weeks of confinement in a kennel or shelter, or are parasitized, poorly fed or otherwise stressed. Will a vaccine given to a stressed animal be as effective over a long period of time as the same vaccine given to a normal, healthy dog? The correct answer is: Maybe and maybe not. Each individual is so unique that no prediction can ever hope to be 100 percent accurate for any dog, cat or human when we are talking about what a vaccine will do. And that's a fact that everyone agrees upon!

Dr. Michael LaRosh at Fort Dodge Laboratories (one of the worlds largest manufacturer's of animal vaccines) has stated that he hopes someday there will be a practical and inexpensive way to measure the overall immune competence of the individual. He states that particularly with cell-mediated immunity there are difficulties in establishing the individual's protection.  Think of "cell-mediated immunity" as a strong, high fence around the fort. If this fence is healthy enough, "humoral antibodies" (which can be measured by doing serum titers) may not even be needed. And no one is certain what levels of serum antibodies is a true protective level. Dr. LaRosh says that most of today's vaccine manufacturers are in the process of conducting extended duration of immunity studies.

He goes on to say "If, for example, a five year study indicates that one year after receiving a vaccine, 90% of dogs are still protected against the specific disease vaccinated for, and at three years 70% are still protected and at five years 50% are still protected ... what level of risk of disease will the pet owner be willing to live with? Every dog owner will have a different comfort zone and some owners may very well choose to vaccinate yearly, not knowing if their dog is in that group of 10% of vaccinates who don't hold an adequate level of humoral immunity after one year. Some pet owners may have a comfort zone at the three year-70% protection probability level and some will vaccinate every five years.

"Wouldn’t it be nice" Dr. LaRosh continues, "if veterinarians had a simple test that could be run quickly and accurately in the office at the time of the vaccination appointment? This blood test would assess serum antibody titers of all the common diseases vaccinated for and give the owner a readout of levels of protection against the diseases. Then the veterinarian could specifically customize a vaccination schedule for that patient based upon chances of exposure to the disease, chances of a reaction to the vaccination, the dog's health status and age, and the owner's comfort zone. No doubt someday this will happen."

Dr. Race Foster of Drs. Foster and Smith, Inc., asks the question "If vaccines really do cause subsequent autoimmune reactions, why aren’t animals coming down with autoimmune diseases after natural exposures to the disease? Some dogs and cats may develop immune disorders subsequent to being vaccinated but it is very hard to prove if the vaccine actually triggered the problem."

And as far as making a standard recommendation for vaccinations, he believes that there are so many variables in each individual dog and cat that a number of considerations should be explored regarding how many vaccines are administered and how often.

"And here is where the pet owner’s veterinarian can be helpful in making the decision".  Dr. Foster goes on to ask a very important and thought provoking question, "Is a vaccine failure really a fault of the vaccine, or a failure of the individual to make protective immunity to the vaccine? If a dog develops an autoimmune disease subsequent to a vaccination why don’t all dogs develop problems from that product? If a veterinarian had ten dogs in front of him to vaccinate, there would be ten different immune systems that would accept the vaccine each in a unique way. Pet owners should keep in mind that no vaccine for humans or pets is 100% protective, 100% safe, in 100% of the recipients of the vaccine."

Dr. Foster's remarks bring up another current hot topic ... do vaccines promote autoimmune diseases? Volumes could be written on this topic alone. Briefly, an autoimmune disease refers to a broad range of ill effects brought on by an abnormal response that The Immune System makes to things it wouldn't ordinarily respond to.

Something triggers or stimulates the body to react to its own tissues, to look at its own tissues as if they were invaders! A good example is autoimmune hemolytic anemia where the body's own red blood cells are destroyed by The Immune System because something told The Immune System that the red blood cells are pathogens, invaders, foreign tissue ... so a battle rages within and can ultimately cause the individual's death!

It is a known fact that some infectious disease agents occasionally trigger immune mediated diseases.  Are vaccines also a culprit in stimulating adverse immune mediated problems? When considering this question, one must staunchly resist the temptation to condemn all vaccines because of occasional failures or complications. There are people who will tell you that no vaccine is safe or effective and that they actually cause more diseases than they prevent. Conversely, a very strong case could be made that vaccinations have prevented far more death and disease than any perceived harm they may have done. (Unfortunately there is no way to prove that an individual is alive today because a vaccine prevented a fatal disease.)

There is overwhelming evidence from all over the world and encompassing many different species of animals that Edward Jenner's idea of stimulating the body to protect itself against disease prior to being naturally exposed is one of mankind’s greatest intellectual accomplishments.

I would suggest that you do some searching on your own through recent dog and cat magazines, the library, your veterinarians borrowed text books (Please bring 'em back!), or the Internet. After a few hours of research you will most certainly gain an insight into the pros and cons of vaccinating; you will begin to approach a personal vaccine comfort zone. But I'll bet you still won't have a firm conviction as to what exactly constitutes too many or too often!

Here's an important word of caution about using the Internet: The problem with the Internet is that you will have a difficult time sorting out fact from fiction. Believe me there is a tremendous amount of data available to you through your computer. However there's a balancing act going on here. You will find everything from hard statistical facts from the Centers for Disease Control to absolute garbage spilled from quasi-experts who take a single case history with questionable data and extrapolate wild and fanciful horror stories about the dangers of vaccinating your pet. I even read somewhere on the Internet where a veterinarian stated that there was "no scientific evidence that vaccinations even work and that they in fact cause far more disease and misery than benefit"! The real danger lies in the possibility that someone will actually believe this sort of nonsense.

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Since Edward Jenner 200 years ago began to inoculate humans with a cow pox virus (not harmful to humans) in order to instruct the human immune system to produce immunity to the very serious human disease called Small Pox, we humans have developed some truly magnificent vaccines. The entire world is now free from the devastating Small Pox disease. Unfortunately, there have been some failures, too. In your search to clarify your own comfort zone about vaccinations, you must be very careful to refrain from making sweeping generalizations from an isolated incident.

A good case in point would be the claim that some people make against vaccinating for all diseases just because back in 1954 one batch of one manufacturers vaccine cause some cases of polio. The problem was quickly rectified and the world has gone on to be relatively safe from this horrible disease. In fact you and I may be alive today because as children we were protected against diseases via vaccinations. A very common mental error is to condemn the entire process simply because of the occasional imperfection.

There are claims that dogs and cats are the innocent victims of over-vaccination. Too many vaccines, given too often, results in autoimmune diseases, arthritis, cancer, behavioral problems and so on. Proof for those claims is hard to come by because all these maladies existed long before vaccines were ever used in animals! There is ample historical and archaeological evidence that animals and humans living in a "natural state" long before there was industrial pollution, antibiotics, vaccines, and processed foods also suffered  many of the same diseases from which we modem creatures suffer.   So we have to be careful when we blame one specific practice (vaccinations) for causing such universal harm!

As an example, I might substitute for vaccinations, "corn-based pet food".  I then proclaim with irrefutable confidence that all these degenerative diseases, autoimmune disorders, cancers and arthritic afflictions of dogs and cats are due to the "modern" trend of feeding dogs and cats cheap, cooked and processed concoctions of corn that we foolishly call pet food! Who could prove I was wrong?  No one.  I would bet I could start a self-perpetuating theory that cancer, arthritis, autoimmune diseases, and behavioral problems in dogs and cats are really a result of processed corn in the pets' diets.  Spreading this theory around on Internet sites, written publications, breed newsletters, and at Holistic meetings, it wouldn't take long for multitudes of pet owners to subscribe to my theory... and nobody would ever be able to PROVE that I was wrong!  Similarly, no one can disprove the theory that  vaccines are the cause of autoimmune diseases, cancer, debilitation and bad behavior.  Anyone espousing such a theory would find comfort and confidence for their cause... no one can prove that they are wrong, if indeed they are wrong.

What veterinary associations are saying:

See UPDATE above

Questionnaires and phone calls to veterinarians in various areas of the country showed that there is a wide variety of opinions regarding vaccination protocols. In fact there was a reluctance to be quoted or to fill out a questionnaire requesting data on vaccine failures, reactions, or dangers and suggested vaccine procedures. The assumption could be drawn that no one really KNOWS for sure which way is THE RIGHT WAY. Let’s take a look at what some organizations are willing to put on paper...

Here is what the FIRST INTERNATIONAL VETERINARY VACCINES AND DIAGNOSTICS CONFERENCE, held in Madison, WI, in July, 1997 had to say:

Unofficial Recommendations:

*Vaccinate puppies and kittens against the clinically important infectious agents such as distemper virus, parvovirus, panleukopenia and rabies.

*Avoid vaccinations before six weeks of age. Give two to four doses of vaccine spaced two to four weeks apart.

*Give annual booster vaccine at one year of age. Thereafter give boosters every three years, unless required more often by law.

*Monitor serum antibody levels annually between boosters. (tjd: This means that your dog or cat should have a blood test done to measure the level of "immune memory" to a disease.)

*Geriatric animals generally do not need booster vaccinations. Monitor serum antibody titers instead.

Dr. W. Jean Dodds, a noted researcher and immunologist in Santa Monica, CA suggests that when giving a Rabies vaccine... not to administer it at the same time as other vaccines. Three to four weeks later, other vaccines can be given but Dr. Dodds believes that after ten years of age booster vaccines are generally not needed and may even be unwise.

She states "For animals previously experiencing adverse vaccine reactions or breeds at higher risk for such reactions (e.g. Weimaraners, Akitas, Harlequin Great Danes), alternatives to booster vaccinations should be considered. These include avoiding boosters except those required by law such as Rabies; measuring serum titers annually for specific diseases; and considering homeopathic alternatives to vaccinating. Some homeopathic approaches are considered as 'unconventional' and the pet owner should be provided with an appropriate disclaimer and should give informed consent to this approach."

Listing each veterinary association’s vaccination protocols would be quite lengthy, plus some protocols will be updated at various times. For your reference you may wish to call an organization and request their current protocols. Your area veterinary school is another source of advice on vaccination procedures.

The American Association of Feline Practitioners has recently released a suggested Protocol for veterinarians to consider when vaccinating cats for various diseases.  Visit the AAFP website to see the 29 page report.

The American Association of Feline Practitioners 1-800-204-3514
The American Veterinary Medical Association 1-847-925-8070
The American Animal Hospital Association 1-800-252-2242
The American Holistic Veterinary Association 1-410-569-0795

What should a pet owner to do?

Realize that pet health care providers who truly have your pet's best interest at heart, do not all agree on what is the ideal vaccination protocol to follow. Accept the fact that some pet health care providers truly believe that across the broad spectrum of optimum health, vaccinations throw the animal's vital energies out of balance. The truth is that vaccines have undoubtedly prevented countless millions of disease related deaths; unfortunately, a few individuals may have been harmed along the way.

Like anything else in life, there is a middle ground that must be struck, an educated and informed judgment that needs to be made when considering the risks versus the benefits of vaccinating the pets in our care. Let us all keep an open mind and a sensitive heart to this issue of vaccinations. If you do have concerns that need addressing, tell your veterinarian that you would like to consider all the options prior to vaccinating your special pet.

Someday, hopefully soon, when we discuss vaccinating our pets, no one will have to ask if we are giving Too Many, Too Often.