Vaccinations
By Shawn Messonnier, DVM

Each animal has unique vaccine needs; if he has protective immunity, vaccines are not needed. Photo courtesy of Ivana Ruddock

Each year, veterinarians send out many reminder cards for annual visits to their dog and cat owners. More often than not, the emphasis is on vaccinating the pet to make sure it is "current on its shots." While vaccines can help decrease infectious diseases, it's time we shift our focus from "annual shots" and instead focus on total health care for our pets.

As new research shows us that annual immunizations may not be needed for every pet, it's time to take a more holistic approach to this important topic. And when you realize that most pets die of chronic disorders such as heart, liver, and kidney disease, our emphasis should be on prevention and early detection of these problems rather than infectious problems such as parvovirus and distemper.

Vaccinosis is the term given to the chronic reaction of the body against repeated immunization. Many holistic veterinarians and owners are concerned about the frequent (and most likely unnecessary) immunization of pets for just about every disease imaginable.

Minor side effects often seen following immunization include fever, stiffness, joint soreness, lethargy, and decreased appetite. A number of more serious conditions have been proven or proposed to be the result of excessive immunization, and animals run the risk of adverse reactions as increasing amounts of foreign antigens are injected into them.

Since vaccination involves altering the immune system, it is not surprising that occasionally adverse effects involving the immune system as a result of immunization also occur. These include injection site sarcomas (an aggressive cancer of cats that may occur in 1:1000 to 1:10000 cats following any injection; vaccines are implicated more than other injectible medications), collapse with autoimmune hemolytic anemia (decreased red blood cell count) or thrombocytopenia (decreased platelet count), liver failure, kidney failure, bone marrow suppression, immune suppression, systemic lupus erythematosus, rheumatoid arthritis, food allergy, atopic dermatitis (allergic disease as a result of immunization is suspected to occur as a result of an augmented immune response to the vaccine and/or other allergens/immunogens, the so-called "allergic breakthrough" phenomenon), glomerulonephritis/renal amyloidosis (different types of immune kidney diseases), seizures, bloating, hypothyroidism, and hyperthyroidism. The administration of vaccines may also interfere with the interpretation of various test results (dogs vaccinated for Lyme's disease will be positive on the screening test for this disorder, necessitating a follow-up test to differentiate between the vaccine and the actual presence of the disease; cats vaccinated against any disease may show a positive titer on the standard corona virus test, called the FIP test).

Both killed vaccines (containing adjuvant to stimulate a greater immune response) and modified live vaccines have been implicated in vaccine reactions. Many vaccine reactions seem to occur following booster immunization with vaccines containing a number of antigens (5-way vaccines, 7-way vaccines, etc.)

Current recommendations are for most immunizations to be given at least annually. An alternative to routine vaccination of every pet is the use of vaccine (antibody) titers. These simple blood tests can give us information about an individual pet's antibody status in relation to specific diseases.

In simple terms, antibodies are proteins made by the pet's white blood cells (specifically B lymphocytes). These antibodies are made whenever a pet contacts an infectious organism (virus or bacteria, as a result of a natural infection) or is vaccinated (the vaccine uses low doses of infectious organisms, tricking the immune system to form protective antibodies without causing disease as might occur in a natural infection). Using a titer test reveals each pet's antibody status. These results are then interpreted in an attempt to determine if the pet is currently protected against a specific infectious disease or if the pet may require immunization.

There are both pros and cons to the use of vaccine (antibody) titers to determine the need to immunize pets.

Pros:

1.Easy to perform
2.Inexpensive (usually under $50)
3.Gives us specific information about each individual patient, allowing the doctor and owner to make a rational and informed decision
4.Replaces the current recommendation for annual vaccination regardless of actual need for every pet.

Cons:

1.While inexpensive, the extra cost may prohibit some owners from taking advantage of the testing.
2.Some diseases will not be titered; rather, automatic immunization will still be given. This is the case for the rabies vaccine. The 3-year rabies vaccine (used by most if not all practitioners) needs to be given only every 3 years. Some states require more frequent immunization regardless of the 3-year duration of immunity. These states may not accept titer information and would still require immunization, regardless of titer status.
3.Not all diseases produce a measurable titer. (For example, antibody levels have been shown to correlate with protection against canine distemper virus, canine parvovirus, canine adenovirus, feline panleukopenia virus, and Lyme's disease. Serum titers do not correlate with protection for the following diseases: kennel cough (Bordetella bronchiseptica and parainfluenza), canine coronavirus, feline enteric coronavirus, and feline chlamydial infection. Cellular immunity (rather than antibodies) provides protection against feline rhinotracheitis virus and feline infectious peritonitis virus, making titers inaccurate in interpreting protection for these diseases. Antibody levels (IgG titers) do provide information about protection against canine leptospirosis, although immunity against this disease following vaccination with inactivated leptospirosis organisms is generally believed to be short-lived (6-12 months)). There is still adequate protection due to the cellular immunity the vaccines for these diseases produce.
4.Titers, like vaccines, are not perfect. There is no guarantee that a pet with an adequate titer (or an annual vaccination) will not become infected or become ill with a disease. The titer only tells us that the pet should have adequate antibodies to fight off the infectious organism and that the pet possesses the ability to mount a secondary antibody response (and fight off the disease).
5.There is no agreed upon correct titer level for determining protective titers. Currently, doctors must use all of the conflicting information available and make an educated decision regarding what constitutes an "adequate, protective" titer.

Common recommendations for protective titers vary with the study being quoted. For example, as I mention in "The Natural Health Bible for Dogs & Cats", protective titers have been reported as follows:

Canine Distemper:
>1:5; >1:20, >1:96.

Canine Parvovirus:
>1:5, >1:80

Feline Calicivirus:
>1:6, >1:24, >1:32

Feline Panleukopenia:
>1:40

Feline Herpesvirus
>1:16

Currently, the use of titers is not perfect but gives us some information about each individual pet. Most holistic doctors will consider immunization only if the titer is low (<1:5.), although some will use the upper end of the titers as mentioned above. The presence of any titer for those diseases in which titer information correlates with disease protection indicates the ability of the pet to respond to immunization and possibly infection. More research is needed to determine which vaccines induce the longest lasting protection, and how titer levels correlate with these specific vaccines.

The best recommendations I can make at this time are as follows:
*While not perfect, titers are the only inexpensive way to assess each pet's unique vaccine needs.
*Standardized testing should be adopted, along with an agreed upon "correct" level to constitute a protective titer (this may be difficult, as each vaccine manufacturer would need to determine the "correct" level for each vaccine produced).
*Any titer indicates the ability of the pet to respond to immunization. The higher the titer, the greater the antibody level at the time of the testing. As long as the pet has protective immunity, however, vaccines are not needed as they do not "boost" the immune system and the ill effects of injectible immunizations might still remain.
*Until we have more information, we probably need to use published studies by vaccine manufacturers showing the levels of titers that afforded vaccinated puppies and kittens protection from disease challenge (on average, a titer somewhere around 1:64).

At this time, most holistic veterinarians use a combination of blood titers plus their knowledge of the pet's lifestyle. For example, if I have an owner with an outdoor cat, that pet is at higher risk of coming in contact with cats that may transmit infectious diseases than one that stays indoors. The need for this cat to be adequately immunized is greater than the cat that never leaves the house except to go for a veterinary visit 1-2 times each year and has little chance of ever contracting an infectious disease. A practice located in an area with a large concentration of parvovirus cases will probably stress current immunization in an attempt to protect any pets that may not be currently immunized.

Because the pet's ability to withstand infection and disease depends on it, a strong immune system (maintained by a healthy diet supplemented with quality nutritional supplements) is of paramount importance.

Discuss titer testing with your holistic veterinarian. I believe using this approach minimizes the guess-work of deciding which pets need immunizations, and allows us to do only what the pet really needs.

About the author:
Shawn Messonnier is author of the award winning "The Natural Health Bible For Dogs & Cats", Prima Publishing, 2001, $24.95. You may contact him at naturalvet@juno.com.


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