I don't think anyone can tell you if heart damage is done. What we do know
is that vaccination probably does put a certain amount of stress on the
immune system.
Below are some excerpts from an article I wrote; it may help you in your
decision-making process. It is a matter of rsik versus benefit. The
protocols in the article attempt to minimize the number of vaccines by
delaying the first vaccine to eight or nine weeks, but that may not be
possible for high risk puppies. Leanne
New Approach to Vaccination of the Canine
by Leanne Bertani, MD
For years, it was believed that annual vaccinations for viral diseases were
necessary to keep our beloved companions out of harm's way. But we have
recently come to a turning point in vaccination of the canine. While we are
greatful for protection from diseases such as distemper and parvovirus,
there is growing realization that vaccination is not always benign.
In 1996, a study was published suggesting an association between
vaccination and autoimmune disease, specifically autoimmune hemolytic
anemia, an often fatal destruction of red blood cells.(1) This was followed
by another study that demonstrated that dogs may develop an autoimmune
response after vaccination.(2) In 1998, the American Association of Feline
Practitioners responded to the increasing incidence of vaccine-induced
fibrosarcomas in cats by changing the recommendation for feline parvovirus
vaccination from annually to every three years.
These events, coupled with the knowledge that some vaccinations for viral
diseases may protect for seven or more years, have caused veterinarians and
dog breeders alike to begin to ask, "Are we vaccinating too much?"
Duration of Immunity for Common Vaccines
Studies have shown that, once fully immunized, more than 90% of canines
retain immunity to Parvovirus-2 and Adenovirus-2 for more than seven years.
(Full immunization may not take place with vaccinations administered prior
to 16 weeks, due to interference by maternal antibodies.) Immunization to
Distemper may last up to 15 years, and immunization to Coronavirus probably
lasts a lifetime. Immunization to Rabies and Parainfluenza lasts about 3
years in about 80-85% of dogs. Note that proven duration of immunity may
vary dependent on the type of vaccination used; for instance, modified live
parvovirus demonstrated a longer duration of immunity than killed virus; one
strain of distemper tested for a longer duration than another. New
recombinant vaccines may be more efficient and produce a longer-lasting
immunity.
Other vaccines, particularly the bacterial ones, are less durable. Some
vaccines to Bordetella may last less than a year and are probably only
effective in about 70% of dogs. Sufficient data on Leptospira, Borrelia
(Lyme) and Giardia vaccine is not available to suggest immunization lasting
much longer than a year.(4)
Progress in the Veterinary Community
The American Veterinary Medical Association Council on Biologic and
Therapeutic Agents published immunization recommendations for dogs and cats
in 1989, suggesting annual revaccination. The companies that produce the
vaccines also suggest annual revaccination. A study published in 1998 found
that 27% of vaccinated dogs had a less-than-protective CPV titer, and 21% of
dogs had a less-than-protective CDV titer, and summarized that the current
practice of annual revaccination of dogs against CPV and CDV infection
should be maintained. (5) (Critics of that study argue that authors used
CDV antibody titers that are inconsistent with sterilizing immunity and
don't take into consideration that those dogs with lower titers will be
protected from disease but not infection.)
With the above in mind, it was understandable that veterinarians were
reluctant to buck tradition, as the legal community generally compares
medical practice to the "standard of care".
But the vaccination revolution received a couple big pushes in 2001. The
January 2001 issue of The Veterinary Clinics of North America (Small Animal
Practice) featured vaccinations and discussed the need for reconsidering
traditional annual vaccinations. A chapter author, Dr. Ronald Schultz,
Professor & Chair at the University of Wisconsin, says that their Veterinary
Medical Teaching Hospital has been on an "every three or more" year
vaccination schedule for cats and dogs for over four years. "The goal for
the future should be to vaccinate more animals than are now vaccinated but
to vaccinate those animals less often and only with the products that the
animal needs," says Dr. Schultz.
Another advance came in April 2001, when the American Veterinary Medical
Association Executive Board approved the Council on Biological Therapeutics
new "Principles of Vaccination." This statement was published in the
Journal of the American Veterinary Medical Association on September 1, 2001.
The principles state that "unnecessary stimulation of the immune system does
not result in enhanced disease resistance and may increase the risk of
adverse post-vaccination events." It recommended that veterinarians create
"core" and "non-core" vaccination programs (see below for examples), and
that vaccine schedules be tailored to the needs of each specific animal.
High Priority ("Core") Vaccines
The high-priority vaccines are those protecting against diseases that are of
greatest risk to the dogs or to public health, and those that carry a large
benefit-risk ratio. Possible vaccines that might be included in many core
programs would include:
1. canine parvovirus-2 (CPV-2)
2. canine distemper virus (CDV)
3. infectious hepatitis, controlled by canine adenovirus-2 (CAV-2).
(4.) rabies (RV) - a priority in all but the "rabies-free" countries
At this time, most products intended for vaccinating for CAV-2 , also
includes Parainfluenza (PI), so vaccination for Parainfluenza may be
included by default.
Rabies vaccine is almost a "no-brainer", as it is considered a core vaccine
in most areas, and is high priority and governed by state law in the United
States. Although there appear to be some rabies-free areas in Canada, most
dogs in the US should receive a rabies vaccine between 4 and 6 months, with
a booster a year later, and then every three years. There are a few states
with a high rabies incidence that may require an earlier initial vaccine,
and yearly revaccination.
Sample Core Protocols: 1998 Colorado State University Protocol
Some universities have already developed new vaccination programs. One of
these is Colorado State University. (7) Their 1998 core recommendation is a
standard three shot series at 8, 12, and 16 weeks of age, including
parvovirus, adenovirus 2, parainfluenza, distemper. A rabies vaccine was
recommended after 16 weeks of age. Following the initial puppy immunization
series, dogs would be boostered one year later and then every three years
thereafter for the above diseases. Bordetella vaccine was recommended at
least 72 hours prior to possible exposure (dog show, trip to boarding
kennel) and could be repeated every two to four months. The summary is
below:
8, 12, & 16 weeks: parvo, adeno, parainfluenza, distemper (Proguard 5)
After 16 weeks: rabies (Imrab 3)
68 weeks, & every 3 years thereafter: parvo, adeno, parainfluenza,
distemper, rabies
Bordetella as required
Dr Dodds
Some veterinarians, such as Jean Dodds, DVM, recommend that vaccines be
given separately if possible, to minimize the consequences to the immune
system. This is presently difficult, as most vaccines in the United States
are only available in combination (polyvalent) vaccinations - sometimes
seven or eight in one injection! But there are a few that are available in
smaller combinations; her recommendations (as of 4/00) for dogs prone to
autoimmune disease are below. (8) Dr. Dodds also recommends that
vaccination be avoided during estrus, pregnancy or lactation.
9 weeks MLV Distemper/Parvovirus only (e.g. Intervet Progard Puppy)
12 weeks MLV Distemper/Parvovirus only (e.g. Intervet Progard Puppy)
16-20 weeks MLV Distemper/Parvovirus only (e.g. Intervet Progard Puppy)
24 weeks or older, if allowable by law Killed Rabies Vaccine
1 year MLV Distemper/Parvovirus only booster
1 year (give 3-4 weeks apart from Dist/Parvo booster) Killed 3 year rabies
vaccine
(MLV=modified-live virus)
After 1 year, annually measure serum antibody titers against specific canine
infectious agents such as distemper and parvovirus. Bordetella, corona
virus, leptospirosis or Lyme only if endemic in the area.
These are only sample core schedules, and recommendations for any one
particular dog should be made by a veterinarian with a valid patient-client
relationship.
Breeders' Compromise
Because of the fear of puppy mortality from distemper and parvo, many
breeders still give annual distemper and parvo vaccinations to dogs and
bitches being bred or shown, but more and more are choosing to discontinue
vaccinations for viral diseases at the time the bitches are retired, with
the exception of rabies where required by law.
The Lower-priority (non-core) Vaccines
Again it comes down to risk vs benefit. Killed vaccines are more risky in
the short term, ie, more likely to cause immediate adverse reactions
(anaphylaxis/anaphylactic shock) than live vaccines, and bacterial vaccines
more risky than viral ones. Those generalities would denote Leptospira
(killed bacterial) as the most likely of the commonly used vaccines to cause
anaphylaxis, followed by Borrelia/Lyme's Disease (killed/recombinant
bacterial), and Rabies (killed viral), Corona and Bordetella. Corona is
available as modified live viral, but the killed viral preparation is
commonly used. Bordetella bronchiseptica is a bacterial vaccine, available
as modified live and killed; the nasal preparation is thought to have the
highest benefit-risk ratio.
The Leptospirosis vaccine is a controversial one. Leptospirosis is an
important disease because it can be transmitted to man and some other
animals, and can cause severe kidney disease. As mentioned above, it is one
of the vaccines most likely to cause a fatal anaphylaxis in puppies, so many
breeders just don't give it. Until recently, the vaccine only covered two
serovars and was effective in less than 50-75% of dogs that received the
vaccine. But two more serovars have been recently added, and leptospirosis
has become endemic in some areas. Therefore, the decision to include
Leptospira will have to be made on the basis of its presence in the dog's
area, as well as the future performance of the two new serovars.
The value of the Canine Coronavirus vaccine is also controversial. Some
authors go as far as to say that it is not needed. Corona is a highly
contagious virus, but one that rarely causes death in an adult dog. It may
cause protracted diarrhea, though, and can be fatal to puppies, so the
decision on whether or not to vaccinate for Coronavirus probably depends on
how much exposure your dogs have to outside dogs, and also whether or not
you raise puppies in your home. Many breeders choose to vaccinate their
adults just one time in hopes that it will decrease the possibility that
they will bring the Coronavirus home to their puppies.
Vaccinations for Borrelia/Lyme's Disease and Giardia are generally not
necessary for the large population of toy dogs that spend most of their time
on the couch. But some of the sportier toys and those in endemic areas may
be vulnerable, so it is best to consult with your veterinarian and possibly
the Public Health Department in making decisions regarding Leptospira,
Borrelia, Corona, and Giardia vaccines.
Bordetella bronchiseptica is a bacteria that causes infection of the trachea
and bronchi; the infection is commonly called "kennel cough", and is kin to
the human "whooping cough". The Bordetella bronchiseptica vaccine is often
given when dogs are likely to be exposed to large numbers of other dogs,
such as a dog show or boarding kennel. It is available both as injection
and as a nasal inhalant. The inhalant vaccine is thought to be less likely
to cause a severe reaction, and also to have less interference by immunity
from colostrum. Immunization to Parainfluenza and CAV-2 is thought to
enhance the protection of the Bordetella vaccine. Unfortunately, the
Bordetella vaccine is not one of the more efficient ones, having a short
duration and about a 70% protection rate, but I expect we will have more
efficient vaccines in the future.
Considerations for Toy Breeds
It does appear that toy breeds may have more adverse reactions to vaccines,
so a less-frequent vaccination schedule may be of particular benefit to this
group. The most frightening response is severe anaphylaxis, most common
after killed bacterial vaccines such as leptospirosis. There are some vets
who will not give a leptospirosis vaccine to a dog under ten pounds for this
reason.
The one milliliter dose volume listed on most vaccine labels is recommended
because that was the volume tested during the licensing process. During the
efficacy testing, the issue of breed was ignored. Consequently, we really
don't have studies to tell us if the Toy Poodle should get the same volume
as the Great Dane. Although a natural inclination would be to halve the
dose for toy breeds, there is little or no scientific data to back up that
recommendation.
Human studies, though, advise against decreasing dosage on the basis of
size. In a study of premature babies given half of a DTP vaccination, those
babies did not appear to develop an adequate immune response to Pertussis.
(9)
A common compromise used by breeders is to halve the dose of the
vaccination during the initial puppy series, giving a full dose after 16
weeks. Leptospirosis is usually omitted until after a year of age, or
omitted entirely, unless there is local concern about the disease. This may
change after the performance of the new vaccine is evaluated.
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