HISTORICAL BACKGROUND

Prior to 1998, vaccination recommendations were limited to the Compendium of Animal Rabies Prevention and Control, published annually by the National Association of State Public Health Veterinarians (at www.nasphv.org). In 1998, the American Association of Feline Practitioners (AAFP) published the first report of an Advisory Panel on Feline Vaccines recommending that adult cats be vaccinated every 3 years, rather than annually, against feline parvovirus (panleukopenia). Reaction to this report was profound. Veterinarians throughout North America voiced concerns that anything other than annual vaccination of adult cats against panleukopenia was inappropriate, irrational, and quite possibly detrimental to the health of the cat population. In December of 2000, the same Advisory Panel published a second iteration of the Guidelines for Feline Vaccination. In that report, the Panel expanded the “every 3 year” booster recommendation to include feline herpesvirus-1, feline calicivirus, and panleukopenia.

Then, in March 2003, the American Animal Hospital Association (AAHA) Canine Vaccine Task Force released its Guidelines on canine vaccination. In that document, 3-year booster intervals in adult dogs are recommended for distemper, parvovirus, adenovirus-2, and parainfluenza virus.

In 2004, some vaccine manufacturers announced results of challenge studies verifying the ability of their canine distemper, parvovirus, and adenovirus-2 combination vaccines to protect dogs against virulent challenge, thereby validating the recommendations outlined in the canine vaccination guidelines.

FUTURE VACCINATION ISSUES

It is important to remember, however, that despite the controversy over 3-year booster intervals for some vaccines, there are several strategic issues justifying the need for veterinarians to reassess recommendations for the selection and use of vaccines. Included among these issues are vaccine safety profiles, profound variation in exposure risk of individual dogs and cats, and changes in vaccine technology (e.g., recombinant vaccines). These issues will take on even more importance in the future as new vaccines continue to be introduced and as more veterinarians question the need for and safety of these products.

The introduction of so many vaccines in the past 10 years, and the promise of more to come, justify the need for the veterinary profession to critically address which vaccines are administered to which patients and at which stage of life.

THE VACCINE GUIDELINES

First, and most importantly, the published Canine and Feline Vaccination Guidelines do not represent vaccination standards. The Guidelines were never intended to be used as a set of enforceable requirements against which all practices would be held accountable. They are merely guidelines. However, the published guidelines are becoming templates for the standard of care appropriate to vaccination practices in the United States. For that reason alone, they are worth reading.

Secondly, the Canine and Feline Vaccination Guidelines do not represent a vaccination protocol. Attempting to use the Guidelines as a defined protocol in practice would be frustrating. Instead, the Guidelines serve as a tool for clinicians to use in developing a rational vaccination protocol appropriate for the individual patient. Vaccine selection and use in veterinary medicine remain the responsibility of the individual practitioner.

CORE VERSUS NON-CORE VACCINES

Canine and Feline Vaccination Guidelines are developed around the concept of Core and Non-Core vaccines. It is important to understand that Vaccination Guidelines merely suggest, they do not mandate, which vaccines should be Core or Non-Core. However, it is in the interest of the individual practice to establish which vaccines meet the definition of Core, then ensure that information is communicated to all professional staff, technicians, and office staff, thereby assuring consistent, clear communication to clients.

DURATION OF IMMUNITY

Perhaps one of the greatest paradigms challenged by the publication of Canine and Feline Vaccination Guidelines is the time-honored “annual booster recommendation.” Recommendations that some vaccines can be administered 3 years (or more) apart without reduction in protective immunity have not been universally accepted. However, the fact remains that over the last decade, the quality of companion animal vaccines has improved. Recent studies have clearly shown that the duration of immunity for many, although not all, canine and feline vaccines is well beyond 1 year. Clearly there is a growing body of data that validates triennial booster vaccination in adult dogs and cats for those vaccines listed in the guidelines as “Core.” However, some vaccines (e.g., Bordetella bronchiseptica, leptospirosis, and Chlamydophila felis vaccines) may not consistently provide a 1-year duration of immunity, despite a product label (package insert) stipulating “annual booster recommended.”

ANNUALIZED VACCINATION PROTOCOLS

The fact that the Canine and Feline Vaccination Guidelines recommend triennial vaccination for certain vaccines in no way stipulates that adult dogs and cats should only be vaccinated every 3 years. In fact, annual vaccination does represent a high standard of medical care as long as the vaccination appointment incorporates a thorough health and wellness examination.

Considering the large population of pet dogs and cats and the remarkable spectrum of risk factors for exposure to infectious pathogens, it is quite unreasonable to assume that a single vaccination protocol would be applicable in all patients seen in practice. Two of the most important variables to consider when assessing risk are: (1) the age of the patient, and (2) the patient’s “lifestyle.” In implementing a vaccination protocol in clinical practice, it is critical for the clinician to consider these factors for the individual patient when recommending for, or against, Non-Core vaccines.

Tables 7-1 through 7-12 show annualized vaccination protocols for dogs and cats at moderate risk (applies to most), high risk, and low risk of exposure to infectious agents, while also taking into consideration the recommendations set forth in the Canine and Feline Vaccination Guidelines.

Table 7-1 ANNUALIZED VACCINATION PROTOCOL FOR DOGS AT MODERATE RISK OF EXPOSURE

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