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Vaccination Protocols

Fine-tuning feline vaccination protocols:  New immunologic tests and monovalent vaccines allow for more appropriate vaccination.

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by Arnold Plotnick MS, DVM, ACVIM, ABVP

Vaccines have been an integral part of preventive health care programs for several decades now.  In fact, no other medical development has been as successful as vaccination in controlling deadly diseases in companion animals. 

Until recently, recommendations for vaccination of cats and dogs were fairly unambiguous.  As new developments in the field of veterinary immunology emerge, important questions are being raised about companion animal vaccines and vaccination protocols.   Issues such as whether veterinarians are vaccinating too often, and related issues such as adverse vaccine reactions, and whether certain vaccines are efficacious or not need to be addressed. 

There is no consensus on the issues mentioned above.  Veterinarians who deal with unvaccinated animals, or animals with poor vaccination histories know that canine distemper, feline panleukopenia, and many other contagious infectious diseases are waiting for the opportunity to re-emerge.  I clearly remember, as a teenager volunteering at a busy neighborhood veterinary practice, the devastation that the parvovirus outbreak in the late 70’s brought to the pet dog population.  Until an effective vaccine was developed and marketed, thousands of pet dogs died terrible deaths from this horrible virus. 

Veterinarians, infectious disease experts, researchers, and many clients have begun to question the need for giving pets yearly booster vaccinations.  The one-year recommendation was not determined by any scientific studies, and you won’t find in today’s veterinary literature many publications demonstrating a need for annual vaccination.  In 1991, veterinarians began to notice a higher than expected number of sarcomas, a type of cancer, occurring on cats’ bodies in places where vaccines were often injected.  Further studies showed that there was an association between vaccine administration and sarcoma development.  While the incidence of these sarcomas was very low, their occurrence was devastating to cats that were affected, with many cats dying from these tumors.  It was the discovery of an association between vaccination and sarcoma development in cats that brought the issue of vaccination to the forefront of veterinary medicine.

To not vaccinate our pets is not an option.  Our challenge is to come up with a reasonable strategy for vaccination that maximizes our ability to prevent infectious disease while minimizing the occurrence of adverse events associated with vaccination.

So, how often should we vaccinate?

It is impractical to recommend a standard vaccination protocol for all cats.  A vaccine risk assessment should be performed yearly for all cats, and each cat’s individual needs evaluated.  Vaccination protocols should be selected for individual patients based on the risk of exposure to individual pathogens, incidence of disease, severity of disease, efficacy and safety of available vaccines, and client-specific requests and limitations. 

The American Association of Feline Practitioners (AAFP) and the Academy of Feline Medicine (AFM) regularly publish a set of feline vaccination guidelines for veterinary practitioners to consider.  Their guidelines reflect the most recent studies on vaccine efficacy, safety, and duration of immunity.  Currently, the AAFP/AFM guidelines recommend the following:

All healthy kittens and adult cats should be vaccinated for life threatening diseases like panleukopenia, herpesvirus, calicivirus (FVRCP), and rabies.  These are considered the “core” vaccines – ones that every cat should receive.  While vaccines come in a variety of form and combinations, the most commonly used FVRCP vaccine is a multivalent vaccine: it contains viral antigens for several diseases. The rabies vaccine is a monovalent vaccine.  It contains viral antigens for one virus: the rabies virus.

Optional or “non-core” vaccines available for cats include Chlamydophila felis (a respiratory pathogen, formerly called Chlamydia), the feline leukemia virus (FeLV), the feline immunodeficiency virus (FIV), the feline infectious peritonitis (FIP) virus, Bordetella (another respiratory pathogen), Giardia (an intestinal protozoan), and ringworm (a skin fungus). Some of these vaccines are believed to be fairly efficacious, while others are considered nearly useless. 

Kittens, typically presented to veterinarians at 6 to 8 weeks of age, should receive an FVRCP vaccine, with additional boosters given every 3 – 4 weeks until 12 weeks of age.  Kittens older than 12 weeks of age, and adult cats with no known vaccination history should receive an FVRCP vaccine, and one additional  FVRCP booster 3 – 4 weeks later.

All cats should receive a rabies vaccine at 12 – 16 weeks of age.

At one year of age, or one year after the last vaccination, an FVRCP and a rabies vaccine should again be administered. 

How often these “core” vaccines should be administered is not entirely clear.  Vaccination is a medical procedure, and like all medical procedures, it carries some degree – granted, a very small degree – of risk The goal of veterinarians should be to vaccinate as many cats as possible, but reduce the number and frequency of unnecessary vaccines. 

Some rabies vaccines have been shown to provide immunity for three years.  There is a rabies vaccine currently manufactured that does not contain some of the irritating substances that have been implicated in the development of tumors at the injection site.  This vaccine, Purevax (Merial, Ltd) is the only vaccine I use in my feline-only veterinary practice. This vaccine, however, is only approved for intervals of 1 year.  Rabies vaccines that have been shown to give immunity for three years should not be given any more frequently than this, as it is not necessary, and only increases the chances of adverse vaccine reactions.

The FVRCP vaccine has been shown, in several studies, to provide immunity for at least three years, and in many cases, considerably longer.  As a result of these studies, it is now being recommended that the FVRCP vaccine be given every three years instead of yearly.  Even at three-year intervals, however, some cats would be still be receiving this vaccination unnecessarily, as some cats retain their immunity to these virus for longer than three years.

Serology (measuring the level of antibodies against a particular pathogen) can be used in lieu of an arbitrary vaccine interval for FVRCP vaccines.  Several studies have shown that measuring the level of antibodies against these viruses correlates well with the degree of immunity to these diseases.  Thus, cats with high antibody levels against panleukopenia, herpesvirus, and calicivirus are considered to be protected against these diseases, and therefore do not need to be vaccinated.  Vaccination is indicated only if the antibody level has dropped to a level that is no longer considered protective. 

The serology tests to measure antibody levels against these viruses have been available for a few years, but veterinarians haven’t taken full advantage of these tests because the serum samples must be sent to an outside laboratory. Results can take several days.  If the serum sample shows an inadequate antibody level, the client and cat has to come back to the hospital for vaccination. This is inconvenient for the client and for the cat, as most cats get very upset when they go to the veterinary office, and clients understandably want to minimize the number of visits if possible. The ideal solution would be a test that can measure the antibody levels to these three viruses that can be performed right in the veterinary office, providing answers in just a few minutes while the client waits.

Once an in-house serology test becomes readily available, veterinarians and clients will have more options when it comes to determining the ideal vaccination schedule for cats.  Some veterinarians may continue to follow the AAFP/AFM recommendations for triennial (every three years) vaccination, while others may choose to test cats yearly, and vaccinate only when the antibody levels indicate that it’s necessary. 

As stated above, vaccination against panleukopenia, herpesvirus and calicivirus tends to be performed using a multivalent vaccines, i.e. a vaccine containing all three viral antigens in one vaccine dose.  If the in-house serologic test shows the antibody levels for all three viruses to be low, then this multivalent FVRCP vaccine would be appropriate.  But what if the antibody levels of only one virus, or only two viruses, are inadequate?  Administering a vaccine containing three viral antigens when only one viral antigen is needed would be considered by some to be over-vaccinating.  Thankfully, vaccine manufacturers have begun marketing monovalent vaccines - vaccnes containing only one viral antigen.  It is now possible to administer one individual panleukopenia vaccine, or just the herpesvirus vaccine, or just the calicivirus, or any combination.  Again, this allows veterinarians to fine-tune the vaccine schedule to the individual cat.           

Vaccines against infectious diseases have done much to reduce sickness and death in companion animals, and vaccination is the cornerstone of preventive veterinary medicine.  As with any medical procedure or decision, the advantages must be balance against the risks, and you and your veterinarian should discuss all of the options now available to determine the best vaccine protocol for your cat.   

 

Related Blog Post:  "Why We Vaccinate (Even Indoor Cats)"     

Updated 4/8/11