Sondag 13 Maart 2011

Vaccination-Addressing Common Concerns

Vaccination

The basics explained; addressing common concerns

Vaccines are one of the greatest medical developments of the modern era. Thanks to vaccines, many formerly common diseases have been controlled. Fatal and crippling diseases such as polio, whooping cough, measles, rubella (German measles) have been so reduced in incidence that many people today have never seen a clinical case. Smallpox, once a great killer, has been practically eradicated. Our dogs also reap the benefits of vaccination science for control of once-common diseases such as distemper, parvo and rabies.

However, in recent years, questions have arisen regarding the safety, efficacy and advisability of vaccinations for our canine friends. Most of these concerns are based solely on anecdotal evidence. A vaccine is given, and days, weeks or months later, a health problem surfaces. As we search for reasons why our dog was so unlucky to develop this problem, we wonder: did the vaccine cause the health problem? While it is tempting to blame the health problem of our dog on a prior vaccine, this is the logical fallacy of coincidental correlation. Simply because one event follows another does not mean that the first event caused the second. It is just as logical to state that putting gas in your car causes car accidents. Medical problems that occur after immunization are often blamed on the vaccine, but, in most cases, solid evidence is lacking.

Search the internet and you will find innumerable websites claiming that vaccines are unnecessary, even harmful.

Much research has been done on vaccination in humans. Despite the many wild claims about alleged dangers to humans from vaccines (liver cancer, autism, brain damage, etc), the studies do not support these claims. It is likely that the case for vaccine dangers in dogs has also been overstated.

Let’s examine some of these concerns about vaccinations for dogs:

“Vaccines don’t work”

Vaccines are highly effective. In several studies, vaccination against specific canine diseases is 100% effective in producing immunity. However, there are always some individuals who will not develop immunity after vaccination. Poor response to a vaccine may be due to the neutralizing effect of maternal antibodies circulating in very young puppies. It can also be a result of the vaccine losing its potency when stored improperly. Poor immune response may be due to a weak vaccine challenge (for example, killed vaccines are not as effective as modified live virus vaccines). Fever and impaired immune response of the host can reduce vaccine effectiveness. Regardless of the cause, these individuals with poor response to a vaccine have the same risk of contracting a disease as non-vaccinated dogs. It is due to the variability in response to vaccine that most veterinarians recommend a puppy “series”, and a second “booster’ vaccination for adults with unknown vaccine history.

In general, live vaccines are more effective than killed vaccines, and viral vaccines are more effective than bacterial vaccines. Bacterial vaccines such as kennel cough and leptospirosis, only provide immunity for a few months to a year at most. Luckily, the core vaccines are modified live viral and, in the case of rabies, killed viral vaccine, with a very high rate of successful, long-lasting immunity.

Vaccines are effective in preventing disease not only in individuals, but also in communities. This type of protection is called “herd immunity.” Herd immunity works by decreasing the numbers of susceptible individuals. When this number drops low enough, the disease will disappear from the community because there are not enough individuals to carry on the catch-and-infect cycle.

According to Ron Schultz, PhD, vaccine researcher the University of Wisconsin, although the US probably vaccinates more dogs than any other country, our coverage is only about 50% of the total canine population. “With anther 20-25% covered, we could, for all practical purposes, eliminate these disease, because we would have so much better herd immunity,” Schultz stated at a 2007 canine health conference.

“Vaccines are not safe”

In truth, few things meet the definition of “safe”. For example, every year in the U.S., 350 people are killed in bathroom or shower-related accidents, and 200 are killed choking on food. Yet few of us regard taking a shower or eating as unsafe activities.

No vaccine is 100% harmless. Almost all vaccines can cause pain, redness, or tenderness at the site of the injection. In addition, vaccination during the perinatal period can cause abortion, congenital anomalies, fetal death, and failure to conceive. More rarely, some individuals may develop transient immune suppression, arthritis, autoimmune hemolytic anemia, encephalitis, and seizures, The distemper vaccine is also under investigation as a possible cause of hypertrophic osteodystrophy. Vaccines can also cause fever and malaise, and (extremely rarely) death. It should be noted that these risks also occur with a naturally-acquired infection.

Allergic responses can result from serum components in the vaccine. A Banfield study done in Florida in 2001-2002 revealed a rate of severe anaphylactic reaction of 1 dog per 5000 (out of a study done on 838,015 dogs).

We need to understand that diseases such as distemper, parvovirus and rabies often cause permanent disabilities and fatalities. The risk of the vaccine must be weighed against the very real risk of contracting the disease.

“Vaccines are not necessary”

In some ways, vaccines are victims of their own success. Many dog owners today have never seen a case of distemper or parvo. As a result, they may question the continued need for vaccines. However, the disease organisms remain in the environment and a danger to every unvaccinated dog. Herd immunity is also some protection for unvaccinated dogs, but it is by no means a guarantee that the dog will not succumb to an infectious disease.

Rabies is transmissible to humans and invariably fatal; consequently, rabies vaccination and re-vaccinations are legal requirements in all states. Rabies is a killed, adjuvant vaccine with higher risk of adverse reactions. There is an ongoing rabies challenge study at this time, to determine duration of immunity obtained from rabies vaccination. If results are as expected, this will hopefully provide a basis for lengthening the legally mandated rabies vaccine administration intervals.

Some people believe that by not vaccinating, they can develop, through “survival of the fittest”, a strain of dogs with “natural resistance” to infectious disease. To illustrate the fallacy of this sort of idea, let’s consider that most deadly of zoonotic contagious diseases, rabies. The existence of this disease has been documented since at least 2300 B.C., and has likely existed for many millennia prior to that. If it were possible to develop a natural resistance to rabies through non-vaccination and “survival of the fittest”, rabies would have ceased to be a threat centuries ago, as the less fit, less immune animals died from the disease. Yet we humans and our dogs remain 100% vulnerable to rabies, and only through recent advances involving immunoglobulin administration and vaccinations have diseases like rabies become a reduced threat.

While in the US we have reduced risk of many infectious canine diseases, canine rabies and adenovirus (infectious hepatitis) have recently been found in imported dogs, so the continued threat of disease remains very real.

“Puppies are too young to be vaccinated”

Because young puppies have had limited exposure to diseases in the environment, they have little developed immunity and are more vulnerable than adults to contract infectious diseases. They receive protection from their mother’s antibodies for several weeks, but once that protection wears off, it could be argued that vaccination is more important for young puppies than for mature dogs.

The age to begin core vaccination in puppies is a topic of much debate. AAHA 2006 guidelines suggest the earliest age in normal circumstances should be 6 weeks, but in the face of an outbreak or in a shelter/rescue situation, vaccination can begin at an even earlier age. Rabies is not recommended to be given until after age 12 weeks. Studies in humans have shown that children are fully capable of responding to vaccines in the first months of life. Studies in dogs have produced similar results.

“It is best not to give more than one vaccine at a time.”

Puppies are capable of responding to millions of different bacteria and viruses because they have billions of immunologic cells circulating in their bodies. Therefore the vaccines given in the first few month of life are literally a raindrop in the ocean of what the puppies’ immune systems successfully encounter in their environment every day.

Studies on human infants show that multiple combined vaccines are easily handled by the immune system.

A Banfield study on dogs indicates that the risk of overall reactions is slightly increased with multivalent vaccines (27 per 10,000) as opposed to single vaccines (7 per 10,000). However, most reactions were transitory and not clinically significant. Also, since the dogs received multiple different antigens simultaneously, a reciprocal increase in reaction rate could reasonably be expected. There was an overall reaction rate of 16 per 10,000 dogs in this study; with 2 per 10,000 dogs vaccinated suffering serious anaphylactic reactions.

“Vaccines cause dogs to develop autoimmune disease”

Results from studies on families and twins show an important role in both genetic and environmental factors in the eventual development of autoimmune disease.

The portion of the genome that codes the genes that help us recognize “self” is called the MHC-the Major Histocompatibility Complex. These genes are located very close to each other and it is rare for recombination to occur. This in effect means that the genes from each parent are inherited intact. (Remember, you inherit genes in pairs, one from each parent). If the parents are closely related, the possibility exists that they share the same genes at that site…they are “homozygous by descent”. If so, there is a high likelihood that their offspring will inherit identical genes in the MHC. It appears that susceptibility to an autoimmune disease is determined by the lack of variability in the MHC genes. Linebreeding and inbreeding may result in this lack of variability. Close breedings increase susceptibility in the offspring to develop an autoimmune disease when an environmental trigger is present.

Though the tendency to autoimmunity is genetic, most autoimmune diseases are triggered by some sort of toxic assault, or viral or bacterial exposure. Scientist believe that the body reacts to small protein-like fragments of the vaccine base that are similar in structure to the normal cellular components of the body. A recent study showed that vaccine contaminants may cause the dog to make antibodies against these contaminants. Not all the vaccinated dogs in this study developed this response….and those who did were in the same particular family group, further reinforcing the genetic basis of autoimmunity.

Dogs who are genetically susceptible to the autoimmune process are at greater risk for such problems as thyroiditis, hypertrophic ostedystrophy, and autoimmune hemolytic anemia. These conditions may be provoked by vaccination and/or infection. However, as noted by Dr. Schultz, vaccines may trigger autoimmune disease, but they do not cause it. And, if dogs do not receive their core vaccines, Dr. Schultz notes, “They won’t go on to develop thyroiditis. They’ll die from distemper or parvo.”

Naked DNA vaccines are under development. These vaccines would contain solely the desired antigen, with no bovine contaminants. This would mean that when this type of vaccine is given, antibodies specific for the disease would be produced, without the high risk of allergic reactions or antibody responses to bovine components.

“My dog is too small to be vaccinated”

Small breeds, and several specific breeds, are at higher risk of adverse vaccine reactions. A Purdue study involving more that a million dogs found that dogs 22 lbs or less had approximately twice the risk compared to dogs weighing over 22 lbs. The one milliliter dose volume listed on most vaccine labels is recommended only because that is the dose used for the licensing process. During testing, the issue of breed or size of dog has received no attention. Since we have research indicating a higher risk of reaction to vaccines by small dogs, hopefully some studies will be done to determine the lowest effective dose for toy breeds and breeds at higher risk of reaction such as Chihuahuas, miniature pinschers, Boston Terriers and dachshunds. According to Dr. Schultz, body size is less critical with biologics than pharmaceuticals, and a toy poodle is as likely to need a full dose of a vaccine as a Saint Bernard.

Vaccine Basics

The goal of a vaccination program is to develop immunity to serious diseases while minimizing risks of allergy and inappropriate immune response.

Natural infection and recovery from a disease confers long-lasting immunity. A vaccine can also have the same beneficial effect on immunity.

The oldest and most common vaccine is the MLV (or modified live virus) vaccine. The actual disease-causing viral organism (the “antigen”) is cultured, then altered so that it won’t cause disease symptoms. Another type of live vaccine, the vector vaccine (VV), is a genetically engineered vaccine which is also very reliable and safe. Both MLV and VV are infectious vaccines. They work by producing a mild disease response in the individual. When the VV or MLV vaccine is given, the body’s immune system responds by producing antibodies which kill the virus. Immunologic memory allows the immune system to remember the organism to which it has been previously been exposed. Duration of immunity is determined by the memory cells, but the only way these cells respond is if the individual becomes infected. Due to the live virus which is introduced to the memory cells through use of a live vaccine, the VV/MLV vaccines induce reliable and long-lasting immunity. A stressed, ill, or immunocompromised dog should not receive a live vaccine.

Another type of vaccine is the noninfectious vaccine, “killed” or “subunit” vaccine. The virus or bacteria is actually killed by use of radiation or a chemical, and cannot produce disease. This type of vaccine has less chance of producing disease symptoms, but may also be less effective in provoking immunity in the host. Rabies vaccine is killed, so that there is no chance of the dog developing a fatal case of rabies. Manufacturers may add “adjuvants” or immune-boosting substances, to the killed vaccines in an attempt to improve their effectiveness. These adjuvants often produce adverse side effect such as local inflammation, allergy, and (in the case of one in ten thousand cats) tumor formation at the vaccine site. Cats lack the tumor suppression gene that would act on an injection site that is inflamed by certain vaccine adjuvants, particularly from rabies and feline leukemia vaccine. This problem in cats has prompted researchers to attempt to develop safer, purer vaccines.

“Core” vaccines recommended for dogs are distemper, adenovirus (hepatitis), parvovirus and rabies. These are all viral vaccines which readily provoke cellular memory and induce long-term immunity. There should be a dose of core vaccine at 14-16 weeks as the final dose in the puppy series, then at age one year, then after that not more than every three years,with the exception of rabies. Rabies should be given once some time after age 12 week, and then not more often than required by local law. Minimum duration of immunity from the core vaccines is thought to be seven to ten years. Yearly vaccination is outmoded and unnecessary, and exposes the dog to an increased risk of an adverse reaction. Those reactions are rare, but unacceptable if your dog receives something he doesn’t need and consequently dies.

Blood levels of antibodies can be measured. This is known as a “titer test”. There is no standardization between different labs and their testing methods, and testing can be costly. The presence of antibodies may indicate a level of protection against a certain disease; however, titer levels needed to infer protection from disease are not known. Titers can be positive in puppies as a "gift" from the mother, and do not necessarily indicate active immunity in the puppy. Titers can be elevated in dogs incubating a disease, who are actively contagious! Therefore, it is not possible to know if a given titer in a specific animal indicates adequate immunity. In the future, measurements of titers may provide a method of determining intervals for re-vaccination.

Vaccine programs should be individualized depending on the age of the dog, the breed, and the diseases prevalent in the area. Consult the American Animal Hospital Association Canine Vaccine Guidelines (2006) for the most recent recommendations:

http://www.aahanet.org/PublicDocuments/VaccineGuidelines06Revised.pdf



"Vaccination Dos and Don'ts"

11. Do Not Vaccinate Needlessly

Don’t revaccinate more often than is needed and only with the vaccines that prevent diseases for which that animal is at risk.

12. Do Not Mix Vaccines in a Single Syringe

If the vaccines are not combined by the company as a multicomponent licensed product, do not combine them prior to administration. Follow the manufacturer’s administration recommendations.

13. Do Not Split Doses

For miniature/toy or any other breeds. If you are concerned about the volume, reconstitute vaccine with 1⁄4 or 1⁄2 the recommended diluent (e.g., sterile water).

14. Do Not Vaccinate Anesthetized Patients

Should an anesthetized animal develop a hypersensitivity reaction, they may vomit and are at increased risk of aspirating.

15. Do Not Vaccinate Pregnant Dogs

The dog may abort or fetuses may get infected.

16. Do Not Vaccinate Animals on Immunosuppressive Therapy

These animals may not develop an adequate immune response, but even worse, they could develop disease (e.g., postvaccinal distemper, clinical canine parvovirus).

17. Do Not Administer Multiple Dose Vaccines Any More Frequently Than Every 2 Weeks

18. Do Not Vaccinate Puppies <2 Weeks of Age

19. Do Make Sure the Last Dose of a Puppy Immunization Series is Administered ≥12 Weeks of Age

At ≥12 weeks of age, interference by maternal antibody is less of a concern and the puppy’s immune system is more mature; thus, there is a greater opportunity for a robust immune response to the vaccine.

10. Do Not Give an Inactivated Product Prior to a Modified Live Product

This will interfere with the ability of the modified live product to immunize (e.g., canine parvovirus-2).

11. Do Not Administer a Canine Distemper-Measles Vaccine Subcutaneously (SC)

It has been shown that poor immunity results when this product is administered SC.

12. Do Not Assume that Vaccines Cannot Harm a Patient

Vaccines are potent medically active agents and have the very real potential of producing adverse events.

13. Do Not Use Nosodes (Holistic Vaccines) to Vaccinate a Puppy

Nosodes do not provide immunity; thus, the puppy will remain susceptible to the disease the nosode was designed to prevent. Use a USDA-licensed vaccine to immunize puppies.

14. Do Not Revaccinate a Dog With Vaccines Previously Known to Induce Anaphylaxis in that Dog

Test the animal’s serum for antibody to determine if the animal is immune. The risk from vaccine-induced anaphylaxis may be much greater than the risk of infection

15. NEVER vaccinate an animal who is ill or debilitated.

References

Novak, Will, DVM, MBA; “Predicting the ‘Unpredictable’ Vaccine Reactions”; Proceeding of the NAVC Congress, 2007.

Schultz, Ron, PhD; “What Everyone Needs to Know About Canine Vaccines and Vaccination Programs”; AKC CHF Health conference, St. Louis, MO, Oct 2007.

Fortney, William, DVM “Newest Vaccination Strategies for Sporting Dogs”, North American Veterinary Conference, 2006.

Thorpe-Vargas, Susan, PhD. “Genetic and Breeding Strategies: Essays for the Dog Breeder”.

Offitt, Paul A., M.D.and Bell, Louis M, M.D., “Vaccines; What You Should Know”; 3rd edition, 2003..

Hogenesch, Harm, Azcona-Olivera, Juan, Scott-Moncrieff, Catharine, Snyder, Paul W.,and Glickman, Larry T., “Vaccine-Induced Autoimmunity in the Dog”; Advances in Veterinary Medicine, Vol 41, pp 733-747.

Rynders, Patricia E., DVM, MS; “New Protocols for Canine Vaccination”; Canine Pediatric Care Symposium,WSAVA 2005.

Greene, Craig E., “Avoiding Vaccine Reactions in Dogs and Cats”; WSAVA 2003.

Roth, J. A., DVM, PhD; “Factors Influencing Vaccine Duration of Immunity”; The North American Veterinary Conference; Jan, 2007.

Maybury, Bonnie A. and Peters, Pamela M., PhD; “Vaccines—How and Why?”; http://www.accessexcellence.org/AE/AEC/CC/vaccines_how_why.php


"The Science of Vaccine Damage" debunked here...

Pure BUNK and pure "JUNK SCIENCE" !!!

There has been a widely circulated article entitled “The Science of Vaccine Damage” which is filled with inaccuracies, half-truths, and scare tactics. Now I must confess, when I first read this article, I fell for it hook, line and sinker! Then, my skeptical nature took over. This article extensively references a limited Purdue study which involved a very small number of beagles. I accessed the study and read the entire report. This study concludes that certain dogs may develop antibodies to bovine contaminants in the vaccine serum. This is certainly no evidence for vaccines causing any long-term health effects in any dogs, let alone ALL dogs…yet that is just what this author states in her article!

I quote here from the Purdue report:

“This study did not find any evidence of autoimmune disease in the vaccinated dogs”

”There was a marked increase of autoantibodies to the skeletal muscle proteins, myoglobin and myosin, in BOTH groups of dogs”(vaccinated and non-vaccinated... this is surmised to be due to frequent blood sampling of the dogs for the study).

“There was no increase of anti-thyroglobulin antibodies in the vaccinated animals, or other evidence of thyroid dysfunction.”

"Vaccination did not cause immunosuppression or alter the response to an unrelated antigen (KLH)......we did not observe a transient lymphopenia in the dogs at any time"

Consider for a moment the process by which a "core" vaccine (such as parvo, distemper or rabies) is produced. The virus is cultured on tissue, in this case cow or "bovine" tissue. With current technology, vaccines invariably will contain traces of bovine serum proteins. When a dog is vaccinated, they will form antibodies not only against the virus, but sometimes against these bovine contaminant proteins also. Various autoantibodies to bovine contaminants were detected in some (not all) of the vaccinated dogs. These antibodies were not found to react with the dog’s own tissues. The long-term significance of these autoantibodies has not yet been determined.

“Since bovine serum components in the vaccine may be responsible for the majority of autoantibodies, elimination of these bovine components may avoid this problem...new generations of vaccines, especially naked DNA vaccines, are free of serum components, and these should not induce autoantibodies.”

BINGO!! Thank goodness for research and development. We are discovering how to make better, safer, more effective vaccines! Great news for our dogs! So the next time you see that article floating around the internet lists, just remember to read it with some skepticism.

I’d like to address a few more of her faulty accusations against vaccination in general. She states “The monkey retrovirus SV40 keeps turning up in human cancer sites”… Per the CDC, SV40 has been found in cancers of people who either DID or DID NOT received the polio vaccine. SV40 has not been present in any vaccine since the early 1960’s. SV40 may be associated with some cancers, but the virus is transmitted to people by a mechanism other than vaccines. Lastly, SV40 has not been proven cause cancer, any more than any other virus which might lie dormant in the body.

She also states that “allergy…should be synonymous with the word ‘vaccination’”, and goes on to state that vaccines sensitize “render allergic”…this is such an inaccurate statement! Actual allergies are to vaccine components are rare, and the process of immune system activation, while perhaps sharing some similarities, is NOT the same as the allergic response process.

More false statements: She states “The Purdue study found that the vaccinated dogs had developed autoantibodies to their own DNA”…Nowhere was this found in this study!

She states, “The study dogs were found good homes.” No, they were euthanized at 22 weeks so that their tissues could be examined....did this woman actually read the study? Or just doesn't understand it? Or doesn't choose to try to understand it?

There are many other misquotes in this article, and faulty conclusions as well, but the worst may well be her own conclusion, “Some of us, myself included, have chosen not to vaccinate our pets at all.”

Luckily for her dogs, herd immunity will likely afford them some protection…even if she refuses to contribute to the health of the community through vaccination.

Once you are terrorized against vaccinating your pets, you can go to the website where she will happily sell you untested, unproven remedies for health and wellness. For just $31 per year you can sign up for a newsletter!

The “Science of Vaccine Damage” article is not an unbiased viewpoint, and far from scientific. We would do better to look to the real scientists and the ongoing research when formulating our health care plans, and not quacks who don't have any understanding of basic biologic principles.

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