Companion Animal Vaccination

Question 1

changes in vaccination

Answer 1

Evidence-based veterinary medicine and the growing belief that delivery of fundamental practices such as vaccination should be based in the latest scientific thinking rather than historical anecdote.

Vets concern over the recognition of new adverse events occurring after vaccination.

Vaccination hesitancy or ‘vaccinophobia’ - concern from the pet-owning public, fueled by media debate about the safety of childhood vaccinations including the combined measles, mumps and rubella vaccine and later the human papillomavirus vaccine.

Question 2

Vaccination Guidelines.

Answer 2

Vaccination guidelines are not legally binding, but are a set of recommendations, based on expert interpretation of current scientific information, that are designed to be read, discussed and adapted by vets for use in their own practices.

Vaccination is not just about protection of the individual animal, but protection of the population through establishing adequate herd immunity.

Question 3

Core and non-core vaccines.

Answer 3

Vaccines may be categorised generically as –

Core - essential for every dog or cat.

Non-core - may be used in those dogs or cats whose geographical location or individual lifestyle places them at risk of exposure to infection.

Not recommended - because there is insufficient scientific evidence to justify the use of these vaccines.

Question 4

core canine vaccines

Answer 4

Canine Distemper Virus
Canine Adenovirus
Canine Parvovirus
Rabies virus (in countries endemic for the disease)

Question 5

non core canine vaccines

Answer 5

Canine parainfluenza virus
Bordetella bronchiseptica
Leptospira
Borrelia

Question 6

non recomended canine vaccines

Answer 6

Canine enteric coronavirus

Question 7

core feline vaccines

Answer 7

Feline parvovirus
Feline herpesvirus type 1
Feline calicivirus
Rabies virus (in countries endemic for the disease)

Question 8

non core feline vaccines

Answer 8

Feline leukaemia virus
Chlamydia felis
Bordetella
Feline immunodeficiency virus

Question 9

not reccomended feline vaccines

Answer 9

Feline infectious peritonitis

Question 10

In the UK, a typical vaccination programme for dogs includes -

Answer 10

Canine distemper virus,

Canine adenovirus type 2 (hepatitis),

Canine parvovirus,

Canine parainfluenza (part of the kc syndrome),

Leptospirosis - Leptospira canicola, icterohaemorrhagiae, Grippotyphosa and Australis.

Question 11

Viral Vaccines.

Distemper.

Answer 11

The virus multiplies in a variety of cell types in a wide range of organs.

The signs associated with Distemper are fever followed by a catarrhal discharge from eyes and nose.
A broncho-pneumonia may develop and in a proportion of cases nervous signs including fits may occur.

Often referred to as “hardpad” due to presence of the virus in the skin leading to hyperkeratosis of the footpads.

Question 12

Viral Vaccines.
Canine adenovirus (CAV) (Infectious canine hepatitis(ICH))

Answer 12

Virus initially invades the tonsils and cervical lymph nodes followed by a viraemia and possible (some recover) involvement of the liver.

Fever, vomiting and diarrhoea followed by jaundice are some of the signs seen in CVH (Rubarth’s disease).

Two antigenically closely-related, but distinct, types, i.e. CAV 1 and CAV 2 (vaccination utilises CAV 2 antigen)

CAV 1 – responsible for the generalised disease.

CAV 2 – Implicated in some cases of respiratory disease but not with systemic infection.

Question 13

Viral Vaccines.
Canine Parvovirus (CPV)

Answer 13

Relatively new disease being first identified in 1978.

No conclusive origin of CPV is known, but it is postulated that CPV arose by natural genetic mutations of the feline panleukopenia virus (CPV and FPLV are more than 98% similar in nucleotide and amino acid sequence).

This disease causes a severe gastro-enteritis.

In very young pups the virus can cause sudden death as the heart muscle is affected (myocarditis).

Question 14

Viral Vaccines.

Parainfluenza (Pi) /CAV-2.

Answer 14

These viruses are implicated as two of the causes of Kennel Cough, an upper respiratory disease, characterised by a harsh cough which spreads easily among animals in close confinement.

“Pure” infections with Pi are rare and mild.

The bacterium Bordetella bronchiseptica may also be involved in this disease (kennel cough).

Question 15

Bacterial Vaccines.

Leptospirosis.

Answer 15

Current vaccine is tetravalent preparation that includes protection against serogroups -

Leptospira canicola

Leptospira icterohaemorrhagiae

Leptospira Grippotyphosa

Leptospira Australis
Clinical manifestations of disease may vary geographically, depending on the serogroup circulating and are determined by the virulence and load of the infecting serovar, environmental facts and the age and immune status of the host.

Risk factors for clinical leptospirosis can vary with country, time of year and presence of the host, although dogs that swim in or drink from outdoor water sources and/or hunt wildlife may be at increased risk, and clinical disease has been associated with heavy rainfall and flooding.

The disease presentation may be subacute, acute or peracute.

Clinical signs can be non-specific and multi-systemic and include –

vomiting,
weakness,
lethargy,
fever,
polyuria/polydipsia (PU/PD)
jaundice.

Question 16

Kennel cough vaccine

Answer 16

an intra-nasal vaccine providing local protection against some of the aetiological agents associated with the kennel cough syndrome.

Vaccines available that provide protection against Bordetella bronchiseptica and canine parainfluenza virus.

Some kennel cough preparations include protection against both B. bronchiseptica and canine parainfluenza virus.

Question 17

versions of kennel cough vaccine in uk

Answer 17

Bronchishield® nasal drops (B. Bronchiseptica, adenovirus type 2, canine Pi)

Canigen KC® (B. Bronchiseptica, canine Pi)

Nobivac KC® (B. Bronchiseptica, canine Pi)

Canigen PI® (canine Pi)

Versican Plus Pi/L4® (canine Pi plus lepto)

Nobivac Pi® (canine Pi)

Question 18

Rabies virus in the context of vaccinating dogs

Answer 18

Rabies virus – Utilised much more frequently since the introduction of the PETS passport scheme which allows dogs to travel from the UK to certain other European countries and return without the need for quarantine.

Onset of immunity - an adequate serological response has been demonstrated 2 to 3 weeks after vaccination.

Duration of immunity is 3 years.

Question 19

Babesiosis vaccination

Answer 19

serious tick-borne disease, caused by a parasite which invades and destroys RBCs in the circulation.

Nobivac piro® was a vaccine that contained antigens from Babesia canis and Babesia rossi – withdrawn at the request of the marketing-authorisation holder (30/05/13).

Pirodog® available for the European market

Question 20

In the UK, a typical vaccination programme for cats includes -

Answer 20

Feline rhinotracheitis herpesvirus (flu).

Feline calicivirus (flu).

Feline panleucopenia virus (enteritis).

Feline leukaemia virus.

Question 21

Viral Vaccines.

a) Panleucopaenia (FPV).

Answer 21

Alternatively known as Infectious Enteritis this disease is characterised by fever, depression, anorexia and finally diarrhoea.

The feline panleucopaenia virus (FPV) is a parvovirus

Question 22

Viral Vaccines.

Answer 22

Clinical signs (sneezing, conjunctivitis, coughing and tongue ulceration)are usually seen in kittens up to 6 months of age.

The infectious agent is a herpes virus.

Question 23

Viral Vaccines.

c) Feline Calicivirus disease (FCD).

Answer 23

The signs of this disease are similar to those seen in FVR.

Question 24

Viral Vaccines.

) Feline Leukaemia virus (FeLV).

Answer 24

FeLV related disorders are numerous and include –

Imunosuppression,
Neoplasia,
Anaemia,
Immune mediated diseases,
Reproductive disorders
Enteritis.

Question 25

Bacterial vaccine.

Chlamydophila felis (Chlamydia psittaci var. felis)

Answer 25

In cats this infection is usually manifest as an upper respiratory tract and eye infection (rhinitis, pharyngitis and conjunctivitis).

Question 26

Other less-commonly used vaccines available for the cat include –

Answer 26

Rabies Virus - As with the dog, vaccination for overseas travel purposes is now permitted.

Bordetella bronchiseptica - to reduce clinical signs of Bordetella bronchiseptica-associated upper respiratory tract disease.

Question 27

Rabbit -

There are vaccines available against -

Answer 27

Myxomatosis.

Viral/Rabbit Haemorrhagic Disease (VHD/RHD) types 1 and 2.

In Britain the licensed vaccine for the control of myxomatosis is Nobivac© Myxo-RHD – a combination vaccine that provides protection against myxomatosis and rabbit haemorrhagic disease type 1.

Question 28

Pigeon vaccination

Answer 28

Paramyxovirus and pigeon pox.

Question 29

Fish vaccination

Answer 29

In 2012 there was an outbreak of canine distemper in ferrets in the UK in particular in the Midlands with confirmed cases in Wolverhampton, Dudley, Halesowen, Milton Keynes, Alsager (Cheshire) and Derby.
With no licensed vaccine available in the UK, many ferrets are not been vaccinated against distemper and inquiries to the three UK manufacturers that market the six combined distemper vaccines licensed for canine use in the UK gave a variety of recommendations for off-label use.

Question 30

Timing of vaccination - considerations

Answer 30

Initial vaccination programmes and MDAs.

When vaccinating a young animal it is very important to ensure that the timing is appropriate in order to ensure maximum protective effect.

Young animals derive Maternally Derived Antibodies (MDAs) from the mother in order to protect them in the first few weeks of life before their immune system has the opportunity to create their own.

MDAs are essential for survival however they also have the potential to inhibit neonatal ability to mount an appropriate immune response.

This can result in vaccine failure, due to 3 mechanisms -

Question 31

3 MDA mechanisms that result in vaccine falure

Answer 31

1. MDA neutralises the vaccinal antigenThe MDA treats the antigen like any other naturally occurring antigen and binds it flagging it up for destruction.2. MDA binds the B-lymphocyteThe MDA binds with the B-lymphocyte preventing the lymphocyte binding with the antigen.3. MDA disguises vaccinal antigen receptorThe MDA binds the antigen disguising it from the B-lymphocyte preventing binding.

Question 32

MDA and vaccination programmes

Answer 32

So, how does this affect the typical canine and feline vaccination programme.

Initial vaccination programmes in the UK typically include 2 vaccinations.

First vaccine – Dependent on species and vaccine administered from between 6 to 10 weeks.

Second vaccine – Dependent on species and vaccine administered 2 to 4 weeks after first vaccine.
MDAs are still present at first and second vaccination so there is potential for the vaccine to fail.

Studies show that up to 10% of puppies may fail to respond to elements of primary core vaccination (canine distemper virus, canine adenovirus or canine parvovirus type 2) when the last of these primary vaccines is given at 12 weeks of age

Question 33

Vaccination protocol for a puppy.

Answer 33

the World Small Animal Veterinary Association (WSAVA) Vaccine Guidelines Group (VGG) recommend a third vaccination at 16 weeks.

The new recommendations (WSAVA VGG) for primary puppy core vaccination for puppies bred in a developed country with good breeding standards (e.g., the UK) are -

A first vaccine at 8 to 9 weeks of age

A second vaccine 3 to 4 weeks later

A third vaccine at 16 weeks of age or older

Question 34

Immune response vs. behaviour.

Answer 34

The critical time for meeting people and other animals and getting familiar with things in the environment, i.e. socialization, is between 3 and 12 weeks of age.

So, approximately3 to 5 weeks of the critical socialisation period occurs before the first vaccination.

Second vaccination may not take place until 12 weeks and we usually recommend a 1 - 2 week waiting period post second vaccination to ensure the immune response has had time to work, so the puppy could be 14 weeks old before fully protected and if we introduce the 16 week vaccine recommended by the WSAVA VGG then the puppy is even older.
Finishing the initial course at 16 weeks means the animal is more likely to be suitably protected, however, if we haven’t allowed for socialisation during this vulnerable period the animal is going to be less well socialised which potentially could lead to behavioural problems in later life.

A compromise must be reached between the need to protect against disease, and the need to avoid behavioural issues later.

As most of the socialisation will be with humans rather than other dogs, such a compromise is feasible –

Question 35

Until puppies are fully protected by vaccination they should -

Answer 35

not be allowed to mix with dogs of unknown vaccination status.
not be taken to parks or walked in other areas which other dogs have fouled
be taken out and about, carrying if necessary, to allow them to experience new sights and sounds without the risk of contact with disease.

Question 36

Vaccination at 12 months of age.

Answer 36

There is a misconception that the purpose of this vaccine is to ‘boost’ the immune response generated by one of the three primary vaccinations, in fact, the main purpose of this vaccine is simply to ‘catch’ those puppies that failed to respond to any of the primary series and establish immunity to core vaccine antigens.

For that reason, the VGG does not believe that it is justified to delay that vaccine, leaving some puppies unprotected for the first vulnerable year of life.

The new recommendation is that this vaccine be brought forward to six months of age and simply be considered the last in a primary puppy series of four core vaccines (perhaps at the time of suture removal after neutering).

Question 37

Booster Vaccinations

Answer 37

Historically, booster vaccinations involved giving all components every year, however research has shown that we do not need to revaccinate all components each year.

Standard recommendations now state that dogs be revaccinated against –

Canine distemper virus (D), canine adenovirus (H) and canine parvovirus (P) every 3 years.

Canine parainfluenza virus (Pi) and Leptospirosis (L) every year.

Cats be revaccinated against –

Rhinotracheitis, calicivirus and feline leukaemia components every year.

Panleucopaenia component revaccinated every three years (some companies advise revaccination every year).

Question 38

Vaccination protocol for rabbits.

Answer 38

Nobivac Myxo RHDV© (myxomatosis and RHDV 1) –
Administer 1 dose of vaccine to rabbits from 5 weeks of age onwards.
Revaccinate annually.

For RHDV Type 2 –

Eravac© (RHDV 2)
Administer 1 dose at the age of 30 days.
Revaccinate annually.

Filavac © (RHDV1 and 2)
Administer at 10 weeks of age.
Revaccinate annually.

Question 39

Vaccine load.

Answer 39

As each animal is an individual and there will be variation in duration of immunity (DOI) between individuals, what are the implications of the current vaccination protocols?

Increasing the interval for revaccination means we can revaccinate certain components less frequently, reducing vaccine load, however -

Do some animals not need revaccinating so soon, if not are these animals being overvaccinated and what are the implications of this?

Are we sure all animals maintain immunity during the vaccine interval, if not what are the implications for this?

Question 40

Adverse consequences of vaccination.

Answer 40

The importance of adverse effects from vaccination must not be overstated - vaccine benefits greatly exceed any risks from the procedure.

Neither must the importance of adverse effects be minimized.

Can we “overvaccinate” an animal?

Overvaccination is an ill-defined concept, a useful definition simply being – “administering vaccines that are not needed by the animal”.

Limited empirical research discussing the effects of “overvaccination”.

However all “medicines” (including vaccinations) involve the risk of negative side-effects and so unnecessary vaccinations equal unnecessary increased risk of adverse reactions.

Question 41

Vaccine-related Suspected Adverse Reactions

Answer 41

Before we consider potential vaccine adverse reactions there are three broad points to bear in mind -

Vaccination is generally regarded to be the safest method of protection.

Benefits to animal must outweigh the risk.

Suspected Adverse Reaction Surveillance Scheme (SARSS) is a national voluntary scheme - is this likely to be an accurate representation?

Question 42

Examples of SARs in cats

Answer 42

Non-specific reaction

Anaphylaxis

Injection site fibrosarcoma

Question 43

Examples of SARs in dogs

Answer 43

Non-specific reaction

Anaphylaxis

Autoimmune - AIHA

Hypertrophic osteodystrophy

Question 44

Non-specific vaccine reaction (dogs and cats)

Answer 44

Usually seen in the first 2 weeks of being vaccinated.

Clinical signs include - pyrexia, lethargy, anorexia, lymphadenopathy.

Presence of this reaction may affect an owner’s attitude to vaccination and make them less likely to vaccinate the following year.

Could this “non-specific reaction” indicate that animal has responded well to the vaccine?

Treatment is usually supportive and clinical signs resolve on their own.

Question 45

Anaphylaxis (dogs and cats) –

Answer 45

Severe, potentially life-threatening, allergic reaction that can affect many of the systems of the body.

Question 46

Vaccine and autoimmune diseases (dogs) –

Answer 46

Some evidence reported in the literature that in genetically predisposed animals vaccination may trigger an immune response followed by an autoimmune disease, e.g. Autoimmune Haemolytic Anaemia (AIHA).

Current research suggests that evidence is lacking.

Question 47

Hypertrophic osteodystrophy (dogs)

Answer 47

in some Weimaraner pups after CDV vaccination (Pathogenesis - decreased blood flow to the metaphyses leads to failure of ossification, necrosis and inflammation of the bone.)

Question 48

Injection-site fibrosarcoma (cats)

Answer 48

presents as mass in skin or sub-cutaneous tissue, locally invasive but can metastasize in approx 10-20% of cases, typically cervical/intrascapular area.

Question 49

Serological testing to assess revaccination requirements

Answer 49

Serological testing involves testing serum to quantify antibody levels (titre).

Previously carried out routinely for PETS with the rabies vaccination (discontinued from January 2012).

Dogs: DHP assessment to determine need for repeat vaccination.

Cats: Feline Panleucopaenia Virus, Herpesvirus, Calicivirus assessment to determine need for repeat vaccination.

(Many other serological tests are available to determine presence and diagnosis of disease).

Question 50

Advantages of serological testing

Answer 50

Individual DOIs.

Reduction of over-vaccination.

Proof for the owner

Interest in creating in-house testing – e.g. “vaccicheck®” antibody test kit in USA.

Development of “in-house tests” – Titerchek, Immunocomb.

Question 51

Issues related to serological testing for DOIs.

Answer 51

Serological testing can not measure cell mediated immunity

Is a snapshot of antibody levels at the time of testing

When do we test?

What do we do with borderline results?

Could external labs cope with increased demand?

Cost - approx £20 - £50 for pre-vaccination testing.

Question 52

Opinion on serological testing for DOIs.

Answer 52

What do the veterinary profession think – is serological testing for DOIs feasible and financially viable (Heayns and Baugh, 2012)?

Key findings –

Vaccine overload was largely considered as being of low importance.

The majority of respondents would consider introducing serology as a “package” option.

Question 53

Summary of vaccination in companion animals

Answer 53

Vaccination of companion animals protects millions of animals from potentially life-threatening disease.

Adverse reactions occur and can be serious, but they are rare.

As in all areas of medicine, individualised vaccination protocols are appropriate and best practice.

Serological testing provides a potential solution to help develop a more focused vaccination protocol for individual animals.