Jump to content
BC Boards

Rabies vaccine being given earlier?


juliepoudrier

Recommended Posts

Laws vary from state to state, but around here a rabies vax could be given as young as 8 weeks as long as it is boostered after 12 weeks.

 

Liz, can you elaborate on this? Specifically, if a rabies is given at 8 weeks, why *booster* at 12? And does it really *booster*? Why the need for 2 so close together? Any data to support the *as long as it is boostered* comment?

Link to comment
Share on other sites

Dogs can be confined at home, on leash when outside, not to leave their property and no contact with anyone who does not live in the house. If the terms of confinement are violated, animal control can take the dog away and the owners either have to pay to keep them in isolation or PTS and rabies test. (Again, check your local laws. They may be different where you live.)

 

The word booster is a misnomer. It is assumed that pups will gain some temporary immunity from a vaccine given prior to the age cutoff. The second vax isn't a booster so much as the first vax they are capable of getting long term immunity from. The one pup I've seen who was vaccinated by the shelter at 9 weeks old will not get his official first, one year rabies vax until he is over 4 months old.

 

I am personally quite careful with vaccines. I give as few as possible and only for diseases for which an animal is at risk. I vary my vaccine protocol for clients based on breed, age, health, liefstyle, etc. I see very few vaccine reactions as a result.

Link to comment
Share on other sites

Liz (and anyone else who has knowledge and an opinion on this),

 

Why would you not want to do multiple vax at the same time? I am trying to reconcile what I know about humans to dogs here. Having spent some time on some "mommy boards" in the past year, something that has been making me want to rip my hair out is the wave of vaccine denialism that's sweeping the country right now WRT human children. One of the big mottoes of these anti-vax moms is "too many, too soon", and a famous pediatrician Dr. Sears wrote a truly horrible book that suggests that parents that do want to vax should space out the vaccines and only give one at a time. However, the science this movement and Dr. Sears uses to support their arguments is really, really awful. Like, ranging from arbitrary statement of hypotheses as if they were facts, to ignoring a lot of stuff that IS known, to basically cooking data through cherry picking etc., to having such poor experimental designs that nothing of value can be gleaned form the studies they champion in support of their assertions.

 

In specific, the "too many" part intrigues me because people here seem to think that is tru for dogs. (I get the too soon, you can't vax human babies effectively for many diseases too young either). But it is my understanding that the argument in humans about too many at a time is two-fold: 1) That babies young immune systems cannot handle so many antigens at once, and 2) that having multiple vaccines at once increases the amount of chemical contaminants that a baby's system has to deal with, potentially overwhelming it's organs etc. For the latter it is particularly aluminum and formaldehyde that are presented as "the bad guys".

 

However, in all respected peer reviewed epidemiological studies, there is no evidence that stretching out the spacing of vax in humans protects them from adverse vax reactions ,and in fact just leaves children unvaccinated or undervaccinated for important diseases longer than they need to be. And immunologists have a point when they point out that it is pretty ridiculous to worry about too many antigens at once, because a nomral kid's immune system deals with many mnay new antigens every day that they are exposed to in their food, from other people for all the colds etc that you don't vax for, and that they just generally stick right into their mouths (since EVERYTHING in the world goes straight into their mouths). This is all essential for healthy immune system development and there is evidence that protecting your human child from too many antigens leads to a greater incidence of immune system problems like allergies later in life.

 

For the second part, aluminum/formaldehyde etc, that sounded bad to me too...until I learned that the amount of aluminum in a vax is so much smaller than what the kid ingests over months of just breastfeeding and breathing. On top of that, aluminum injected IM is handled completely differently than when you ingest it other ways - it is sequestered and excreted quite quickly. But injested aluminum which we all are getting all the time is apparently stored in the body. Formaldehyde also sounds scary, until you remmeber that it is a normal product of normal metabolic processes (that is, made by the body already) and therefore metabolozed quite safely in the small amounts that occur in cells (which is much larger than that in human vaccine doses).

 

So basically, in humans, the vast, vast majority of research (and all of the well-done studies) fails to show increased risk from doing more than one vax at once, and instead there is evidence that such a spaced schedule actually has substantial increased risk of underprotection.

 

I totally realize all of this research is specific to humans though, and may not at all apply to dogs and dog vaccines and their vaccine schedule. I am wondering if people here have any insight about this, if there have been any good studies done in dogs. Any vaccination totally IS a risk/benefit analysis, and I want to know as much as I can to figure out how best to vaccinate Odin and any future puppies. Thanks in advance.

Link to comment
Share on other sites

The word booster is a misnomer. It is assumed that pups will gain some temporary immunity from a vaccine given prior to the age cutoff. The second vax isn't a booster so much as the first vax they are capable of getting long term immunity from. The one pup I've seen who was vaccinated by the shelter at 9 weeks old will not get his official first, one year rabies vax until he is over 4 months old.

 

Thank you. I still can't wrap my head around some of this. There is no *age* cutoff, it's relative to the individual pup and what maternal antibodies it received, no? So, why even give a pup a 9 wk rabies only to turn around and do it again in 3 weeks? Why hit their system like this? How is it the first shot is not official? Age related? In that case wasn't the shot at 9 weeks used off label?

 

Something else I don't get is how is the dose for a chi chi is the same as a dane??? Don't worry I'm firmly planted in the "less is more" when it comes to vaccines :)

 

Ooky, pure myth or hype I am not sure but the case was tossed out of court if I recall regarding the parents that claimed the vaccines caused Autism. I'm willing to spread out necessary inoculations, verify coverage (titre) and leave it alone from there on.

Link to comment
Share on other sites

 

 

Ooky, pure myth or hype I am not sure but the case was tossed out of court if I recall regarding the parents that claimed the vaccines caused Autism. I'm willing to spread out necessary inoculations, verify coverage (titre) and leave it alone from there on.

 

Karen yes, the guy who caused all that scare (Andrew Wakefield) actually had his medical license revoked too because his research was fradulent and also didn't follow ethics codes. That research has been thoroughly discredited. There is no repuatable epidemiological evidence that vaccines cause autism in humans, although apparently it is very hard for people to let go of that fear now that it is in the public consciousness.

Link to comment
Share on other sites

There is a study that followed 10,000 dogs as they were vaccinated over a period of years. The most clear risk factor for a reaction was an increasing number of vaccines in a single visit. It didn't matter so much if a vaccine had multiple agents as how many actual injections were given. IOW, a dog that gets a DA2PPV-L vax is less likely to have a reaction than a dog that gets a rabies and Lyme and bordetella vax. No correlation was found between the type of vax (eg rabies vs lepto vs Lyme) and likelihood of reacting, except I believe for intranasal vs injectable kennel cough.

 

I don't stretch the puppy series much beyond the usual 4 months old, but I have clients coming in for tech visits in between doctor visits to split vax.

 

There can't be a known correct age to vax for an individual pup. You are just playing the odds and hoping they respond at a certain age. The whole reason people do a series of vax for parvo and other common diseases is to provide temporary immunity when the pup is at highest risk for those agents. The series ends at an age when most pups will respond with long term immunity. Vaccine schedule can and should be altered for individual pups based on their risk factors.

 

A tiny dog gets the same dose as a big dog because both their bodies need to see a minimum number of antigens to respond. Its numbers, not size, that are important.

Link to comment
Share on other sites

Thank you Liz, that is great info. Very interesting that it seems to be the number of shots, not the number of antigens. Makes me wonder what is the cause for that (something purposefully in there like an adjuvant or preservative? contaminants? the physical injections themselves?). I would love to see the discussion and what the authors made of those results.

 

Out of curiosity do you know if the study was able to calculate the relative risk increase in multi-shot visits vs one-shot visits?

Link to comment
Share on other sites

Ooky,

You wrote a very good argument, and have done a lot more reading on this subject than I have, but here are a couple of reasons why I like to space out the vaccinations:

 

I spent many years as a research scientist (immunology and molecular genetics) and have a somewhat jaded viewpoint of how research is published and disseminated, where it is published and how it is interpreted. One of my main points of cynicism is who is supporting the research being reported - a pharmaceutical company who stands to reap $$ or a non-interfering granting agency. Even peer-reviewed papers can suffer from a funding bias - which unfortunately is often not disclosed. I had a statistics professor that told the class that he could make statistics say almost anything when one knows what analyses to run.

 

There has been some research that suggests that giving too many vaccines at once results in a lower response for an individual antigen. In other words, if you were to vaccinate with a combo vaccination containing Antigen A, B, C, and D, you might achieve a certain titer for Antigen A (and for B and C, etc.). And yes, this titer may be "good enough" for protection -- but if Antigen A was inoculated by itself, the titer for Antigen A is often significantly higher than that achieved in a combo vaccine. I consider that receiving more "bang for my buck". So I would rather vaccinate to achieve the highest titer possible in the hopes that the interval for a subsequent vaccination is extended or the titer stays high enough as to not need another vaccination or simply for a higher level of protection.

 

The strategy of vaccinating with multiple antigens in one vaccination is not necessarily based on "best practice" methodology, rather it is often a matter of convenience and public policy. The vaccine has been formulated to produce a protective level of antibodies against multiple diseases in the majority of normal individuals. It is convenient because one doesn't have to make multiple return trips to the doctor/vet, and it satifies public policy because the child or pup is vaccinated against several common diseases in one visit Hence, is good for public health. It is a fact that there are families and dog owners who visit the clinician sporadically at best so when they are in the office, the goal is to cover as many bases as possible.

 

With respect to babies/toddlers sticking everything in their mouths and thus exposing themselves to multiple antigens and so what is wrong with a vaccine that has multiple antigens: I find that argument to be close to comparing apples and oranges. The route of entry of the antigen into the body is distinctly different in the two cases. In the first example, the antigen can enter the body through the GI tract or the mucous membranes, whereas an inoculation introduces the antigen directly into the body/blood system. There are different immune processes involved in both pathways.

 

FWIW, I do try to space out vaccinations, but at times, I have gone the multiple vaccination route (although never more than two) because of convenience.

 

Jovi

Link to comment
Share on other sites

I spent many years as a research scientist (immunology and molecular genetics) and have a somewhat jaded viewpoint of how research is published and disseminated, where it is published and how it is interpreted. One of my main points of cynicism is who is supporting the research being reported - a pharmaceutical company who stands to reap $$ or a non-interfering granting agency. Even peer-reviewed papers can suffer from a funding bias - which unfortunately is often not disclosed. I had a statistics professor that told the class that he could make statistics say almost anything when one knows what analyses to run.

 

Thanks for your reply, Jovi. I really appreciate the thoughtful and well-reasoned responses I get from this board.

 

I also spent several years as a research scientist at the Salk Institute, however I left molecular bio several years ago and went into ecology so I am definitely not an expert in immunology, epidemiology, medicine, and definitely not veterinary science, nor am I trying to purport to be. After personally being involved in medical research I am not jaded more than I am aware that there is useful, robust, elegant, and brilliantly conceived research and useless, flawed, and biased research, and everything in between. I think that the funding bias issue is something to keep in mind, but can also be a straw man argument. Just because a research project is funded by "Big Pharma" does not mean that the design of the research is flawed or the conclusions automatically invalid. You have to look at the actual research design and evaluate the robustness of the conclusions the authors draw from it to know whether research is useful or not. Yet the issue of funding bias is almost universally brought up by anti-vax people towards any clinical or epidemiological study adding evidence of a human vax's safety/efficacy/lack of correlation with autism, whatever. Without regard to the methods used in the study, and often, also without regard to whether the study actually WAS funded by big pharma or not. Many studies showing the safety and effectiveness of the current multi-vax schedule in humans were not actually funded by Big Pharma - studies that agree with conclusions from different studies that were funded by Big Pharma. (If this is ever successfully pointed out the tactic often then becomes, "Well, is WAS conducted by so-and-so, who is completely a puppet of the CDC!") etc. But in absence of evidence that the research, the statistical analyses, and the conclusions being drawn are flawed/biased, such an argument is irrelevant. For example in my field, a lot of the work I do is funded by solar and wind energy. That has not stopped my team from finding, describing, and showing evidence for several significant environmental impacts that occur directly because of solar and wind energy development. That have direct negative financial consequences on the very industry and firms that have funded us. So, someone saying that of course our research and observations are going to be biased towards pro-solar because we are funded very heavily by solar would be throwing up an irrelevant argument, because the potential bias of our conclusions should be weighed based on the quality of the work itself.

 

As for "lies, damn lies, and statistics", I think every research scientist who has taken analytical statistics knows the power they have, in the right hands, to distort data and teh conclusions you can draw from it (or should!) A large part of my frustration with the anti-vax moms is that the meta-analysis "evidence" they always throw at me to shut me up on this issue is just taking statistics and cherry picking data and making reality the "expert"'s complete mathematical prostitute.

 

There has been some research that suggests that giving too many vaccines at once results in a lower response for an individual antigen. In other words, if you were to vaccinate with a combo vaccination containing Antigen A, B, C, and D, you might achieve a certain titer for Antigen A (and for B and C, etc.). And yes, this titer may be "good enough" for protection -- but if Antigen A was inoculated by itself, the titer for Antigen A is often significantly higher than that achieved in a combo vaccine. I consider that receiving more "bang for my buck". So I would rather vaccinate to achieve the highest titer possible in the hopes that the interval for a subsequent vaccination is extended or the titer stays high enough as to not need another vaccination or simply for a higher level of protection.

 

Nicely framed, something to think about for sure. But I guess my first question is "what is too many?" Is it a straight correlation or a threshold? Also, some vaccines tend to either provide protection in a certain individual, or do not. Other vaccines seem to be more analog in the response, so that you might still get the disease but have a much much milder case with a significantly reduced risk of serious complications, or there is greater variation in the duration of protection amongst individuals. So, would both types be affected by such a lowered response? I think it was the immunologist Paul Offit that calculated that a human baby could theoretically safely and effectively receive 10,000 vaccines, based on the number of B-cells etc. So what is the balance of evidence that multpile antigen vax schedules are effective in either humans or dogs? do And finally, I guess I would consider that antibody immunity that you can measure by titer is only half the story, and doesn't consider cellular immunity. So, I could see a situation where you get lower titer measures, but there is no measurable difference in percentage of individuals with protection. But this is not all to say that concerns about reduced efficacy are not a very good and well reasoned argument in favor of spacing administration.

 

T

he strategy of vaccinating with multiple antigens in one vaccination is not necessarily based on "best practice" methodology, rather it is often a matter of convenience and public policy. The vaccine has been formulated to produce a protective level of antibodies against multiple diseases in the majority of normal individuals. It is convenient because one doesn't have to make multiple return trips to the doctor/vet, and it satifies public policy because the child or pup is vaccinated against several common diseases in one visit Hence, is good for public health. It is a fact that there are families and dog owners who visit the clinician sporadically at best so when they are in the office, the goal is to cover as many bases as possible.

 

Can't disagree with any of this, or what Liz said about tailoring her vax schedule for puppies! Best practices for one individual may also not be the best practices for another, and best practices for the public often need to account for the lowest denominator. So, it *could* be better to space out by a few weeks each vax you receive (and I'm not conceding that it is, in humans), but if it means the person gets busy and never goes back or goes back later than they should to get the next one, it may be a worse bet because they could end up unprotected or underprotected which could be a worse risk than the risk of inefficacy or even increased vax reactions.

 

This is also where humans are so different than dogs, because with a lot of human vaccine -preventable diseases the true public health goal is eradication through herd immunity, not necessarily 100% protection levels in each individual. You can't have herd immunity for rabies or lepto because there will always be a huge reservoir of unvaccinated individuals (wildlife) even if you did vax every dog in the country. I'll get back to this later.

 

With respect to babies/toddlers sticking everything in their mouths and thus exposing themselves to multiple antigens and so what is wrong with a vaccine that has multiple antigens: I find that argument to be close to comparing apples and oranges. The route of entry of the antigen into the body is distinctly different in the two cases. In the first example, the antigen can enter the body through the GI tract or the mucous membranes, whereas an inoculation introduces the antigen directly into the body/blood system. There are different immune processes involved in both pathways.

 

Well, to be fair, a lot of virulent diseases that babies and toddlers are at risk for ARE caused by pathogens whose normal route of infection is either through the GI tract or mucous membranes of the mouth. Take for example rotavirus, which is one of the new vax kids receive in the US, which is actually administered as a sugar solution that they drink and is not injected. But I also feel like there is not a lot to support the theory in my mind at least that an injected antigen that has been engineered to be non-virulent is going to be more dangerous or challenging to the typical child's immune system than a non-injected antigen that is virulent. And just because a vax is injected for a disease that is not normally contracted subcutaneously, does not mean the injected vax is less safe than a vax given in a route that is more like the "biological norm" for infection of that disease. Take the flu vax, which you can get injected or via a nasal spray - except I CAN'T get it via nasal spray because I have asthma. There is a much increased risk of vaccine-related respiratory complications using the nasal spray flu vax in people with asthma than there is for the injected flu vax.

 

But my example of babies sticking everything in their mouths, and this being apples and oranges when we are discussing normal levels of non-vax antigen exposure for an infant, is only one example. I am here to tell you I stand by my assertion they are BUCKETS of disease, just crawling with antigens of every variety. :lol: On all fronts of ingestion/antigen uptake, including via broken skin from diaper rash, scrapes, etc. By the way I feel I should note here I LOVE my child more than anything. But she is basically an often-slimy, drooly, sticky-hands Typhoid Mary. The number of antigens *I* am exposed to because I am in close contact with her has shot up by orders of magnitude, based on the amount of times I have been sick in the past year. And with stuff I just wasn't getting anymore now that I was an adult. :lol: So, I stand by my assertion that it is hard to believe that only a handful more antigens present a significant risk JUST based on the numbers.

FWIW, I do try to space out vaccinations, but at times, I have gone the multiple vaccination route (although never more than two) because of convenience.

 

Thank you for your very well-worded response, arguments, and explanation for your decision, which I have really enjoyed and appreciated. I do NOT say all this stuff about humans in order to say I think it is not warranted to space vax in dogs, because that really IS apples and oranges. That is why I asked in the first place. Odin is due for new vax and I am right now trying to decide whether to space, and whether to re-vax for lepto, so this is all really timely. I am busy (as we all are!) and the convenience side of it is not actually a non-issue for me, with either my dog or my human. One major way too I could see on dogs being substantially different than humans is that dog vax may just be much more dangerous than the human vax on the CDC schedule. For one thing, there definitely ARE human vax that are too dangerous to be considered worth the risk currently, like smallpox. About 1 out of a million people who get that vax die. And I seem to remember AK dog doc reporting efficacy rates for common dog vax that make me wonder if several of the dog vax aren't more like that (like non response of only 1 in 7000 for rabies or something? I think it is up in the sticky in this group). Since you can't expect to rely on herd immunity, it would make sense to really maximize individual effectiveness, with the potential side effect being more, and maybe more dangerous vaccine reactions as a result. Like, measles mumps and rubella, shown to be a very safe vax, has a non-response rate of 1 in 10 people. But because MMR vax uptake rates (used to be) so high, measles was still effectively eradicated in the US in 2000. If they had a version of MMR with 1 in 7000 effectiveness rates, I bet there is at least some chance would be not as safe of a vax.

 

Thanks again to you and Karen and Liz for discussing this with me!

Link to comment
Share on other sites

And if you tried to use all single agent vaccines you would be vacciting puppies for many months and putting them at high risk of becoming ill.

 

There are no good or easy answers when it comes to vaccines. You just have to balance the risks in each individual patient. Don't be afraid to have those discussions with your vet in regards to each animal in your household.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...