Guidelines - Imunização em Cães e Gatos - WSAVA
Guidelines - Imunização em Cães e Gatos - WSAVA
CONTENTS
Executive Summary. . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ..3
Introduction . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ..4
Evidence Based Veterinary Medicine. . . . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ..4
The Purpose of Guidelines . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ..5
Current Issues in Small Animal Vaccinology. . . . . . ... . . ... . . ... . . ... . . ... . . ... . . ..5
Types of Vaccine . . . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ..6
Canine Vaccination Guidelines. . . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ..7
Feline Vaccination Guidelines . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . . 12
Vaccination in the Shelter Environment . . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . . 15
General Considerations . . . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . . 15
Tables 1 to 7 . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . . 17
Acknowledgments . . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . . 23
References. . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . . 23
Appendix I. Canine and Feline Infectious Disease Fact Sheets . . ... . . ... . . ... . . ... . . . 27
Appendix II. Frequently Asked Questions . . . ... . . ... . . ... . . ... . . ... . . ... . . ... . . . 33
EXECUTIVE SUMMARY
The WSAVA Vaccination Guidelines Group (VGG) was convened in order to develop guidelines for the vaccination of dogs and cats that have global
application. The first version of these guidelines was published in 2007 and they were updated in 2010. The pres-ent document provides an updated
and expanded version of these international guidelines for the vaccination of small companion animals and indicates the scientific evidence base on
which the recommendations are made. The VGG recognises that the keeping of pet small animals is subject to significant variation in practice and
associated economics throughout the world and that vaccination recommendations that might apply to a developed country may not be appropriate
for a developing country. These guidelines are not a mandatory edict, but rather should be used by national associations and individual veterinary
practices to develop vaccination schedules relevant to the local situation. However, the VGG strongly recommends that wherever possible ALL dogs
and cats receive the benefit of vaccination. This not only protects the individual animal, but provides optimum ‘herd immunity’ that minimizes the
likelihood of infectious disease outbreaks.
With this background in mind, the VGG has defined core vaccines as those which ALL dogs and cats, regardless of circumstances
or geographical location, should receive. Core vaccines protect animals from severe, life-threatening diseases that have global distribu-
tion. Core vaccines for dogs are those that protect against canine distemper virus (CDV), canine adenovirus (CAV) and the variants of
canine parvovirus type 2 (CPV-2). Core vaccines for cats are those that protect against feline parvovirus (FPV), feline calicivirus (FCV)
and feline herpesvirus-1 (FHV-1). In areas of the world where rabies virus infection is endemic, vaccination against this agent should
be considered core for both species, even if there is no legal requirement for routine vaccination.
The VGG recognizes that maternally derived antibody (MDA) significantly interferes with the efficacy of most current core vac-cines
administered to pups and kittens in early life. As the level of MDA varies significantly among litters, the VGG recommends the
administration of multiple core vaccine doses to pups and kittens, with the final dose of these being delivered at 16 weeks or older or
above and then followed by a booster at 6- or 12-months of age. In cultural or financial situations where a pet animal may only be
permitted the benefit of a single vaccination, that vaccination should be with core vaccines at 16 weeks of age or older.
The VGG supports the use of simple in-practice tests for determination of seroconversion to the core vaccine components (CDV, CAV, CPV-2
and FPV) following vaccination, for determination of seroprotection in adult dogs and for management of infectious disease outbreaks in shelters.
Vaccines should not be given needlessly. Core vaccines should not be given any more frequently than every three years after the
6- or 12-month booster injection following the puppy/kitten series, because the duration of immunity (DOI) is many years and may be
up to the lifetime of the pet.
The VGG has defined non-core vaccines as those that are required by only those animals whose geographical location, local envi-
ronment or lifestyle places them at risk of contracting specific infections. The VGG has also classified some vaccines as not recom-
mended (where there is insufficient scientific evidence to justify their use) and has not considered a number of minority products which
have restricted geographical availability or application.
The VGG strongly supports the concept of regular (usually annual) health checks which removes the emphasis from, and client
expectation of, annual revaccination. The annual health check may still encompass administration of selected non-core vaccines which
should be administered annually, as the DOI for these products is generally 1 year.
The VGG has considered the use of vaccines in the shelter environment, again recognizing the particular circumstances of such
establishments and the financial constraints under which they sometimes operate. The VGG minimum shelter guidelines are simple:
that all dogs and cats entering such an establishment should be vaccinated before, or at the time of entry, with core vaccines. Where
finances permit, repeated core vaccines should be administered as per the schedules defined in the guidelines and non-core vaccines
against respiratory disease may be included.
The VGG recognizes the importance of adverse reaction reporting schemes, but understands that these are variably developed in
different countries. Wherever possible, veterinarians should be actively encouraged to report all possible adverse events to the manu-
facturer and/or regulatory authority to expand the knowledge base that drives development of improved vaccine safety.
These fundamental concepts proposed by the VGG may be encapsulated in the following statement:
INTRODUCTION
The WSAVA Vaccination Guidelines Group (VGG) was convened in 2006 with the aim of producing global vaccination guidelines for
dogs and cats that would consider international differences in economic and societal factors that impact on the keeping of these small
companion animals. The WSAVA guidelines are therefore intended to be much broader in scope than those produced for North America
by the American Academy of Feline Practitioners (Scherk et al. 2013) and the American Animal Hospital Association (Welborn et al.
2011) or for Europe by the Advisory Board on Cat Diseases (Hosie et al. 2013). The first WSAVA guidelines were published in 2007
(Day et al. 2007) and these were updated in 2010 (Day et al. 2010) with an accompanying document written for the owners and breeders
of pet dogs and cats. Between 2011 and 2013, the VGG focused on dog and cat infectious disease and vac-cinology on the Asian
continent and produced regional recommendations on aspects of vaccination for Asian practitioners (Day et al.
2014). In 2014 and 2015, the VGG has worked on updating the global canine and feline vaccination guidelines as now presented in
this document.
The format and much of the content of this 2015 revision remain similar to the guidelines published in 2010; however, specific
changes in the current document include:
1. More explicit attention to demonstrating an evidence-based approach to the WSAVA recommendations, with development of a new
classification scheme for evidence related to vaccinology and more complete referencing of pertinent scientific literature.
2. Changes to recommendations made for the timing of core vaccination of puppies and kittens to take into account new data on
persistence of maternally-derived antibody (MDA) in these animals. Specifically, timing of the final vaccine in the puppy or kit-ten
series has been extended to 16 weeks of age or older.
3. Changes to the recommendation for a 12-month booster vaccine for puppies and kittens to provide the option of reducing this interval
to 6 months (26 weeks) of age.
4. Clarification and further discussion of the revaccination intervals for adult cats receiving modified live virus (MLV) vaccines against
feline herpesvirus (FHV-1) and feline calicivirus (FCV).
5. Inclusion of information concerning newly available vaccines (e.g. oral Bordetella bronchiseptica vaccine for dogs, FCV vaccine
containing two strains of virus and multiple-serogroup Leptospira vaccines).
6. Reclassification of the feline immunodeficiency virus (FIV) vaccine to non-core.
7. Modification of the timing of core vaccinations for puppies and kittens in the shelter setting.
8. An extended discussion on the use of in-house serological testing for antibodies specific for core vaccine antigens, including the
application of these tests to the management of shelter outbreaks of infectious disease.
9. Further consideration of the optimum anatomical site for vaccination of cats.
10. Update of the VGG disease fact sheets and expansion of the list of frequently asked questions.
The concept of evidence-based veterinary medicine (EBVM) has become increasingly prominent since the WSAVA vaccination
guidelines were first published in 2007. Categories defining the weight of evidence underlying any procedure in veterinary practice (e.g.
medical, surgical or diagnostic procedures or the administration of pharmaceuticals) have been defined and applied previously to
European recommendations for feline vaccination (Lloret, 2009). The VGG aimed for the current update of the WSAVA global vaccination
guidelines to adopt a more explicitly evidence-based approach, so that practitioners could be made aware of the nature of evidence that
underpins the recommendations made. Accordingly, this document is more fully referenced than previous iterations of the guidelines.
Additionally, the VGG wished to apply a ranking of supportive evidence, but found that the currently used schemes were poorly
applicable to the specialist area of vaccinology. For this reason, the VGG has developed its own EBVM classification, proposing four
levels of evidence related to investigations of small companion animal vaccination. These are:
Category 1 evidence: a recommendation supported by peer-reviewed scientific publication of either experimental or field data.
Evidence within this category might still be of variable scientific quality despite peer review, as the peer review process does not con-form to a
universal standard.
Category 2 evidence: a recommendation supported by unpublished commercially sensitive studies submitted as part of a regulatory
package for licensed veterinary vaccines. The assumption for this level of evidence is that information appearing on the datasheets of
licensed products has been through competent peer review by regulatory authorities.
Category 3 evidence: a recommendation supported by commercial or independent experimental or field data that have not been
published in the peer reviewed scientific literature or were not included in a formal regulatory package and subjected to scrutiny by
regulators.
Category 4 evidence: a recommendation unsupported by experimental or field data, but assumed from knowledge of the ‘first prin-
ciples’ of microbiology and immunology or supported by widely-held expert opinion.
Throughout this document, statements may be followed by a qualifier [EB1], [EB2], [EB3] or [EB4] reflecting an ‘evidence base’
of category 1, 2, 3 or 4, respectively. For each occasion of use only the most rigorous level of evidence available will be given.
These WSAVA vaccination guidelines do NOT serve as a set of globally-applicable rules for the administration of vaccines to dogs and
cats. It is simply not possible to produce a set of guidelines that applies equally to each of the 80 WSAVA member nations as there
are vast differences between countries and geographical regions with respect to infectious disease presence/absence or prevalence,
vaccine product availability, owned versus free-roaming dog and cat populations, practice and client economics and societal attitudes.
Instead, these guidelines are intended to provide national small animal veterinary associations and WSAVA members with current scientific advice
and best practice vaccination concepts. It is up to national associations or individual practices to read, discuss and adapt these guidelines for their own
particular practice situations. These guidelines are not proscriptive; for example, it is entirely possible that what might be considered a non-core vaccine
in many countries, or particular geographical regions, might be used as a core vaccine elsewhere.
Practitioners are sometimes alarmed that guidelines recommendations appear contrary to those given on the product datasheet (or
‘summary of product characteristics’ [SPC] in Europe), and therefore feel that if they adopt guidelines recommendations, they are
leaving themselves open to litigation. The distinct difference between a datasheet and a guidelines document has been clearly
discussed by Thiry and Horzinek (2007).
The data sheet or SPC is a document that forms part of the registration process for a specific vaccine. A datasheet will give details
of the quality, safety and efficacy of a product and in the case of vaccines will describe the minimum duration of immunity (DOI) of the
product. The DOI is based on experimental evidence (i.e. how long after vaccination is an animal protected from infection or disease
as determined by challenge with virulent infectious agent), represents a minimum value and need not reflect the true DOI of a vaccine.
Most companion animal core vaccines, until relatively recently, had a 1-year minimum DOI and carried a recommenda-tion for annual
revaccination. In more recent years many of the same products have been licensed with a minimum DOI of 3 (or sometimes 4) years.
In fact, in many countries the majority of core MLV vaccines are now licensed for triennial revaccination of adult animals. However,
there are many other countries in which the identical products still carry a 1-year minimum DOI; simply because the manufacturer has
not applied for a change in its product label recommendations or because the national licensing authority has not permitted the change
to be made. This unfortunate situation does lead to confusion amongst practitioners in those countries.
Above all, it must be remembered that even a 3-year license is a minimum DOI for core vaccines and for most core vaccines the true
DOI is likely to be considerably longer, if not lifelong, for the majority of vaccine recipients.
Therefore, there will remain instances where the guidelines may recommend triennial or less frequent revaccination, but all avail-
able products in a particular country still carry a 1-year licensed DOI. In this instance, the veterinarian may use a vaccine according to
guidelines (and therefore current scientific thinking) by obtaining informed (and documented) owner consent for this deviation from
manufacturer’s recommendations (‘off-label use’). Veterinarians should also be aware that company technical representatives will
continue to advise that the veterinarian must adhere to the recommendations given in their datasheets, as they are obliged to do since
these documents have been through the licensing procedure.
Further confusion may arise when veterinarians compare the recommendations given in different sets of guidelines. There are, for
example, subtle differences in recommendations made in different countries that reflect differences in the opinions of local expert
groups, the prevalence of particular infectious diseases and in the typical lifestyles of pet animals that may make them more or less
exposed to infections. The VGG faces the difficult challenge of setting a middle-course through various national or regional guidelines.
Its recommendations attempt to provide a balanced perspective to account for global differences in the keeping of small companion
animals.
In summary, veterinarians should feel comfortable about vaccinating according to the schedules given in these guidelines, but should cross-
reference these with local recommendations where available. Where the VGG recommendations differ from current product label recommendations
the practitioner needs to be sure to obtain informed client consent in order to use the vaccine in accordance with the VGG recommendations.
If vaccination has been so successful, then why is it necessary to continually re-evaluate vaccination practice? There is little doubt
that, in most developed countries, some of the major infectious diseases of dogs and cats are considered at most uncommon in the
pet population. However, even in those countries there remain geographical pockets of infection and sporadic outbreaks of disease
may occur, and the situation regarding free-roaming or shelter populations is distinctly different from that in owned pet animals. In
many developing countries these key infectious diseases remain as common as they once were in developed nations and a major cause
of mortality in small animals. Although it is difficult to obtain accurate figures, even in developed countries it is estimated that only 30–
50% of the pet animal population is vaccinated, and this is significantly less in developing nations. The global economic reces-sion
post-2008 has had further impact on the uptake of preventive healthcare by pet owners in developed countries and survey data
suggests a recent decline in vaccination (Anon 2013a).
In small animal medicine, we have been slow to grasp the concept of ‘herd immunity’ – that vaccination of individual pet animals is
important, not only to protect the individual, but to reduce the number of susceptible animals in the regional population, and thus the
prevalence of disease. Herd immunity related to use of core vaccines that provide a long (many years) DOI is highly dependent on the
percentage of animals in the population vaccinated and not the number of vaccinations that occur annually. Therefore, every effort
should be made to vaccinate a higher percentage of cats and dogs with the core vaccines. It is simply not possible to induce ‘better’
immunity in an individual animal by giving repeated vaccinations, i.e. a dog receiving a core MLV vaccine every 3 years will be equally
well protected compared with one receiving the same vaccine annually (Bohm et al. 2004, Mouzin et al. 2004, Mitchell et al. 2012)
[EB1], but this may not necessarily be the case for feline core vaccines (see below).
In recent years the re-emerging concept of ‘One Health’ has also impacted on the field of vaccinology. The management of infec-tious diseases
through the collaborative interaction of human medical, animal and environmental healthcare professionals provides a rational and cost-effective goal
at a time when the majority of newly emergent human infectious diseases is proposed to derive from wild or domestic animal sources (Gibbs 2014).
The WSAVA has embraced the One Health concept with establishment of a One Health Committee in 2010 (Day 2010), the work of which overlaps
with that of the VGG when tackling the major small companion animal zoonoses of canine rabies and leishmaniosis.
A second major concept regarding vaccination of dogs and cats has been the recognition that we should aim to reduce the ‘vaccine
load’ on individual animals in order to minimize the potential for adverse reactions to vaccine products and reduce the time and financial
burden on clients and veterinarians of unjustified veterinary medical procedures. For these reasons we have seen the develop-ment
of vaccination guidelines based on a rational analysis of the vaccine requirements for each pet, and the proposal that vaccines be
considered ‘core’ and ‘non-core’ in nature. To an extent this categorization of products has been based on available scientific evidence
and personal experience – but concerted effort to introduce effective companion animal disease surveillance on a global scale would
provide a more definitive basis on which to recommend vaccine usage (Day et al. 2012). In parallel with the categorization of vaccines
has been the push towards marketing products with extended DOI, to reduce the unnecessary administration of vaccines and thereby
further improve vaccine safety. Both of these changes have necessitated a frame-shift in the mind-set of veterinary practitioners, which
is now becoming the accepted norm in many countries.
The following VGG guidelines are prepared when considering the optimum model of committed pet owners, willing and able to bring
their animals to the veterinarian, for the full recommended course of vaccination. The VGG is aware that there are less commit-ted or
able pet owners in every country and there are countries where severe financial or societal constraints often determine the nature of
the vaccine course that can be administered. In situations where, for example, a decision must be made that an individual pet may
have to receive only a single core vaccination during its lifetime, the VGG would emphasise that this should optimally be given at a time
when that animal is most capable of responding immunologically, i.e. at greater than 16 weeks of age.
The VGG has additionally considered vaccination in the shelter situation. The guidelines that we have proposed are those that we
consider provide the optimum level of protection for these highly susceptible animals. The VGG also recognises that many shelters run
with limited financial support which may constrain the extent of vaccination used. The minimum vaccination protocol in this
situation would be a single administration of core vaccines at or before the time of admission to the shelter.
This document seeks to address these current issues in canine and feline vaccinology, and to suggest practical measures by which
the veterinary profession may move further towards more rational use of vaccines in these species. The most important message of
the VGG is therefore encapsulated in the following statement:
TYPES OF VACCINE
Before discussing specific vaccination guidelines, a brief review of the types of small companion animal vaccine available is justified.
Vaccines may be considered simply as either ‘infectious’ or ‘non-infectious’ in nature.
Most infectious vaccines used in dogs and cats contain organisms that are attenuated to reduce virulence (i.e. ‘modified live virus’
[MLV] or attenuated vaccines), but the organisms are intact and viable and induce immunity by inducing low-level infection and
replicating within the animal, without producing significant tissue pathology or clinical signs of infectious disease. Infectious vac-cines
have the advantage of more effectively inducing immunity at relevant anatomical sites when administered parenterally and are more
likely to induce robust cell-mediated and humoral (antibody-mediated) immunity. Some infectious vaccines are administered
directly to mucosal sites (i.e. intranasal or oral vaccines) where they are even more effective at inducing relevant protective mucosal
immunity. Some recombinant vectored vaccines (i.e. a live vector organism carrying genetic material encoding an antigen from the
target pathogen) may also be considered ‘infectious’; however, the vector organism is not relevant to, or pathogenic in, the dog or cat.
When administered to an animal that lacks maternally-derived antibody (MDA) an infectious vaccine will generally induce protec-tion
with a single dose.
Non-infectious vaccines (also known as killed or inactivated vaccines and including subunit and naked DNA vaccines) contain an
inactivated but antigenically intact virus or organism, or a natural or synthetic antigen derived from that virus or organism, or the DNA
that can encode such an antigen. Non-infectious agents are unable to infect, replicate or induce pathology or clinical signs of infectious
disease. They generally require an adjuvant to increase their potency and usually require multiple doses (even in an adult animal) to
induce protection. Non-infectious vaccines are administered parenterally and may be less likely to induce both cell-mediated and
humoral immunity and generally have a shorter DOI compared with infectious vaccines.
Non-core vaccines are those for which use is determined on the basis of the geographical and lifestyle exposure risks of the indi-
vidual and an assessment of risk–benefit ratios (i.e. the risk of being unvaccinated and susceptible or the risk of being vaccinated and
developing an adverse reaction versus the benefit of being protected against the infection in question). Not recommended vaccines
are those for which there is little scientific justification (insufficient evidence base) for their use.
An integral part of core vaccination of puppies is the ‘booster’ vaccine that has traditionally been given either at 12 months of age
or 12 months after the last of the primary series of puppy vaccines. The main aim of this vaccine is to ensure that a protective immune
response develops in any dog that may have failed to respond to any of the vaccines in the primary core series, rather than necessarily
‘boosting’ the immune response. The delivery of this vaccine at 12 months of age is likely to have been chosen historically as a
conve-nient time to request the owner to attend the practice for a first annual health check. This therefore implies that should an
individual puppy fail to respond to any of the primary core vaccinations, that puppy may be unprotected until it receives this 12-month vaccine.
This might account for occurrences of infectious disease (e.g. canine parvoviral enteritis) in a proportion of vaccinated puppies at less
than 12 months of age. The VGG has re-evaluated this practice and now suggests that veterinarians might wish to reduce this possible
window of susceptibility by bringing forward this vaccine from 52 weeks to 26 weeks of age (or indeed at any time point between 26
and 52 weeks of age; however, 26 weeks of age provides a convenient timing). This practice will require that pet owners clearly
understand why this is recommended, because as indicated in Table 5, adopting such a protocol will mean that vaccination started in
a 6 or 7 week old puppy, might now entail up to five vaccine visits in the first 6 months of life. For core vaccines, after a 26 week
‘booster’, another core vaccine would not be required for at least another 3 years. This new recommendation for vaccination at 6
months of age as an alternative to vaccination at about 1 year of age is certainly not mutually exclusive to, and does not preclude, a 1-
year or 16-month ‘first annual health check’. Many veterinarians are understandably keen to check the animals under their care at
around the time they reach skeletal maturity.
A negative test result indicates that the dog has little or no antibody, and that revaccination is recommended. Some seronegative
dogs are in fact immune (false-negative) and their revaccination would be unnecessary because they would make a rapid and sub-
stantial anamnestic response to vaccination (Mouzin et al. 2004). However, such dogs cannot be detected readily and an animal with a
negative result, regardless of the test used, should be considered as having no antibody and potentially susceptible to infection. In
contrast, a positive test result would lead to the conclusion that revaccination is not required.
Monitoring serum antibody specific for canine rabies is not generally used in the same manner for determining revaccina-tion
requirements as these are mandated by law. Laboratory testing for a protective rabies antibody titre (considered as more than 0·5 IU/ml)
is required for international pet travel. Rabies serology is only performed by recognized reference laboratories.
Serological testing for CDV, CAV and CPV-2 has application for determining protective immunity in the puppy, for informing
revaccination intervals in adult dogs and in management of infectious disease outbreaks in shelters.
A dedicated owner may wish to confirm that a puppy is protected after the course of primary vaccinations when these are com-pleted
at 16 weeks or older (Figure 1). A serum sample taken at least 4 weeks after the final vaccination may be tested. This interval will ensure
that MDA is no longer present and that even ‘slow responder’ puppies have seroconverted. A seropositive puppy would
not require a 26 or 52 week booster and could next receive core vaccine 3 years later. Seronegative puppies should be revaccinated
and retested. If the pup again tests negative, it should be considered a non-responder that is possibly incapable of developing protective
immunity.
Testing for antibody is presently the only practical way to ensure that a puppy’s immune system has recognized the vaccinal antigen.
Vaccines may fail to induce protective immunity in a puppy for various reasons:
Positive Negative
Likely to be unprotected
May have CMI or innate immunity
affording some protection
Fig 1. Flow chart for serological testing of puppies
testing before release. Post-manufacture factors such as incorrect storage or transportation (interrupted cold chain) and handling
(dis-infectant use) of the vaccine in the veterinary practice, may result in inactivation of an MLV product. The VGG has recognized
that such ‘vaccine husbandry’ remains an issue in many countries and has included some simple guidelines in Table 6.
(3) The animal is a poor responder (its immune system intrinsically fails to recognize the vaccinal antigens)
If an animal fails to develop an antibody response after repeated revaccination, it should be considered a genetic non-responder.
Because immunological non-responsiveness is genetically controlled in other species, certain breeds of dogs have been suspected
to be poor-responders. It is believed (but unproven) that the high susceptibility to CPV-2 recognized in certain Rottweilers and
Dobermanns during the 1980s (regardless of their vaccination history) relates in part to a high prevalence of non-responders (Houston
et al. 1994) [EB4]. In the USA today, these two breeds seem to have no greater numbers of non-responders to CPV-2 than other
breeds, possibly because carriers of the genetic trait may have died from CPV-2 infection. Some dogs of these breeds may be low or
non-responders to other antigens. For example, in the UK and Germany, the non-responder phenotype remains prevalent amongst
Rottweilers [EB3] for CPV-2 and recent studies have shown this breed to have a higher proportion of animals failing to achieve the
titre of rabies antibody required for pet travel (Kennedy et al. 2007) [EB1]. Some broad estimates have been made of the proportion
of genetic non-responders in the canine population, these being: 1 in every 5,000 dogs for CDV, 1 in every 100,000 dogs for CAV
and 1 in every 1,000 dogs for CPV-2 [EB4].
Passive Immunization
While vaccination (i.e. active immunization) dominates infectious disease prevention, passive immunization continues to be used in
the treatment of infectious disease in many countries.
Although virus infections trigger both cellular and humoral immunity, it is mainly the antibody response that contributes to the
reduction of viral load and recovery. In many virus infections, antibody levels are therefore taken as correlates of protection. During
viraemia, pre-existing or injected antibodies directed against surface structures of virions bind to the particles, neutralize their infec-
tivity and prepare them for removal. Therapeutically, most serum or immunoglobulin preparations used in passive immunization are
injected subcutaneously (because they are from a different animal species) and quickly reach the circulation. Not unexpectedly,
intravenous infusions of plasma or serum (from the same species) have been found to work as well. In local infections, such as those
initiated by the bite of a rabid carnivore, post-exposure antibody prophylaxis has also proven invaluable in human medicine. Human
rabies immune globulin provides rapid protection when given on the first day of the post-exposure prophylaxis regimen. As much as
possible of the preparation is infiltrated into and around the wound, and may be given intramuscularly at a site distant from the rabies
vaccine, which is applied simultaneously.
In companion animal practice, preventive active immunization is so commonplace that serum prophylaxis/therapy is considered only under
exceptional circumstances (e.g. when a dog is presented with distemper or a cat is presented with panleukopenia, or dur-ing a disease outbreak in a
kennel/cattery). There is still a market for serum and immunoglobulin products, and companies produc-ing them exist in the USA, Germany, the Czech
Republic, Slovakia, Russia and Brazil. The preparations are either of homologous or heterologous (e.g. horse) origin, are polyvalent (directed against
several viruses) and consist of sera or their immunoglobulin fraction.
Despite the availability of such products, the VGG recommends that they be used conservatively, and only after careful consider-
ation. In the case of an outbreak of CDV infection in a kennel, it is much safer and more effective to vaccinate all dogs with CDV
vaccine rather than give immune serum (see below and Table 7) (Larson & Schultz 2006) [EB1]. In such a situation it has previously
been recommended that MLV vaccines be administered intravenously (off-label) rather than subcutaneously or intramuscularly, but
there is little evidence that this practice provides more effective or rapid protection than subcutaneous or intramuscular injection.
Administration of CDV vaccines by any of those routes will provide protection from severe disease and death immediately or very
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shortly after vaccination. In this instance the vaccine does not prevent infection, but instead it protects from severe disease (especially
from neurological disease) so the animal will survive and will subsequently be immune for life.
In the case of a cattery outbreak of FPV infection, or a kennel outbreak of CPV-2 infection, a recent study has shown that if immune
plasma is given after clinical signs appear, there is no benefit in reduction of morbidity or mortality (Bragg et al. 2012) [EB1].
However, this work has been criticised because only a small volume (12 ml) of immune plasma was given to each puppy in this study.
Much larger volumes (6·6–11 ml/kg) are routinely used by researchers and practitioners and these large doses are believed by some
experienced clinicians and investigators to have efficacy (Dodds 2012) [EB4]. In order to have a maximal beneficial effect, immune
serum or plasma must be given after infection, but prior to the onset of clinical signs. In this case administration of immune serum or
plasma is best provided within 24–48 hours after infection and a large amount of high titred serum or plasma is required. The serum or
plasma must be given parenterally (e.g. subcutaneously, intravenously or intraperitoneally) and not orally. There is no benefit from oral
administration even when treatment is started prior to infection.
An important consideration in a shelter situation is the relative cost of these commercial products. An alternative practice that is
sometimes used in a shelter situation is to collect serum or plasma from animals in the shelter that have survived disease or have been
recently vaccinated. However, this practice carries risk as the serum will not necessarily have been screened for transmissible
pathogens (e.g. haemoparasites or feline retroviruses). Serological testing provides a more effective approach to controlling disease
outbreaks in a shelter situation (see below and Table 7).
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The VGG has also reconsidered the FIV vaccine, which in previous iterations of these guidelines has been categorized as ‘not
recommended’. The basis for this categorization was: (1) questions over the cross-protection between subtypes of virus included in
the vaccine and those subtypes and recombinants in the field in different geographical areas (Hosie et al. 1995, Dunham et al. 2006,
Yamamoto et al. 2007, Coleman et al. 2014, Beczkowski et al. 2015a) [EB1], (2) the interference of the vaccine with antibody testing
used for diagnosis of FIV infection (Hosie & Beatty 2007) [EB1], and (3) the fact that this is an adjuvanted vaccine that must be given
repeatedly (a primary course of three injections and annual revaccination) to a species susceptible to injection site sarcoma. The
VGG is aware that in some parts of the world, there remains a significant prevalence of FIV seropositivity and/or infection (Bennett
et al. 1989, Hosie et al. 1989, Friend et al. 1990, Glennon et al. 1991, Bandecchi et al. 1992, Hitt et al. 1992, Ueland and Lutz 1992,
Jones et al. 1995, Hofmann-Lehmann et al. 1996, Yilmaz et al. 2000, Lee et al. 2002, Muirden 2002, Norris et al. 2007, Gleich et al.
2009, Ravi et al. 2010, Bande et al. 2012, Chang Fung Martel et al. 2013, Rypula et al. 2014) [EB1]. There are now discriminatory
serological tests (Kusuhara et al. 2007, Levy et al. 2008, Westman et al. 2015) and more robust polymerase chain reaction (PCR)
test-ing for the diagnosis of FIV infection (Arjona et al. 2007, Wang et al. 2010, Morton et al. 2012) [EB1]. In many countries, it is most
unlikely that cat owners will be persuaded to keep their cats indoors, away from the major risk of FIV transmission (bites by infected
cats). Disease progression in FIV-infected cats has recently been shown to be impacted by housing conditions and number of cats in
the household (Beczkowski et al. 2015b). Given that this vaccine has been shown to have efficacy in some studies, but not in others,
and might benefit some at-risk populations of cats, the VGG has reclassified the product as a non-core vaccine.
E12 Journal of Small Animal Practice • Vol 57 • January 2016 • © 2016 WSAVA
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Journal of Small Animal Practice • Vol 57 • January 2016 • © 2016 WSAVA E13
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• Any risk of FISS is outweighed by the benefit of protective immunity conferred by vaccines. Current estimates of the prevalence of
FISS are 1 in every 5,000 to 12,500 cats vaccinated (Gobar and Kass 2002, Dean et al. 2013).
• Non-adjuvanted vaccines should be administered to cats wherever possible.
• Vaccines (particularly adjuvanted products) or other injectables should not be administered into the interscapular region.
• Vaccines (particularly adjuvanted products) should be administered into other subcutaneous (and not intramuscular) sites. The choice
of these sites should be based on a balance between the ease of surgical resection of any FISS that might develop and accept-able
safety for the vaccinator (i.e. to avoid accidental self-injection during difficult restraint of the animal).
• Vaccines should be administered into a different site on each occasion. This site should be recorded in the patient’s record or on the
vaccination card by use of a diagram indicating which products were administered on any one occasion. The sites should be ‘rotated’
on each occasion. Alternatively, a practice might develop a group policy that all feline vaccinations are administered to a specific site
during one calendar year and this site is then rotated during the following year.
• The VGG encourages all cases of suspected FISS to be notified via the appropriate national reporting route for suspected adverse reactions or to
the vaccine manufacturer.
Serological Testing
Since the publication of the 2010 guidelines, one commercial in-practice rapid test for determination of serum antibody to FPV, FCV
and FHV-1 has become available. This test has now been validated and applied in a series of published investigations (DiGangi et al.
2011, Mende et al. 2014) [EB1]. This test kit may be used for the determination of the presence of protective anti-body against FPV as
there is excellent correlation between the presence of such antibody and resistance to infection (Lappin et al.
2002) [EB1]. The FPV test kit is reported to have 89% specificity and 79% sensitivity (Mende et al. 2014) or 99% specificity and 49%
sensitivity (DiGangi et al. 2011) when compared with a haemagglutination inhibition test. A negative test result indicates that a cat has
little or no antibody, and that revaccination is recommended. However, some seronegative cats are in fact immune
(false-negative) and their revaccination would be unnecessary. In contrast, a positive test result would lead to the conclusion that
revaccination is not required.
E14 Journal of Small Animal Practice • Vol 57 • January 2016 • © 2016 WSAVA
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The correlation between circulating serum antibody and protection against FCV and FHV-1 infection is less robust than the pres-ence of
adequate local mucosal immunity and cell-mediated immunity, respectively. For that reason, a negative test result for FCV or FHV-1 antibody
would not necessarily indicate lack of protection in a particular cat (Lappin et al. 2002) [EB1]. These tests can be applied in practice as
described above for the dog: for determination of protection of kittens following FPV vaccination, for determi-nation of protection against FPV
in adult cats (in order to inform decisions about revaccination) and for use in the shelter situation in the control of outbreaks of FPV infection.
It should be emphasized that antibody testing for FIV is used to diagnose disease and is of no value in determining immunity to FIV, but as
discussed above, where FIV vaccine is used and FIV infection is suspected, diagnosis should be made using a discriminatory serological test
or, preferably, a validated PCR test.
An animal shelter is a holding facility for animals usually awaiting adoption, rescue or reclamation by owners. In general, animal shel-ters are
characterized by a random source population with a mostly unknown vaccination history, high population turnover and high infectious disease
risk. The term ‘shelter’ encompasses situations ranging from sanctuaries that possess a stable population, to facilities that admit hundreds of
animals per day, to rescue and foster homes that care for multiple individuals or litters at any given time. Just as vaccination strategy varies
with each individual pet, there is no one-size-fits-all strategy for vaccinating shelter animals. The likeli-hood of exposure and the potentially
devastating consequences of infection necessitate a clearly defined shelter vaccination program.
Shelter medicine differs from individual care in that clinicians have to practice in an environment where eradication of infectious disease
cannot be attained. It is possible, however, to minimize the spread of infections within a high-density, high-risk population and maintain the
health of not-yet-infected individuals. When the overall purpose is to place healthy pets into welcoming homes, the time and effort dedicated
to controlling infectious disease is only one of many variables in the complex shelter medicine and hus-bandry equation. The recommendations
provided here attempt to address some shelter-unique issues as they pertain to vaccination
and disease control.
Guidelines and recommendations for vaccines to be used in shelters are given in Tables 2 and 4. In these updated guidelines, we
have standardized the recommendations for puppies and kittens entering a shelter to indicate that core vaccination may be started as early
as 4–6 weeks of age, and (where funding permits) revaccination should be every 2 weeks until the animal reaches 20 weeks of age, if it
remains in the shelter until that time [EB4]. Recent US studies have shown that cats entering shelters may be seropositive for vaccine-
preventable infectious disease agents. DiGangi et al. (2012) reported seropositivity for FPV (60.2%), FHV-1 (89%) and FCV (63.4%) and
Fischer et al. (2007) reported seropositivity for FPV (33%), FHV-1 (21%), FCV (64%) and rabies virus (3%).
Seropositivity to CDV (41.2%) was less than for CPV (84.3%) in dogs entering one US shelter (Litster et al. 2012) and in another study 35.5%
of dogs were seropositive to both CDV and CPV, 7.7% to CDV only, 31.5% to CPV only and 25.3% to neither virus (Lechner et al. 2010). If
unambiguous documentation of vaccination is provided for an adult animal at the time of admission to a shelter, there is no reason to
revaccinate with canine core vaccines, but feline core vaccines, specifically FCV and FHV-1, may be of value in boosting immunity.
The VGG discriminates between a shelter and a boarding kennel/cattery. The latter are facilities where fully vaccinated animals
may be temporarily boarded for relatively short periods of time (e.g. when owners are on vacation). It should be a requirement of entry to any
such facility that the individual dog or cat is fully vaccinated with core products given according to the guidelines presented herein. In dogs,
the use of non-core vaccines against respiratory infections is also appropriate under these circumstances. The VGG is aware that in some
countries vaccination protocols for animals entering a boarding kennel/cattery are formulated by local authorities and may be contrary to
current guidelines (e.g. insistence on annual revaccination). The VGG encourages such authorities to recon-sider these recommendations in
light of current scientific thinking and product availability and encourages the veterinary profession and national associations to lobby for such
change.
Since publication of the 2010 guidelines, the availability of rapid in-house serological test kits has had major impact on the man-agement
of outbreaks of CDV, CPV or FPV in animal shelters [EB3]. The approach to use of these kits in such situations is outlined in Table 7.
GENERAL CONSIDERATIONS
Journal of Small Animal Practice • Vol 57 • January 2016 • © 2016 WSAVA E15
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quality of care will diminish. It is therefore essential that veterinarians stress the importance of all aspects of a comprehensive indi-vidualized health
care program. Emphasis should be placed on detailed history taking; thorough physical examination performed in the presence of the client, and
individualized patient care. The importance of dental care, proper nutrition, appropriate diagnostic testing and the control of parasites and of zoonotic
diseases should be addressed during evaluation of each pet. Behavioural concerns should be discussed, as well as the necessity for more frequent,
tailored examination of young and geriatric animals and animals of particular breeds with well characterized disease predispositions. Discussion of
vaccination is simply one part of the annual health check visit.
During regular (usually annual) health checks, clinicians should assess the need for core and non-core vaccines for that particular
year. The practitioner should explain to the client the types of vaccines available, their potential benefits and risks, and their applica-
bility to the particular animal, given its lifestyle and risk of exposure. While an animal might not receive core vaccination every year,
most non-core vaccines require annual administration – so owners will continue to see their animal vaccinated annually. The regional
incidence and risk factors for various infectious diseases should also be discussed. Ways to reduce the impact of acquired disease (e.g.
avoiding overcrowding, improving nutrition, and restricting access to infected animals) should also be reviewed.
Vaccinations should be considered as only one component of a comprehensive preventive health care plan individualized based on
the age, breed, health status, environment (potential exposure to harmful agents), lifestyle (contact with other animals) and travel habits
of the pet.
Age has a significant effect on the preventive health care needs of any given individual. Puppy/kitten programs have traditionally
focused on vaccinations, parasite control and neutering. Today, opportunity exists to incorporate behaviour counselling and zoo-notic
disease management. For the ageing pet, senior care programs are becoming increasingly popular. Nutritional, dental disease and
parasite control assessment and counselling should take place on an individualized basis throughout the life of the pet. There is no
evidence that older dogs and cats, which have been fully vaccinated as pups or kittens, require a specialized programme of core
vaccination (Day 2010, Horzinek 2010, Schultz et al. 2010). Experimental evidence shows that older dogs and cats have persisting
immunological memory to core vaccines, as detected by measurement of serum antibody, and that this may be readily boosted by
administration of a single vaccine dose (Day 2010) [EB1]. In adult animals, decisions about revaccination with most core products (CDV,
CAV and CPV and FPV) may be made via serological testing. Practitioners who offer this alternative to vaccination report that it is
greatly appreciated by owners who may have concerns about vaccination frequency and offering this alternative acts as a ‘practice
builder’. By contrast, aged animals may not be as efficient at mounting primary immune responses to novel antigens that they have not
previously encountered (Day 2010) [EB1]. Studies of UK dogs and cats vaccinated for the first time against rabies for pet travel have
clearly shown that more aged animals fail to achieve the legally required antibody titre (Kennedy et al. 2007) [EB1].
The environment in which a pet resides can profoundly affect its health status and should be assessed during annual health care
visits in order to define risk factors and develop appropriate preventive measures.
By estimating the extent to which dogs and cats come into contact with other animals in unobserved circumstances, veterinarians
can assess the need for non-core vaccinations. Dogs that visit kennels, grooming salons, common areas and wooded, tick-infested
areas are potentially at greater risk from certain infectious diseases than dogs that do not frequent these areas.
Just as the human population has become more mobile, so has the pet population, resulting in potential exposure to infectious
agents, parasites and environmental hazards not found where the animal normally lives. Determining past and anticipated future travel
during each visit allows for greater individualization of preventive care and diagnostic testing plans.
The use of peel-off vaccine labels and stamps that imprint the medical record with the outline of a pet facilitates this type of record keeping which
is mandatory in some countries. Adverse events should be recorded in a manner that will alert all staff members during future visits. Informed
consent should be documented in the medical record in order to demonstrate that relevant information was provided to the client and that the client
authorized the procedure (e.g. ‘off-label’ use of products as discussed above). At the very least, this notation should indicate that a discussion of
risks and benefits took place prior to vaccination.
VGG recommends that vaccination certificates be designed to include not just the dates on which vaccines were administered, but
also a field for the veterinarian to state the date on which vaccination is next recommended. This will help diminish confusion in the
minds of pet owners and kennel/cattery proprietors.
E16 Journal of Small Animal Practice • Vol 57 • January 2016 • © 2016 WSAVA
Initial
Initial
Table Vaccine
Comments
parenteral)
MLV,
(CPV-2;
Parvovirus-2
Canine weeks
8
6–
at
Administer apart
weeks
4
2–
doses
Two at
(booster)
Revaccination Core
Revaccination
Vaccination
MLV,
(CDV;
Virus
Distemper
Canine [EB1].
older
or
age
16
until
weeks
4
2–
every
then
age,
of years.
3
every
than
often
more
not
then
age,
of
year
1
or
months
6
either
parenteral)
Recommendation
(rCDV,
Virus
Distemper
Canine
Recombinant
parenteral) [EB4].
rCDV
or
vaccine
MLV
of
dose
one
but
manufacturers,
by
recommended
generally
are
protective
considered
is
parenteral)
MLV,
(CAV-2;
Adenovirus-2
Canine
parenteral)
(killed,
CPV-2 available.
MLV
where
recommended
Not
Machine Translated by Google
killed
and
MLV
(CAV-1;
Adenovirus-1
Canine available.
MLV
CAV-2
where
Recommended
Not
parenteral)
parenteral)
(killed
Rabies at
dose
one
Administer dose.
single
a
Administer 1
at
(booster)
Revaccination the
areas
in
or
statue
by
required
where
Core
first.
after
4
2–
given
may
dose
at
revaccinated
be
should
puppy
the
age,
than
earlier
performed
is
cination
vac-
If
age.
of
weeks
12 endemic.
is
disease
statute.
by
dictated
deter-
is
boosters
of
Timing
available.
are
DOI
3-
or
1-
a
either
with
vaccines
rabies
Canine
age.
of
year
be
may
areas
some
in
but
DOI,
licensed
this
by
mined
second
a
areas
risk
high
In
parenteral)
MLV,
(CPiV; [EB4].
older
or
age
16
until
weeks
4
2–
every
then
age,
of [EB4].
protective
considered
is
dose
one
but
manufacturers,
by
recommended
generally
are annually.
then
age,
of
year
1
or
months
6
either tract.
respiratory
upper
is
tion
infec-
of
site
primary
as
product
parenteral
the
bacterium)
avirulent
(live
bronchiseptica
Bordetella as
dose
single
a
Administer dose.
single
A very
in
often
more
or
Annually
intranasal)
ria, age.
of
weeks
3
as
early booster.
annual
by
tected
pro-
not
animals
risk
high- death.
including
vac-
oral
Intranasal
vaccinates.
of
percentage
both
CPiV
with
combination
in
or
product
+CAV-2
+CPiV
intranasal
(MLV)
CPiV
+
bronchiseptica
B. single
available
is
bronchiseptica
B.
core.
Non-
reactions,
adverse
severe
to
lead
this
as
injection
parenteral
by
delivered
be
NOT
MUST
cines
small
a
in
occur
may
discharge
nasal
or
sneezing,
coughing,
days)
10
(3–
Transient
CAV2.
and
CPiV
intranasal
oral)
bacteria,
avirulent
(live
bronchiseptica
B. manufacturer’s
current
The
age.
weeks
8
from
vaccine
this
of
use
for
is
recommendation
bacterin,
(killed
bronchiseptica
Bordetella 8
6–
at
dose
one
Administer apart.
weeks
4
2–
doses
Two very
in
often
more
or
Annually preferred
are
products
oral
or
Intranasal
core.
Non-
parenteral)
extract,
parenteral booster.
annual
by
tected
pro-
not
animals
risk
high-
antigen
wall
(cell
bronchiseptica
Bordetella at
dose
one
and
age.
of
weeks
12
10– 2015).
(Ellis
advantage
this
questions
compilation
protection
local
provide
parenteral
killed
to
of
time
the
at
published
review
a
however,
[EB4];
killed
borreliosis;
(Lyme
burgdorferi
Borrelia for
is
Recommendation apart.
weeks
4
2–
doses,
Two prior
just
Revaccinate
Annually.
A
protein
surface
Outer
(recombinant-
parenteral)
bacterin,
whole label
off-
constitute
will
exposure.
risk
high
a
ifthere
9
early
as
be
may
4
2–
given
is
second
A
older.
or
age
of
this
vaccines,
some
For
vaccines
Borrelia
later.
weeks
12
at
dose
initial regionally.
determined
as
season
tick
of
start
to in
use
for
only
recommended
Generally
core.
Non-
disease
where
or
high,
be
to
considered
is
exposure
living
exposure,
of
risk
high
known
a
with
dogs
borreliosis)
(rLyme
burgdorferi
Borrelia endemic.
be
to
known
is
tick
vector
of
risk
the
where
regions
visiting
or
in
parenteral)
[OspA],
use.
E17
E18
Initial
Table Vaccine
Comments
serogroups
(with
Leptospira
Questioning apart.
weeks
4
2–
doses
Two Annually.
Revaccination
InitialVaccination
parenteral)
bacterin,
killed
icterohaemorrhagiae;
and
canicola of
8
at
Initial
weeks
4
2–
given
is
dose
second
A
older.
or
age bacterin
past,
In
developed
been
have
vaccines
core.
Non-
[EB1].
2005)
al.
et
(Moore
bacterins
from
risk
greater
no
indicates
study
published
one
[EB4]
low
this
base
evidence
The
dogs.
breed
small
particularly
–
events
adverse
allergic
prevalence
higher
a
linked
be
to
suggested
vaccine
This
risk.
at
them
places
lifestyle
whose
should
Vaccination
‘serovar’.
and
‘serogroup’
terms
of
use
with
confusion
often
is
There
vars.
multiple
include
may
serogroups
Leptospira
that
Note
areas.
geographical
different
in
groups
sero-
pathogenic
circulating
known
the
for
account
Machine Translated by Google
Recommendation
other
some
and
USA
the
in
available
Also later.
grippotyphosa.
serogroup
australis,
Europe
in
pomona,
and
grippotyphosa
serogroups
with
countries
[EB1].
annually
administered
must
products
these
therefore
duration,
shorter
may
and
robust
less
is
that
protection
provide
known
dogs
for
or
established
been
has
exposure
of
risk
a
where
areas
geographical
in
use
to
restricted
be
vaccine
monovalent
a
is
there
Australia
In
available.
are
vaccines
orrhagiae
icterohaem-
monovalent
Zealand
New
in
and
australis
serogroup
containing
view.
this
takes
also
2015)
al.
et
(Schuller
Leptospirosis
on
Statement
Consensus
European
killed
H3N8;
(CIV;
virus
influenza
Canine weeks
4
2–
doses
Two apart
weeks
4
2–
doses
Two Annually risk
at-
for
Consider
USA.
in
only
Licensed
core.
Non-
parenteral)
adjuvanted, age.
of
weeks
>6
at
dose
initial
with
apart [EB1].
care
day
or
shows
dog
kennels,
in
those
as
such
dogs
housed
co-
of
groups
MLV,
and
killed
(CCV;
Coronavirus
Canine
parenteral) usually
are
infections
Recommended.
Not
pathogen
enteric
primary
significant
a
2009,
al.
et
(Buonavoglia
variants
genic
patho-
against
protect
would
vaccines
existing
that
evidence
no
is
There
vaccines.
available
currently-
use
justify
not
does
disease
CCV
confirmed
of
Prevalence
signs.
clinical
mild
cause
or
subclinical
agent.
infectious
this
for
postulates
Koch’s
satisfied
have
studies
No
dog.
adult
in
unconvinced
remains
VGG
the
commonly,
isolated
be
can
CCV
Although
[EB1].
2009)
al.
et
Decaro
given.
is
recommendation
supporting
evidence
of
level
[EB2]
datasheets
on
those
with
consistent
not
are
table
this
in
recommendations
the
Where
availability:
geographical
restricted
have
that
products
following
the
consider
not
did
VGG
The
License
USDA
Conditional
–
(eastern
adamanteus
Crotalux
and
vaccine)
rattlesnake
(western
atrox
Crotalus
Licensed
EU
–
saponin)
in
canis
B.
from
antigen
parasite
(soluble
vaccine
Babesia
Licensed
EU
–
vaccine
herpesvirus
Canine
EU
the
and
Brazil
in
licensed
–
vaccines
Leishmania
Initial
Initial
Comments
CPiV
without
or
with
(MLV)
CPV-2
CAV-2
+
CDV immedi-
or
to
prior
dose
one
Administer immedi-
or
to
prior
dose
one
Administer 6
at
beginning
vaccinated
be
should
puppies
Ideally
Various
Table Recommended
CPiV
without
or
with
CPV-2
CAV-2
+
rCDV facility.
the
in
still
is
animal
if
age
20
until
intervals
week
2
at
Repeat
age.
of
weeks
4
early
as
admission,
on
ately weeks.
2
in
Repeat
admission.
on
ately indicated.
be
may
CPV-2)
or
and/
CDV
(for
age
4
early
as
vaccination
outbreak,
an
face
the
In
age.
of
weeks
Parenteral
but
immunization,
with
interfere
can
present,
if
MDA,
available.
not
often
is
history
nursing
intranasal) early
as
dose
single
a
Administer
if
results,
best
For
age.
of
weeks
3 [EB4].
protection
protec-
be
may
dose
single
A
mended. death.
reactions
adverse
severe
to
lead
may
this
as
parenterally
administered
be
NOT
MUST
vaccines
oral
or
Intranasal
situation.
shelter
the
[EB4].
age
after
given
be
should
dose
additional
an
age,
of
weeks
6
to
prior
administered greater
provide
might
dose
second
a
situation
risk
high-
this
in
but
tive,
+CAV-2
(MLV)
+CPiV
bronchiseptica
B.
intranasal
oral)
bacteria,
avirulent
(live
bronchiseptica
B.
extract
antigen
or
(bacterin
bronchiseptica
Bordetella admission
of
time
at
dose
one
Administer are
apart
weeks
2
doses
Two it
when
only
recommended
is
vaccination
Parenteral
only)
administration
parenteral
for later.
2
dose
second
a
and
age)
of
weeks
8
6–
(from recommended. vaccine.
oral
or
intranasal
an
administer
to
possible
not
is
cough’)
(‘kennel
complex
disease
respiratory
Canine
disease.
manage
help
to
used
be
only
should
vaccine
the
and
disease
preventable
vaccine-
a
not
is
Rabies at
administered
be
should
dose
single
A at
administered
be
should
dose
single
A determined
be
will
vaccine
rabies
of
administration
The
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E20
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intranasal)
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indicated
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signs
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to
reported
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vaccine
of
inoculation
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confirmed.
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disease
clinical
with
associated
infections
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environments
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in
animals
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trol
parenteral)
parenteral)
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weeks
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tered
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live,
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single
a
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single
a
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indicated
is
booster
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cats
where
cases
in
considered
be
may
Vaccination
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age.
of
weeks
4
early
as
intranasally intranasally. risk.
sustained
with
cats colonies.
large
in
kept
are
that
cats
example,
for
infection;
of
risk
specific
at
be
to
likely
intranasal)
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Infectious
Feline as
dose
single
a
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4
3–
doses
Two recommended
is
booster
Annual only
available,
studies
limited
the
to
According
Recommended.
Not
adjuvanted,
non-
MLV,
(FIP; later.
4
3–
dose
second
a
and
age
of
weeks
16
as
early apart. manufacturer.
the
by
intranasal)
older.
or
age
is
It
protection.
level
some
develop
likely
are
vaccination
of
time
the
antibody-
feline
to
known
cats
weeks
16
at
negative
antibody
coronavirus
be
will
cat
a
that
rare
given.
is
recommendation
supporting
evidence
of
level
[EB2]
datasheets
on
those
with
consistent
not
are
table
this
in
recommendations
the
Where
E21
Machine Translated by Google
FPV Administer a single dose prior to or at the time Administer a single dose at the time of MLV preparations are preferable.
FHV-1 of admission as early as 4–6 weeks of age; admission; repeat in 2 weeks if the Use of intranasal FPV vaccines is not recommended in the
FCV then, every 2 weeks until 20 weeks of age if animal remains in the shelter. shelter environment (Schultz 2009). Use of intranasal FCV/FHV-1 MLV
still in the facility. vaccines may be preferable when rapid onset (48 hrs) of immunity is
important. Post-vaccinal sneezing, more commonly seen following
administration of intranasal FCV/FHV-1 vaccine is impossible to distin-
guish from active infection.
Rabies A single dose should be administered at the time A single dose should be The administration of rabies vaccine will be determined by whether the shelter
of discharge from the facility. administered at the time of discharge is in a country in which the disease is endemic and vaccination is required
from the facility. by law.
The VGG does not recommend the use of other feline vaccines in the shelter situation.
Table 5. Core Vaccination Schedules for Puppies and Kittens First Presented Between 6–9 Weeks of Age and Revaccinated Every 3 or 4
Weeks
Age at first presentation Core vaccination schedule
This table provides examples of possible vaccination schedules for puppies and kittens where vaccines are given either every 3 or 4 weeks, as would normally be done in veterinary practice for owned pet
animals. Although revaccination every 2 weeks might be used in areas of high infectious disease pressure in some geographical areas, such a protocol is not shown for simplic-ity of presentation.
After the 26 or 52 week booster vaccine; vaccinate with core products no more frequently than every 3 years (with the exception of feline respiratory virus vaccines for higher risk cats).
• Freeze-dried vaccines should be reconstituted immediately before use with appropriate diluent or liquid vaccine given simultaneously (as per manu-facturer’s recommendations). It is bad practice
and contraindicated to make up the vaccines anticipated to be used during the day first thing in the morning. Some vaccine components (e.g. CDV, FHV-1) are particularly labile in this regard and
so these vaccines may not induce adequate immunity if not reconstituted just before use.
• Vaccines should only be mixed together in the same syringe if this is specified as acceptable in the manufacturer’s data sheets.
• Vaccine injection sites should not be sterilized with alcohol or other disinfectant as this may inactivate infectious (MLV) vaccines.
• Vaccines should be ‘in date’ and precise details of batch numbers, components and site of injection should be noted in the animal’s medical record.
Disease outbreak within a shelter: all Seropositive animals These are protected and will not become infected or die.
animals within the shelter should be tested These should be separated from the non- or low-responder animals.
serologically (i.e. for CDV, CPV2 and FPV
outbreaks)
Seronegative animals These should be separated from the seropositive animals. These animals are
susceptible and should not be adopted out of the shelter until after the incubation period for the infection (i.e.
at least 2 weeks for CPV, at least 6 weeks for CDV).
These animals should be vaccinated and retested to confirm seropositivity after the incubation periods above.
Animals outside of a shelter needing to be Seropositive animals These may safely enter the shelter as they are protected from disease.
admitted in the face of a dis-ease outbreak in
the shelter
Seronegative animals These animals should be vaccinated and sent to foster homes until after they have seroconverted. They
should not be allowed to enter the shelter until they are seropositive.
E22 Journal of Small Animal Practice • Vol 57 • January 2016 • © 2016 WSAVA
Machine Translated by Google
Adverse Events
Adverse events are defined as any side effects or unintended consequences (including lack of protection) associated with the admin-
istration of a vaccine product. They include any injury, toxicity or hypersensitivity reaction associated with vaccination, whether or not
the event can be directly attributed to the vaccine. Adverse events should be reported, whether their association with vaccination is
recognized or only suspected. A vaccine adverse event report should identify the product(s) and animal(s) involved in the event(s)
and the individual submitting the report.
Reporting field observations of unexpected vaccine performance is the most important means by which the manufacturer and the
regulatory agency are alerted to potential vaccine safety or efficacy problems that may warrant further investigation. The purpose of
pre-licensure safety studies is to detect relatively common adverse events. Rare or delayed adverse events will be detected only by
post-marketing surveillance through analysis of reported adverse events. Adverse events should be reported to the manufacturer and/
or the local regulatory authority. In many countries governmental surveillance schemes are not available and reactions should therefore
be notified to the manufacturer. The VGG recognizes that there is gross under-reporting of vaccine-associated adverse events,
because of the passive nature of reporting schemes, which impedes knowledge of the ongoing safety of these products [EB4]. The
VGG would actively encourage all veterinarians to participate in such surveillance schemes.
If a particular adverse event is well documented, reporting serves to provide a baseline against which future reports can be com-
pared. In addition, reported adverse events can lead to detection of previously unrecognized reactions, detection of increases in known
reactions, recognition of risk factors associated with reactions, identification of vaccine lots with unusual events or higher numbers of
adverse events, and can further stimulate clinical, epidemiological or laboratory studies. Therefore, veterinarians are encouraged to
report any clinically significant adverse event occurring during or after administration of any licensed vaccine. Reporting a vaccine
adverse event is not an indictment against a particular vaccine; it facilitates review of temporally associated conditions and adds to the
safety database of the product.
ACKNOWLEDGMENTS
The work of the Vaccination Guidelines Group has been generously sponsored by MSD Animal Health and the WSAVA. The VGG is
an independent group of academic experts who have formulated these guidelines without consultation with industry.
Representatives of the sponsoring company do not attend VGG meetings and the company does not have the right of veto over VGG
recommendations.
The VGG again acknowledges the important work undertaken by the American Animal Hospital Association (AAHA) Canine Vaccine
Task Force, the American Association of Feline Practitioners (AAFP) Feline Vaccine Advisory Panel in developing recommen-dations
for the vaccination of dogs and cats (respectively) in North America. The VGG also acknowledges the work of the European Advisory
Board on Cat Diseases (ABCD) in formulating recommendations for feline vaccination from the European perspective.
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APPENDICES
Inactivated (Killed) Vaccines: Only a few killed CPV-2 vaccines are available; they are less effective and take much longer to induce an immune
response when compared with the MLV vaccines (Pollock & Carmichael 1982b). They are not recommended for routine use. Killed vaccines may
provide some benefit in wild and exotic species or pregnant bitches, where some MLV vaccines are not rec-ommended. However, killed CPV-2
vaccines have not been tested for safety or efficacy in these situations.
Precautions
• MLV vaccines should not be used in wildlife species.
• MLV vaccines should not be used in pregnant bitches unless specifically indicated.
• Puppies younger than 4–6 weeks of age should not be vaccinated with MLV products.
Disease Facts
• After infection, it takes 3–7 days for signs of disease to appear.
• CPV-2 faecal shedding rarely persists for >2 weeks.
• Dogs persistently infected for >4 weeks have not been reported and one can expect the animal to die or clear the virus in that period
of time.
• In the environment, the virus can remain infectious for 1 year or more. Therefore, all facilities where infected animals have been present must
be considered infected.
• A positive faecal antigen detection test result in a puppy with clinical signs suggestive of canine parvoviral enteritis will not have been caused
by any recent CPV vaccine the animal may have received (DeCaro et al. 2014).
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tory disease associated with CAV-2 infection. They are exceptionally effective and will not cause the adverse reaction commonly seen with
CAV-1 vaccines known as allergic uveitis or ‘blue eye’ (Curtis & Barnett, 1983). In addition to parenteral MLV CAV-2 vaccine preparations
there are combination or monovalent products to protect against the canine infectious respiratory disease complex (CIRDC), which includes
Bordetella bronchiseptica and canine parainfluenza virus (CPiV) and CAV-2. The intranasal product that contains CAV-2, CPiV and Bordetella
can be used to decrease the severity of CIRDC, but should not be used as the only vaccine to prevent ICH; for this purpose, the parenteral
MLV-CAV-2 should also be given.
Inactivated (Killed) Vaccines: Inactivated (killed) CAV-1 and CAV-2 vaccines are sold in some countries, but they are not recom-mended
when MLV products are available, as they are less effective.
Precautions
• Intranasal CAV-2 vaccine is intended as an aid in the prevention of upper respiratory disease caused by CAV-2 and is not intended to
protect against CAV-1 infection.
Disease Facts
• CAV-1 is transmitted primarily through contaminated secretions/excretions such as saliva and urine.
• CAV-1 and CAV-2 are moderately stable, surviving for several days to weeks in the environment.
• After experimental infection with CAV-1, it takes 5 days or longer for signs of ICH to appear.
• The ‘window of susceptibility’ is defined as the period of time during which a puppy can be infected by field virus, but vaccines cannot
immunize. Unlike CPV-2 vaccines, there generally is not a prolonged ‘window’ for CAV-2 vaccines (i.e. <2 weeks).
• CAV-2 is transmitted primarily through the air.
• CIRDC has complex pathogenesis involving stress, poor ventilation, dust, ammonia gas in unsanitary facilities and infections with
Streptococcus spp., Bordetella bronchiseptica, Mycoplasma spp., CAV-2, CPiV, CIV, canine pneumovirus and canine respiratory
coronavirus.
• CAV-2 combined with other agents associated with CIRDC can cause respiratory disease in 3–4 days.
• As a multifactorial disease CIRDC is not vaccine-preventable. The current vaccines only help in reducing disease severity.
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• DOI after vaccination with rCDV vaccine is ÿ5 years, based on challenge and ÿ 6 years based on serology.
• DOI after vaccination with killed vaccines is likely to be shorter than for MLV or recombinant vaccines.
• MDA interferes with active immunization for varying periods of time in the puppy, depending on the titre of colostral antibody and the
amount of antibody absorbed after birth.
• The ‘window of susceptibility’ is defined as the period of time during which a pup can be infected by field virus, but vaccines cannot
immunize. Unlike CPV-2 vaccines, there generally is not a prolonged ‘window of susceptibility’ for CDV vaccines (<2 weeks).
• Puppy vaccination using MLV products should not start earlier than 6 weeks of age unless the product has a specific license (some
products may be used from 4 weeks of age); after completing the series at 16 weeks or older and vaccinating again at 26 or 52 weeks
of age, revaccination need not be done more often than every 3 years.
• In the absence of MDA, MLV and recombinant vaccines provide immunity rapidly after vaccination.
• The presence of serum antibody, regardless of titre, in an actively immunized dog over the age of 20 weeks is correlated with protection.
Precautions
• The MLV preparations are attenuated (modified and safe) for use in the domestic dog, not for use in wild and exotic species. These vaccines
are highly virulent (e.g. in the black-footed ferret and grey fox), causing disease and death (Carpenter et al. 1976, Pearson 1977, Durchfeld et
al. 1990). Vaccination of these species with MLV vaccines should not be performed unless there is evidence to support the safety of a specific
product.
• Puppies younger than 4–6 weeks of age should not be vaccinated with MLV vaccines.
Disease Facts
• Signs of disease appear between 2–6 weeks after infection.
• During the incubation period, CDV causes immunosuppression, making the animal more susceptible to microbial infections. These
secondary infections may lead to respiratory disease, pneumonia and death, before the more typical signs of distemper virus infec-tion
appear.
• In the environment, the virus quickly loses infectivity.
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• After completing the kitten series at 16 weeks or older and vaccinating again at 26 or 52 weeks of age, revaccination need not be
done more often than every 3 years.
• The presence of serum antibody, regardless of titre, in an actively immunized cat over the age of 20 weeks is correlated with
protection.
• When vaccination is being used to control disease in the face of an outbreak in a shelter situation, the more rapid induction of immunity
induced by MLV vaccines is of clinical advantage.
• There is a very early onset of protection after vaccination with MLV products (Brun & Chappuis 1979).
Precautions
• MLV FPV vaccines should not be used in wild animal species unless there is evidence to show that they are safe.
• MLV FPV vaccines should never be used in pregnant queens because of the risk of transfer of virus to the fetus and fetal damage.
In some countries, inactivated FPV vaccines are licensed for use in pregnant queens, but in general, unnecessary administration of
products to pregnant queens should be avoided.
• MLV FPV vaccines should never be administered to kittens less than 4–6 weeks of age, to avoid damage to the cerebellum which is
still developing in neonates.
• MLV FPV vaccines should not be used in severely immunosuppressed individuals – although the risk appears small, with severe
immunosuppression (for example with clinical FIV or FeLV infection or with the use of highly immunosuppressive drugs) failure to
control viral replication could potentially lead to clinical signs after vaccination.
Disease Facts
• After infection, it takes 2–7 days for signs of disease to appear.
• Vomiting usually develops 1–2 days after the onset of fever. Diarrhoea may begin later, but is not always present. Dehydration devel-
ops rapidly, and an affected cat may sit at a water bowl, obviously thirsty, but without drinking. Terminal cases are hypothermic and
may develop septic shock and disseminated intravascular coagulation.
• In the environment, the virus can remain infectious for 1 year or more (Gordon & Angrick 1986) so all facilities where infected animals
have been present must be considered contaminated.
• Assessment of the DOI is difficult. Complete clinical protection is seen only shortly after vaccination, and the degree of protection
decreases with time (Gaskell et al. 2007).
• Immunity is far from solid after natural infection/disease and is of variable duration.
• Persistence of antibody titre after vaccination with a killed FHV-1 vaccine was demonstrated for 3 years (Scott & Geissinger 1997),
but antibody titre for FHV-1 does not correlate well with protection (Gaskell et al. 2007).
• Protection from challenge with virulent FHV-1 7.5 years after vaccination with two doses of killed vaccines was not complete, but was
similar to protection after 1 year with the killed product (Scott & Geissinger 1999).
• After completing the kitten series at 16 weeks or older and vaccinating again at 26 or 52 weeks of age, revaccination need not be
done more often than every 3 years in cats at low risk; however, cats at higher risk (e.g. those that regularly attend boarding catteries)
should be revaccinated more frequently.
• If booster vaccinations have lapsed in a previously well-vaccinated cat, a single injection is considered adequate to boost immuno-
logical memory.
• No herpesvirus vaccine can protect against infection with virulent virus; FHV-1 will become latent and may be reactivated during
periods of severe stress. The reactivated virus may cause clinical signs in vaccinated animals (Gaskell et al. 2007); the virus may
be shed, transmitted to susceptible animals and cause disease in susceptible kittens and cats (Gaskell et al. 2007).
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• Cell-mediated immunity plays an important role in protection, since the absence of detectable serum antibody levels in vaccinated cats
does not necessarily indicate that cats are susceptible to disease.
• MDA interferes with active immunization for varying periods of time in the kitten, depending on the titre of colostral antibody and the
amount of antibody absorbed after birth. The primary course of vaccination is usually started at around 6–8 weeks of age. MDA interferes
less with MLV intranasal (IN) vaccines than parenterally administered MLV products. It would be expected that the IN
vaccines will immunize earlier than the parenteral vaccines in kittens with MDA.
• In breeding catteries, infections mostly appear in kittens prior to weaning, typically between 4–8 weeks of age, as MDA wanes. In most
cases, the source of infection is the queen, whose latent virus is reactivated due to the stress of parturition and lactation.
Precautions
• Modified live parenteral FHV-1 and FCV vaccines retain some pathogenic potential and may induce disease if administered incor-rectly
(i.e. when accidentally aerosolized or ingested or inhaled from vaccine deposited on the skin/hair).
• Upper respiratory disease signs are sometimes seen following intranasal vaccination.
Disease Facts
• Viral excretion starts as soon as 24 hours after infection and lasts for 1–3 weeks.
• Acute disease appears after 2–6 days and resolves within 10–14 days.
• The virus spreads along the sensory nerves and reaches neuronal cell bodies, particularly in the trigeminal ganglia, which are the main sites of
latency. Most cats become lifelong latent carriers, shedding the virus periodically, upon stressful events (Gaskell et al.
2007). In contrast, shedding of FCV is continuous for a period of months after infection. Herpesvirus genomic DNA persists in the nucleus of
infected neurons without replication.
• In the environment, the virus is labile and inactivated by commonly used disinfectants.
Inactivated (Killed) Vaccines: Killed adjuvanted vaccines are also available. One killed vaccine (non-adjuvanted) contains two cali-civirus
strains (G1 and 431 strains; Poulet et al. 2005).
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Precautions
• Upper respiratory disease signs may be seen occasionally as a complication of intranasal vaccination (Lappin et al. 2006, 2009).
• Because of the multitude of antigenically differing viruses circulating in the field, vaccine strain combinations have been chosen to
cross-protect against severe clinical disease, but mild disease may still occur in vaccinated cats.
• In contrast to FHV-1, which is shed intermittently after stressful events, shedding of FCV is continuous, but usually ceases after several
months (Coyne et al. 2006a). The impact of vaccination on shedding is controversial, with observations ranging from moder-ate
reduction to extension of the period of virus shedding post infection. Live parenteral FCV vaccine strains can be shed, although
infrequently.
Disease Facts
• FCV infection can cause acute oral and upper respiratory signs, but has also been associated with chronic gingivostomatitis, which
may be immune-mediated.
• The incubation period is 2–10 days. Oral ulceration (particularly of the margins of the tongue), sneezing and serous nasal discharge
are the main signs. Acute oral and upper respiratory disease signs are mainly seen in kittens.
• A distinct syndrome, the ‘virulent systemic feline calicivirus (VS-FCV) disease’ is occasionally described (Coyne et al. 2006b). The
incubation period for this infection in cats exposed in shelters and hospitals is 1–5 days; in the home environment it may be up to 12
days. This disease appears to be more severe in adults than kittens. Vaccination with current vaccines does not protect cats against
field infections, but some protection has been shown experimentally (Poulet & Lemeter 2008, Huang et al. 2010). This might be due to
the inherent characteristics of the hypervirulent strains. There is a killed VS-FCV strain in a vaccine available in the USA that contains
both ‘traditional’ and VS-FCV isolates and is reported to provide protection against homologous VS-FCV (Huang et al.
2010). It is not known if this strain of VS-FCV will provide protection against heterologous VS-FCV strains.
Inactivated (Killed) Vaccines: The use of killed vaccines is the rule for individual dog and cat protection and mass canine vaccination
programmes. The killed vaccines are easier to manage than live preparations because of their stability at ambient temperatures, and
accidents of self-inoculation do not represent a risk, as would be the case for MLV vaccines.
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Disease Facts
• Signs of disease appear between 2 weeks and several months after infection, depending upon the site of infection (transmission is
generally by bite or scratch). Any unexplained aggressive behaviour or sudden behavioural change must be considered suspicious.
• The disease manifests itself as a ‘furious’ or a ‘dumb’ form. Signs of the classical ‘furious’ form of rabies include reduced palpebral,
corneal and pupillary reflexes, strabismus, dropped jaw, salivation, pica, seizures, twitching, tremors, disorientation, aimless pacing,
aimless snapping and biting, exaggerated emotional responses (irritability, rage, fear), photophobia, as well as ataxia and paralysis,
ultimately followed by coma and death from respiratory arrest. The ‘dumb’ form of rabies is more common in dogs than cats and
presents as lower motor neuron paralysis that progresses from the site of the bite injury to involve the entire central nervous system.
The paralysis rapidly leads to coma and death from respiratory failure.
• In the environment, the virus quickly loses infectivity, and is readily inactivated using detergent-based disinfectants.
1. May I give a MLV product to a wild, exotic species or to a domestic species other than to the ones which the vaccine was
licensed to protect?
No, never give MLV vaccines unless they have been shown to be safe in that species. Many MLV vaccines have caused disease in
ani-mal species other than those for which they had been licensed. Even worse, the vaccine could be shed from the wild animals,
regain virulence through multiple passages and cause disease even in the target species for which it had been developed.
A safe and effective vaccine for species that are susceptible to CDV is the canarypox virus-vectored recombinant CDV vaccine that
is available as a monovalent product for ferrets or a combination product for dogs. The monovalent vaccine is used in many wild and
exotic species susceptible to CDV, but is only available in certain countries.
2. May I vaccinate a puppy that is at high risk of getting CDV with a human measles vaccine?
No. Due to an insufficient amount of virus, the human MV vaccine is not immunogenic in the puppy. Measles virus vaccines made
specifically for the dog (sometimes combined with CDV and additional viral components) may give temporary protection at an earlier
age than a CDV vaccine. At 16 weeks or older, the puppy must be vaccinated with a CDV vaccine, to achieve permanent immunity.
3. Can certain vaccines immunize pups having maternally derived antibody (MDA) against CDV at an earlier age?
Yes. The heterotypic measles vaccine for dogs will immunize pups about 4 weeks earlier than the MLV-CDV vaccines. Similarly, the
canarypox vectored recombinant CDV vaccine will immunize approximately 4 weeks earlier than some MLV vaccines and there are
some high titre MLV vaccines (i.e. vaccines containing a greater mass of virus in the vaccine ampoule) which also immunize at an
earlier age in puppies with MDA.
4. I know that maternally derived antibodies (MDA) can prevent active immunization with MLV vaccines - but can they also
block immunity to killed vaccines?
Yes. MDA can block certain killed vaccines. If the killed product requires two doses, as is often the case, and the first dose is blocked
by MDA, then the second dose will not immunize. In this circumstance, the second dose will prime (if not blocked), and a third dose is
required to immunize and boost.
This is not true for MLV vaccines, where in the absence of MDA it only takes a single dose to prime, immunize, and boost. Nev-
ertheless two doses are often recommended, particularly in young animals, to be sure one is given when MDA has waned and cannot
block. That is why in the puppy or kitten series, the last dose should be given at 16 weeks of age or older.
5. I have been told that certain canine MLV combination core products need only be given twice, with the last dose at an age
as young as 10 weeks. Is that accurate?
The VGG is aware that certain canine vaccines are licensed for such an ‘early finish’ in order to allow pups the benefit of early socializa-
tion. The VGG accepts the importance of puppy socialization, but has reservations about the immunological validity of this approach to
vaccination. No combination core product currently available will immunize an acceptable percentage of puppies (particularly not
against CPV-2) when the last dose is given at 10 weeks of age. The VGG advises that wherever possible the last dose should be given
at 16 weeks of age or older, regardless of the number of doses given earlier. The VGG recommends that owners of pups that have not
completed a full puppy vaccination series carefully control the exposure of their pup to environments outside of the home and only
permit contact with healthy and fully vaccinated dogs.
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6. Are there parenteral and intranasal vaccines that protect against the same disease?
Yes, particularly canine vaccines against the canine infectious respiratory disease complex (CIRDC) and feline vaccines against upper
respiratory disease caused by FCV and FHV-1.
You should be careful to give the product by the route for which it is intended. If you use the parenteral (i.e. subcutaneous) MLV
vaccines containing FCV and FHV-1 locally (i.e. intranasally or orally), you could cause serious disease in the cat. If you use the killed
FCV and FHV-1 vaccines locally, you would not get any immunity and might cause significant adverse reactions. If you gave the
intranasal live CIRDC vaccine parenterally, you could cause a severe necrotizing local reaction and even kill the dog, while giving the
parenteral killed Bordetella vaccine intranasally will not immunize and may cause a hypersensitivity reaction.
However, both types of products can be given at the same time or at various times in the life of the animal. Vaccinating both
parenterally and intranasally may actually provide better immunity than vaccinating at only one site (Reagan et al. 2014, Ellis 2015).
Thus parenteral vaccination provides protection in the lung, but little or no immunity in the upper respiratory tract (especially local
secretory IgA and CMI), while intranasal vaccination will engender good secretory IgA and local CMI and non-specific immunity (e.g.
type-I interferons), but will not always provide immunity in the lung.
7. How long after vaccination does it take for the dog to develop immunity that will prevent severe disease when the core vaccines are
used?
This is dependent on the animal, the vaccine and the disease.
The fastest immunity is provided by MLV and recombinant canarypox virus vectored CDV vaccines. The immune response starts
within minutes to hours and provides protection within a day to animals without interfering levels of MDA and in dogs that are not
severely immunosuppressed.
Immunity to CPV-2 and FPV develops after as few as 3 days and is usually present by 5 days when an effective MLV vaccine is
used. In contrast, the killed CPV-2 and FPV vaccines often take 2 to 3 weeks or longer to provide protective immunity.
CAV-2 MLV given parenterally would provide immunity against CAV-1 in 5–7 days. However, when given intranasally, the same level
of immunity to CAV-1 is not present until after 2 or more weeks and in some dogs it doesn’t develop. Thus parenteral CAV-2 is
recommended for immunity to CAV-1.
Time from vaccination to immunity is difficult to determine for FCV and FHV-1 because some animals will not develop protec-
tive immunity. However, when it does develop, it takes 7–14 days (Lappin 2012).
8. What can I expect from the core vaccines in terms of efficacy in the properly vaccinated puppy/dog and kitten/cat?
Dogs properly vaccinated with MLV or recombinant CDV, CPV-2 and CAV-2 would have ÿ98% protection from disease. Simi-
larly we would expect a very high protection from infection.
For the properly vaccinated cat that had received MLV vaccines, we would estimate that ÿ98% would be protected from disease and
infection with FPV. In contrast, we can expect FCV and FHV-1 vaccines, at best, to protect from disease, not infection, espe-cially in a
highly contaminated environment (e.g. shelter) and protection would be seen in 60 to 70% of recipients in a high risk environment.
Protection would appear to be much higher in the household pet cat isolated from other cats or with cats that have been vaccinated and
in the household for a long time because the risk for infection with the viruses is so much lower, as is the stress level.
9. Are there mutants (biotypes or variants) of CDV or CPV-2 in the field that the current vaccines cannot provide protective
immunity against?
Not as far as we know. This is not controversial for CDV. All of the current CDV and CPV-2 vaccines provide protection from all the
known isolates of CDV or CPV-2, respectively, when tested experimentally as well as in the field. However, there is one report of an
outbreak of CPV-2c in Italian dogs that were vaccinated with a MLV vaccine (Decaro et al. 2008). There is another report from the same
group of an aged vaccinated dog developing CPV-2c-related disease (Decaro et al. 2009).
10. Do the current CPV-2 vaccines provide protection from disease caused by the new variant CPV-2c? How long does the
protection last?
Yes. The CPV-2 vaccines, regardless of what variant they contain, stimulate an active immune response (e.g. antibody response), that
provides long term (4 or more years) protection from all current CPV-2 variants (2a, 2b, and 2c) when the dogs are challenged.
11. Can parvovirus vaccines (e.g. canine parvovirus-2 and feline parvovirus [panleukopenia]) be administered orally?
No. CPV-2 and FPV vaccines, when given orally, will not immunize. They will immunize when given intranasally, however the most
effective route is parenteral (subcutaneous or intramuscular) vaccination using the appropriate vaccines.
12. Can certain CPV-2 vaccines immunize pups with MDA at an earlier age than other CPV-2 vaccines?
Yes. Certain CPV-2 vaccines with higher viral titres (i.e. mass of virus in the vaccine ampoule) and/or with more immunogenic isolates
(regardless of variant) will immunize quite a few weeks earlier than other standard CPV-2 vaccines.
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13. When a Leptospira vaccine (bacterin) is used, should it be a product with two serogroups or one with more than two
serogroups (e.g. three or four component products available in some countries)?
When a Leptospira vaccine is used in high risk dogs, the commercial vaccine that contains all of the serogroups that cause disease in
the dog in that region, if available, should be used. In many countries there is insufficient knowledge of which serogroups are circulating
in the canine population. The VGG would encourage collection of such data.
14. Do Leptospira vaccines give long term (e.g. years) immunity and are they highly effective, like the core viral vaccines?
No. Leptospira vaccines provide relatively short-term immunity. Also, some Leptospira products prevent clinical disease, but fail to pro-
tect against infection and shedding of the bacteria, especially when infection occurs more than 6 months after vaccination. Persistence
of antibody after vaccination will often be only for a few months and immunological memory for protective immunity is relatively short
(e.g. 1 year).
15. Do any feline leukaemia virus vaccines (e.g. killed adjuvanted, subunit, recombinant) provide protection with only one dose of
vaccine?
No. All feline leukaemia virus vaccines require a minimum of two doses of vaccine. The two doses should preferably be given 2–4
weeks apart, starting at 8 weeks of age or older. Only after that initial series of two vaccines can you then give a single dose to boost
the response. When the interval between the initial two doses exceeds 6 weeks or more, it is recommended that the cat be revaccinated,
making certain that two doses be given at an interval of 2–4 weeks.
16. Do cats need to be revaccinated with FeLV vaccines every year after they have received the kitten vaccine and a booster
at one year?
No. Revaccination should be every 2–3 years. Annual revaccination with adjuvanted vaccines might increase the risk of development
of injection site sarcoma.
18. Can a cat vaccinated with FIV vaccine be infected with FIV?
Yes. The vaccine will not prevent infection and latency for all subtypes of FIV, thus FIV vaccinated cats can also be infected and act as
a source of virus for susceptible cats.
19. Will the current CIRDC vaccines provide any protection from disease caused by canine influenza virus (CIV)?
No. The racing greyhounds that have been found infected and that developed CIV disease had been routinely vaccinated 3 or more
times a year with commercial CIRDC vaccines. CIV is antigenically unrelated to any other virus of dogs, but related to Equine Influenza
Virus (H3N8). A CIV vaccine is available in the USA and is recommended for at-risk dogs. A vaccine against the newly emerged (2015)
H3N2 virus in the United States has just been conditionally licensed.
20. Is there a vaccine available to aid in the prevention of disease caused by canine influenza virus (CIV)?
Yes. There is a vaccine available in the USA that is designed to aid in the prevention of influenza in dogs caused by the H3N8 virus.
The product is an adjuvanted killed vaccine that, like many killed vaccines, requires two initial doses given 2–4 weeks apart. The
efficacy and duration of immunity of this CIV vaccine or others that may be developed in the future will be determined in the next few
years as information accumulates in the field.
21. Are there vaccines available for dogs and/or cats that are not designed to prevent infectious diseases caused by viruses,
bacteria, fungi/yeasts and/or parasites?
Yes. There are vaccines that aid in the prevention of death from snakebites with certain species of snakes, and to aid in the treatment
of oral melanomas in dogs.
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23. What does the VGG think of the use of canine enteric coronavirus vaccines?
The VGG does not recommend the use of canine coronavirus vaccines as there is insufficient evidence that this vaccine is protective,
or indeed that enteric coronavirus is a significant canine pathogen. Variant strains of this virus have been reported to cause severe
systemic disease in adult dogs and puppies in various parts of the world, but it is unclear whether the available vaccines would protect
against these variants. The identification of coronavirus with a test kit does not necessarily mean it is the cause of disease.
25. Will the number of different antigens in multivalent vaccines adversely affect the efficacy of the vaccine?
No. For a multivalent vaccine to be licensed, the manufacturer must prove that each component of the vaccine can induce protective
immunity, generally in challenge studies.
26. Can you give all vaccinations at once to an adult dog presented with no previous history of vaccination?
This is a similar question to that above. Yes, a dog should be able to respond to multiple antigens delivered simultaneously. However,
you should never mix different vaccines in the same syringe unless specifically indicated by the datasheet. From first principles, it would
be good practice to deliver the different vaccines to different anatomical sites so that different lymph nodes are involved in generating
the adaptive immune response, but no studies have formally proven this.
27. What are the differences between MLV vaccines and ‘genetically modified’ vaccines?
Genetically modified vaccines include virus vectored vaccines, genetically mutated (gene deleted) vaccines and naked DNA vaccines.
These vaccines may theoretically be safer than certain MLV vaccines as there is no chance of ‘reversion to virulence’. These vaccines
are also designed to produce an optimum immune response.
28. Can infectious (MLV) vaccines ‘break through’ MDA better than non-infectious (killed or subunit) vaccines?
Yes, some MLV vaccines and some genetically modified vaccines appear to be able to generate immunity in the presence of MDA earlier than non-
infectious vaccines.
29. Why don’t we have suitable combinations of core vaccines available to allow them to be used in accordance with the
guidelines?
Suitable products are not available in all countries. If you do not have them, then you and your national small animal veterinary
association should lobby the manufacturers and government regulators to bring the suitable products to your marketplace. In many
cases, industry would like to make new products available, but the block lies with the licensing authority.
30. Is it better to use vaccines containing local strains rather than international vaccines?
There is no evidence that international core vaccines are unable to provide good protection against CDV, CAV-1, CAV-2, CPV-2, FPV,
FCV, FHV-1 and rabies virus, worldwide. In most instances strain variation does not change the key protective antigens of the organism
that are conserved between strains. In the case of Leptospira, inclusion of additional, locally-important serogroups in a vac-cine may
lead to enhanced protection.
31. How do practices know that vaccines delivered to them have been stored correctly and that they are still potent?
International manufacturers utilize temperature indication systems during the bulk delivery stages to ensure continuation of the cold
chain from importation to practice delivery.
33. Does the VGG recommend which vaccine brand should be used?
No. The VGG is an independent academic group that does not make product-specific recommendations. However, in the case of
international vaccines, the VGG knows that all of these products have undergone rigorous assessment of quality, safety and
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efficacy that has permitted their licensing in many countries. The VGG does not recommend the use of some vaccines – but this is based
on a lack of adequate scientific evidence (i.e. peer-reviewed scientific literature) that the vaccine is necessary or efficacious.
Recommendations are reviewed and adjusted as needed periodically.
34. If one wants to use just the DHPPi without the Leptospira component of a vaccine what should be used to reconstitute the DHPPi?
You should ask this question of the manufacturer or supplier of the particular vaccine, but a suitable diluent may be sterile normal saline
or sterile water for injection. If not, the manufacturer should be able to provide you with the specific diluent required.
35. Can rabies vaccine be used in small mammals (e.g. rabbits, guinea pigs etc.)?
The VGG does not recommend routine rabies vaccination of small mammals, except for ferrets; however some rabies vaccines are
licensed for use in all mammalian species.
37. What happens if a dog is bitten by a free-roaming dog after receiving the initial puppy rabies vaccine; should it receive post-exposure
prophylaxis (PEP)? What if that dog receives PEP and is then bitten again some weeks later, should it receive another course of PEP?
If the bitten puppy has been vaccinated properly it should be protected against rabies. The VGG is aware that in some countries, PEP is
used in this situation for the benefit of the puppy, and more importantly for the benefit of the human family. Repeated PEP is not justified.
By that time the puppy will have received multiple vaccinations and further injections will provide no added benefit.
39. May I co-inject different vaccines (not part of a single commercial product) into the same animal?
Yes. However, different vaccines should be injected into separate sites that are drained by different lymph nodes.
40. Can you give rabies and DHPPi vaccine at the same time (concurrently)?
Yes, but unless the vaccines have a specific concurrent use claim on the product label, then this may be considered ‘off-label’ use.
Ideally the two vaccines used concurrently in this way should be given at different anatomical sites in order that vaccine antigens are
carried to different lymph nodes in order to stimulate adaptive immunity at two distinct locations.
41. May I use smaller vaccine doses in small breeds to reduce the risk of adverse reactions?
No. The volume (e.g. 1.0 ml) as recommended by the manufacturer generally represents the minimum immunizing dose, therefore the
total amount must be given. In the USA a new product has been released that is designed for small dogs. This is formulated as a 0.5 ml
dose, but contains much the same amount of antigen and adjuvant as a conventional 1.0 ml vaccine. A 0.5 ml dose feline
vaccine is also available and again it is only the volume (and not antigen or adjuvant content) that has been reduced.
42. Should the large dog (Great Dane) be injected with the same volume of vaccine as the small dog (Chihuahua)?
Yes. Unlike pharmaceuticals that are dose-dependent, vaccines are not based on volume per body mass (size), but rather on the mini-
mum immunizing dose.
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immunity and colostral antibody for the puppies. Vaccination with MLV and killed products during pregnancy should be avoided, if at all
possible. There are exceptions, especially in shelters, where vaccination would be advised if the pregnant animal has never been
vaccinated and there is an outbreak of disease (e.g. CDV or FPV).
45. Does immunosuppressive glucocorticoid treatment in the cat or dog interfere with vaccine immunity?
Studies of both species suggest that immunosuppressive glucocorticoid treatment prior to or concurrently with vaccination does not have a significant
suppressive effect on antibody production in response to vaccines. However, revaccination is recommended several weeks (2 or more) after
glucocorticoid therapy has ended, especially when treatment occurred during administration of the initial series of core vaccines.
46. May I vaccinate pets that are on immunosuppressive or cytotoxic therapy (other than glucocorticoids) (e.g. for cancer or
autoimmune diseases)?
No. Vaccination especially with MLV products should be avoided as they may cause disease; vaccination with killed products may not
be effective or may aggravate the immune-mediated disease. A study of cats treated with high-dose ciclosporin demonstrated that there
was no effect on the serological response to booster FPV and FCV vaccines given during treatment, but that protective antibody
responses to FHV-1, FeLV and rabies were delayed. In contrast, treated cats failed to develop antibody after a primary course of FIV
vaccine, suggesting that ciclosporin treatment impairs the primary, but not memory, vaccinal immune response (Roberts et al. 2015).
47. How long after stopping immunosuppressive therapy do I wait before revaccinating a pet?
A minimum of 2 weeks.
48. Should you vaccinate Ehrlichia canis-infected dogs since these dogs can be immunosuppressed?
There is no evidence that a dog with monocytic ehrlichiosis cannot respond adequately to vaccination, or that protective antibody titres
against core vaccine components diminish in E. canis-infected dogs. Ideally, the dog would be treated and any essential vaccina-tion
performed after the cessation of therapy. It may be a legal requirement to give rabies vaccine to such cases in any event.
53. When should the last vaccine dose be given in the puppy and kitten vaccine series?
The last dose of vaccine should be given at 16 weeks of age or older.
54. Why don’t the VGG recommend rabies vaccination until 12 weeks of age?
Some rabies vaccines are licensed to be given earlier than 12 weeks of age, but we recommend that where this is done the animal
receives another vaccine at 12 weeks of age. In the context of mass vaccination campaigns against rabies, it is important to vaccinate
as many dogs in the area as possible, including puppies less than 12 weeks of age.
55. May I inject a killed vaccine, followed a short time later with a MLV for the same disease?
No. The killed vaccine may induce an effective antibody response that will neutralize the MLV in the vaccine, thereby prevent-ing
immunization. It would be preferable to give the MLV vaccine first and if/when needed, revaccinate with the killed vaccine preparation.
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57. May I give a killed Bordetella vaccine destined for parenteral use intranasally?
No. This will not stimulate a protective response to the Bordetella, but may cause a hypersensitivity response; you should give a live intranasal
vaccine via the intranasal route, as specified by the data sheet.
58. If the puppy sneezes after intranasal vaccination is it necessary to vaccinate again?
Sneezing, with loss of some of the vaccine, is commonly observed after the use of intranasal products. These vaccines have been
designed to allow for partial loss of the product and so it should not be necessary to revaccinate, unless it is clear that none or very little of
the product was delivered successfully.
59. Are precautions necessary when using MLV FHV-1/FCV parenteral vaccines in cats?
Yes. Mucosal (e.g. conjunctival and nasal) contact with the preparation must be avoided, because the vaccine virus can cause disease.
Such contact might come via inappropriate aerosolization of the vaccine or by the cat grooming off vaccine that leaks from an injec-
tion site.
60. May I use different vaccine brands (manufacturers) during the vaccination program?
Yes. It may even be desirable to use vaccines from different manufacturers during the life of an animal, because different products may
contain different strains (e.g. of feline calicivirus). However, it is not recommended to mix vaccines that contain different strains (e.g.
FCV or Leptospira serogroups) during a primary vaccination programme.
64. Will a single vaccine dose provide any benefit to the dog or cat? Will it benefit the canine and feline populations?
Yes. One dose of a MLV canine core vaccine (CDV, CPV-2 CAV-2) or MLV FPV vaccine should provide long term immunity when given to
animals at or after 16 weeks of age. Every puppy and kitten 16 weeks of age or older should receive at least one dose of MLV core vaccines.
In the case of feline respiratory core vaccines (FCV and FHV-1), protection would be maximized by administering two doses of vaccine 2–4
weeks apart.
If that were done, herd (population) immunity would be significantly improved. Even in the USA with its good vaccination record, probably
<50% of all puppies and <25% of all kittens ever receive a vaccine. We must vaccinate more animals in the population with core vaccines to
achieve better herd immunity (e.g. 75% or higher) and prevent epidemic outbreaks.
65. When an animal first receives a vaccine that requires two doses to immunize (e.g. killed vaccines like Leptospira bacterins or
feline leukaemia virus), and it does not return for the second dose within Ä6 weeks, is there any immunity?
No. A single dose of a two-dose vaccine does not provide immunity. The first dose is for priming the immune system, the second for immunizing. If a second
dose is not given within 6 weeks of the first, the regime should start again, making sure the two doses are given within 2–6 weeks. After those two doses,
revaccination with a single dose can be done at yearly or greater intervals to boost the response.
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66. For how long can a reconstituted MLV vaccine sit at room temperature without losing activity?
At room temperature, some of the more sensitive vaccines (e.g. CDV, FHV-1) will lose their ability to immunize in 2–3 hours, whereas
other components will remain immunogenic for several days (e.g. CPV, FPV). The VGG recommends that MLV vaccines, after
reconstitution, should be used within 1 to 2 hrs.
67. If an animal has gone beyond the time that is generally considered to be the minimum DOI for the core vaccine (7 to 9
years for CDV, CPV-2, CAV-2; 7 years for FPV), do I have to start the series of vaccinations again (multiple doses 2–4 weeks
apart)?
No. For MLV vaccines, multiple doses are only required for puppies or kittens which have MDA. The VGG is aware that many data
sheets do advise re-starting a vaccination series, but does not endorse this practice which is inconsistent with fundamental immune
system function and the principles of immunological memory.
68. Should I vaccinate a cat infected with FeLV and/or FIV infection?
A FeLV or FIV positive cat that is clinically well would ideally be housed indoors away from other cats to minimize the risk of expo-sure to infectious
disease. However, if it were deemed necessary to vaccinate with core components (FPV, FCV and FHV-1) expert groups currently recommend that
this should be with killed (not MLV) vaccines. Such cats should not be vaccinated against FeLV or FIV. A FeLV or FIV positive cat with clinical illness
should not be vaccinated. In some countries there is a legal requirement for rabies vaccination that would also include retrovirus-infected cats.
70. Does severe nutritional deficiency affect the immune response to vaccines?
Yes. It has been shown that certain severe deficiencies of vitamins and trace minerals (e.g. Vitamin E/Selenium) can interfere with
the development of a protective immune response in puppies. Known or suspected nutritional deficiencies should be corrected by
appropriate nutritional supplementation and the animals should be revaccinated to ensure there is adequate protective immunity.
71. If a puppy or kitten fails to receive colostrum will it have any passive antibody protection from the dam?
Depending on the antibody titre of the dam they will have little or, most likely, no protection as approximately 95% or more of the
passive antibody for the newborn puppy and kitten is obtained from the colostrum which is absorbed via the intestine into systemic
circulation for up to 24 hours after birth.
72. Should a puppy or kitten that fails to receive colostrum be vaccinated during the first few weeks of life since they will not
have maternally derived antibody to block active immunization?
No. Puppies and kittens less than 4–6 weeks of age should not be vaccinated with the MLV core vaccines. Certain of the modified
live vaccine viruses when given to puppies/kittens less than 2 weeks of age and without MDA can infect the central nervous system
and/or cause disease and possibly death of the animal. This occurs because there is little or no thermoregulatory control of body
temperature during the first week or more after birth, thus innate and adaptive immunity is significantly impaired.
73. How can these colostrum-deprived young animals be protected from the core diseases?
Artificial colostrum can be fed if the puppy or kitten is less than 1 day old. Artificial colostrum is 50% milk replacer (e.g. EsbilacTM or
other similar product) and 50% immune serum (preferably from the dam or other well vaccinated animal living in the same environ-
ment as the dam). If pups or kittens are older and 1 day of age, serum from a well immunized adult animal (free of infectious disease)
can be given subcutaneously or intraperitoneally or citrated plasma can be given intravenously. Depending on size of the animal,
approximately 3 to 10 ml of serum or plasma should be administered twice daily for up to 3 days.
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against core diseases (i.e. CDV, CAV and CPV-2) and elect not to revaccinate that animal. Current advice is that serological assess-
ment is performed every 3 years, but in dogs older than 10 years, this should be done annually. In many countries there is also a legal
requirement to vaccinate against rabies at particular intervals.
76. For an adult dog with an unknown Leptospira vaccination history, what’s the recommended vaccination protocol? Is it
still two doses 2–4 weeks apart as in puppies?
Yes, this dog would require two doses of vaccine given 2–4 weeks apart and then annual revaccination thereafter.
78. Should a cat be vaccinated if it already has signs of upper respiratory disease?
A cat with current clinical disease should not be vaccinated. Once it has recovered, the cat should have some natural immunity to FCV
or FHV (or both if both agents were involved in causing the respiratory disease), but such immunity is never sterilizing (even after
vaccination). There is no indication NOT to vaccinate a cat that has recovered from a respiratory viral infection. A trivalent vaccine will
protect against FPV and also against the respiratory virus (FHV-1 or FCV) that was not involved in causing the earlier respiratory
disease.
79. Power cuts are not uncommon in parts of our country and they can last for 2–3 days. What should one do as regards any
vaccine in the fridge at the time – is it OK to use?
MLV vaccine that has not been stored at appropriate temperature for 2–3 days should not be used. Some of the components of these vaccines (e.g.
CDV) are temperature sensitive and there may have been inactivation of the virus. If you are in any doubt, you should contact the manufacturer for
advice.
81. How long after CPV-2/CDV vaccination should you wait before measuring protective antibody concentrations using in-clinic tests?
This question is most relevant for puppies, because adult dogs are likely already to have serum antibodies present at the time of
booster vaccination, regardless of how long an interval there has been since they were last vaccinated. If a puppy receives its final
primary vaccine at 16 weeks of age, then it may be tested from 20 weeks of age onwards. Any antibody present at that stage cannot
be of passive, maternal origin and therefore indicates that the puppy is actively protected.
82. Why don’t the VGG recommend routine rabies antibody testing?
For many veterinarians, this question may be of little practical consequence, as regular rabies vaccination of dogs and cats is a legal
requirement in many countries, irrespective of any titre results. Rabies antibody testing is only required in certain situations related to
international pet travel. The international rabies vaccines are highly efficacious and it is generally considered that there is no need to
demonstrate immunity post vaccination.
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83. Can we use antibody tests (CDV, CPV-2 and CAV) to test the MDA in order to decide the first vaccination time?
Theoretically this would be possible and years ago a ‘nomogram’ was often used to estimate when pups might best respond to vaccina-
tion on the basis of the titre of antibody in the serum of the bitch. In practice, it would be very difficult and expensive to repeatedly sample
and test young puppies in order to monitor the decline of MDA.
84. What happens to the antibody titre over the 3-year period post-vaccination?
For CDV, CAV-2, CPV-2 and FPV the antibody titre will be consistently present at similar titre. This has been shown in numerous field
serological surveys of dogs last vaccinated up to 9 years previously and in experimental studies for dogs last vaccinated up to 14 years
pre-viously. For Leptospira the titres will decline rapidly after vaccination and in any case are not well correlated with protection. Serum
anti-body titres are less relevant for FCV and FHV-1 where the most important type of immunity is mucosal or cell-mediated, respectively.
85. In an animal that has completed its puppy/kitten shots, is a higher antibody titre required to protect against heavy disease
challenge?
For CDV, CAV-2, CPV-2 and FPV the answer is no. The presence of antibody (no matter what the titre) indicates protective immu-nity
and immunological memory is present in that animal. Giving more frequent vaccines to animals in an attempt to increase anti-body titre
is a pointless exercise. It is impossible to create ‘greater immunity’ by attempting to increase an antibody titre.
86. Can we test dogs as an alternative to annual vaccination? We are concerned about the advice to only boost every 3 years.
Yes, certainly. There are now well-validated in-practice serological test kits that permit determination of the presence of protective serum
antibody specific for CDV, CAV, CPV-2 and FPV. In other countries, these kits are used to confirm protection at 3-yearly intervals (instead
of automatic revaccination for core diseases). You could perform serology annually, but if you were to collect and analyze the data that
you generated within your practice, you will quickly find that annual testing is unjustified.
87. In the annual health check, what tests/examinations should you do?
The annual health check should focus on an excellent basic physical examination (including body temperature, cardiac auscultation and
palpation). A thorough history should be taken to understand the lifestyle and disease risks (e.g. travel, boarding, indoor versus outdoor
exposure). The fundamentals of nutrition and parasite control should be discussed with the owners. In some countries, the health check
might also involve routine testing for prevalent infectious diseases.
88. Some owners may be reluctant to come back just for an annual health check. What advice can be provided to promote the
health check concept in order to improve owner compliance?
This is all a matter of education. Clients should realize that the health check examines all aspects of the health and wellbeing of their pet
and may pick up the early stages of clinical problems. In terms of vaccination, the health check examination might include serol-ogy
(every 3 years for core vaccine antigens) or the annual administration of non-core vaccine if such vaccines are required.
89. The costs of an annual health check are far too high for my clients.
The annual health check may be as simple as an excellent clinical history and physical examination – the costs for which are purely the
professional time of the veterinarian. Fundamentally, the concept of an ‘annual health check’ is a new way of delivering what most
practitioners already offer as a ‘vaccination booster and physical examination’. For more affluent clientele, the annual health check has
proven a means of offering other veterinary services and increasing practice profitability. This is also an example of practicing better
quality medicine and about redefining the veterinarian – client relationship.
91. Are certain vaccines or combinations of vaccines more likely to cause adverse reactions than others?
Although this is often presumed, there is little scientific evidence to support this statement. The development of an adverse reaction is
often dependent on the genetics of the animal (e.g. small breed dogs or families of dogs) (Moore et al. 2005, Kennedy et al. 2007).
It has been suggested that bacterins (killed bacterial vaccines), such as Leptospira, Bordetella, Borrelia and Chlamydia are more likely
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to cause type I hypersensitivity adverse reactions than MLV viral vaccines, but evidence to support this is lacking. It has been sug-
gested that adjuvanted FeLV and rabies vaccines are more likely to be associated with feline injection site sarcoma, but again, there is
conflicting evidence.
92. Should dogs and cats with a history of adverse reaction or immune-mediated diseases (e.g. hives, facial oedema, anaphy-
laxis, injection site sarcoma, autoimmune disease etc.) be vaccinated?
If the vaccine suggested to cause the adverse reaction is a core vaccine, a serological test can be performed and if the animal is found
to be seropositive (antibody to CDV, CAV, CPV-2, FPV) revaccination is not necessary. If the vaccine is an optional non-core vaccine
(e.g. Leptospira or Bordetella bacterin) revaccination is discouraged. For rabies, the local authorities must be consulted to determine
whether the rabies vaccine is to be administered by law or whether antibody titre may be determined as an alternative.
If vaccination is absolutely necessary then switching product (manufacturer) may be helpful. However, this strategy may not always
be successful since hypersensitivity reactions are known to be related to excipients contained within the vaccine (e.g. traces of bovine
serum albumin used in the virus culture process) which are common to many different products. The use of antihistamines or anti-
inflam-matory doses of glucocorticoid pre-revaccination is acceptable and does not interfere with the vaccinal immune response.
Revaccinated susceptible animals should be closely monitored for up to 24 hours post-vaccination although such reactions (Type I
hypersensitivity) generally occur within minutes of exposure. Other types of hypersensitivity (II, III or IV) can occur much later (e.g. hours to months)
93. Small breeds of dog commonly suffer from adverse reactions. Is it possible to reduce the dose of vaccine to avoid this?
No. Vaccine doses are not calculated on a mg/kg basis, as are drugs. The entire antigenic load is needed to stimulate immunity effec-
tively. You should not split vaccine doses, nor give reduced volumes to small dogs. In the USA a new product has been released that is
designed for small dogs. This is formulated as a 0.5 ml dose, but contains much the same amount of antigen and adjuvant as does a
conventional 1.0 ml vaccine and is unlikely to significantly reduce the prevalence of adverse events in small breed dogs. This, and other
commercial vaccines now often contain reduced concentrations of excipients (see Q92) and it is the reduction in concentration of
extraneous protein that is likely more important in reducing adverse events.
96. Are there dogs and cats that cannot develop an immune response to vaccines?
Yes. This is a genetic characteristic seen particularly in some breeds, and these animals are called ‘non-responders’. Genetically related
(same family or same breed) animals will often share this non-responsiveness. If the animal is a non-responder to a highly pathogenic
agent, like canine parvovirus or feline panleukopenia virus, the infected animal may die if infected. If it is a non-responder to a patho-
gen that rarely causes death, it may become sick but will survive (e.g. after a Bordetella bronchiseptica infection).
97. Do puppies develop immunosuppression after the initial series of core vaccines?
Yes. If a combination product containing MLV-CDV and MLV-CAV-2 with other components is used, a period of immunosuppres-sion
lasting approximately 1 week develops, beginning 3 days after vaccination (Strasser et al. 2003). This immunosuppression is part of the
normal vaccine response and rarely, if ever, causes any clinical problem. If the combination vaccine does not contain either MLV-CDV
or MLV-CAV-2, then such suppression does not occur.
98. What can be done to avoid the immunosuppression in puppies, as all should receive the core vaccines (CDV, CPV-2 and
CAV-2)?
The puppies could receive a bivalent vaccine containing CDV and CPV-2 parenterally and the CAV-2 could be given later.
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99. Is the immune response to Leptospira responsible for causing a hypersensitivity response in certain dogs also short lived
(e.g. <1 year), like immunity from infection?
No. Unlike immunity and IgG memory, which are relatively short lived (ÿ1 year), memory for immediate hypersensitivity, as deter-mined
by skin testing, is long lived (ÿ4 years).
100. Can you use steroids to treat a case of a mild allergic reaction to a vaccine?
Yes; reactions such as facial oedema and pruritus may be treated with anti-inflammatory (not immunosuppressive) doses of oral glu-
cocorticoid (e.g. prednisolone) and/or with antihistamines.
103. How do we know that a feline sarcoma was caused by a vaccine? How do we deal with this type of sarcoma?
A feline injection site sarcoma (FISS) arises at an anatomical location into which injectable product has been delivered previously. It is
suspected that a wide range of injectables, including vaccines, may potentially trigger these tumours. It is important to record the site of
vaccination in cats in the medial record of the animal and the WSAVA guidelines give advice on suggested best locations for vaccinating
cats. Non-adjuvanted vaccines should be chosen for cats wherever possible. Unfortunately, these sarcomas are very aggres-sive. They
infiltrate widely and around 20% may metastasize. They require significant surgical resection that is often best performed by a specialist
and adjunct radiotherapy and immunotherapy may be used.
104. Why are there more hypersensitivity cases caused by rabies vaccine than before? Why is this more common among toy
poodle dogs?
Hypersensitivity reactions may be caused by any type of vaccine. We now know that a dominant antigen that causes these reactions is
bovine serum albumin (BSA) that is incorporated into vaccines during their production. Manufacturers are now reducing the con-
centration of BSA in animal vaccines. Such reactions are more common in many toy breeds and in many countries these breeds are
now particularly popular (Miyaji et al. 2012). There is likely to be a genetic susceptibility, but this is poorly understood.
105. Why do some dog breeding kennels continually have problems with dogs dying from CDV and CPV-2 infections?
The most likely cause for this scenario is that the breeding stock is not adequately vaccinated. Outbreaks might occur amongst pup-
pies that did not obtain sufficient MDA as the bitch was not effectively vaccinated. In contrast, where puppy vaccination is not per-
formed according to WSAVA guidelines (i.e. with a final puppy vaccine at 16 weeks of age or older) there is a risk that some puppies
may be unprotected if the bitch does have a high level of MDA. Finally, there are some breeds of dog (e.g. Rottweiler, Dobermann) that
have a greater risk of being genetic non-responders to these vaccines. Good husbandry, hygiene and nutrition all play a role in minimizing
disease outbreaks in kennels.
106. Can a modified live virus revert to virulence? Will a dog be infected by a MLV vaccine?
Yes, a MLV vaccine strain can theoretically revert to virulence, but this is exceedingly rare. As part of vaccine licensing manufacturers
are required to prove that this cannot occur if the vaccine virus is shed. MLV vaccines are called ‘infectious vaccines’ because they work
by inducing a low level of infection (and virus replication) in the dog, sufficient to induce immunity, but not disease. In the case of canine
parvovirus, vaccinated dogs might shed the MLV vaccine strain of virus in the faeces for a short period after vaccination. This does not
pose a risk to other dogs.
107. Some pups were vaccinated at 6 weeks of age with DHPPi and developed parvovirus infection at 7 weeks of age; why did
this happen?
The most common reason for this occurrence (i.e. infection in a vaccinated pup) is that the animal was already incubating infectious
virus before it was vaccinated. It is possible that these pups might have been infected during the ‘window of susceptibility’ when they no
longer had sufficient MDA to fully protect them against virulent street virus, but the MDA that was present was still sufficient to interfere
with their immune response to a recently administered vaccine.
108. Apart from the (very small) risk of adverse reaction, what are the other risks of annual vaccination?
The risks of adverse reaction following vaccination are indeed relatively small. For dogs and cats this is in the order of 30 to 50 reac-
tions for every 10,000 animals vaccinated, respectively, and the vast majority of these are non-serious reactions (e.g. transient pyrexia
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and lethargy, allergic reactions). However, if a serious reaction occurs in one of your client’s animals – that is a difficult discussion to
have. Adoption of new guidelines is not simply about minimizing the risk of adverse reactions – it is about practicing better, evidence-
based veterinary medicine and only performing a medical procedure (i.e. vaccination) when this is required.
109. Some dogs are genetically poor responders (e.g. Rottweilers). How should one vaccinate these breeds?
The WSAVA guidelines contain a useful flow diagram that helps you to identify non-responder dogs. All puppies should be vacci-
nated in the same way (with a final vaccination at 16 weeks of age or older) and if you are concerned about the breed and the poten-
tial for lack of response, you should serologically test at 20 weeks of age. Most non-responders will fail to seroconvert to just one of
the core vaccine antigens (i.e. CDV, CAV or CPV-2). You may attempt to revaccinate and retest that dog, but a true non-responder
(or low-responder) may still not respond to revaccination. Such animals simply lack the immunological ability to make an immune
response to that particular antigen and will never respond to that vaccine component. Owners should be made aware that these dogs
will be at risk, and ideally they should not be used for breeding.
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