Posted on 04/22/2002 6:20:53 AM PDT by Cincinatus' Wife
Experts say annual vaccines waste money, can be risky
Debra Grierson leaves the veterinarian's office clutching Maddie and Beignet, her Yorkshire terriers, and a credit card receipt for nearly $400.
That's the cost for the tiny dogs' annual exams, including heartworm checks, dental checks and a barrage of shots.
"They're just like our children," said the Houston homemaker. "We would do anything, whatever they needed."
What many pet owners don't know, researchers say, is that most yearly vaccines for dogs and cats are a waste of money -- and potentially deadly. Shots for the most important pet diseases last three to seven years, or longer, and annual shots put pets at greater risk of vaccine-related problems.
The Texas Department of Health is holding public hearings to consider changing the yearly rabies shot requirement to once every three years. Thirty-three other states already have adopted a triennial rabies schedule. Texas A&M University's and most other veterinary schools now teach that most shots should be given every three years.
"Veterinarians are charging customers $36 million a year for vaccinations that are not necessary," said Bob Rogers, a vet in Spring who adopted a reduced vaccine schedule. "Not only are these vaccines unnecessary, they're causing harm to pets."
Just as humans don't need a measles shot every year, neither do dogs or cats need annual injections for illnesses such as parvo, distemper or kennel cough. Even rabies shots are effective for at least three years.
The news has been slow to reach consumers, partly because few veterinarians outside academic settings are embracing the concept. Vaccine makers haven't done the studies needed to change vaccine labels. Vets, who charge $30 to $60 for yearly shots, are loath to defy vaccine label instructions and lose an important source of revenue. In addition, they worry their patients won't fare as well without yearly exams.
"I know some vets feel threatened because they think, `People won't come back to my office if I don't have the vaccine as a carrot,' " said Alice Wolf, a professor of small-animal medicine at Texas A&M and an advocate of reduced vaccinations. "A yearly exam is very important."
The movement to extend vaccine intervals is gaining ground because of growing evidence that vaccines themselves can trigger a fatal cancer in cats and a deadly blood disorder in dogs.
Rogers conducts public seminars on the subject with evangelical zeal but thus far has been unsuccessful in persuading the Texas Veterinary Medical Association to adopt a formal policy.
"I'm asking the Texas attorney general's office if this is theft by deception," said Rogers, whose Critter Fixer practice won an ethics award from the Better Business Bureau in 2000. "They just keep coming out with more vaccines that are unnecessary and don't work. Professors give seminars, and nobody comes and nobody changes."
When rabies shots became common for pets in the 1950s, no one questioned the value of annual vaccination. Distemper, which kills 50 percent of victims, could be warded off with a shot. Parvovirus, which kills swiftly and gruesomely by causing a toxic proliferation of bacteria in the digestive system, was vanquished with a vaccine. Over the years, more and more shots were added to the schedule, preventing costly and potentially deadly disease in furry family members.
Then animal doctors began noticing something ominous: rare instances of cancer in normal, healthy cats and an unusual immune reaction in dogs. The shots apparently caused feline fibrosarcoma, a grotesque tumor at the site of the shot, which is fatal if not discovered early and cut out completely. Dogs developed a vaccine-related disease in which the dog's body rejects its own blood.
"That really caused people to ask the question, `If we can cause that kind of harm with a vaccine ... are we vaccinating too much?' " said Ronald Schultz, a veterinary immunologist at the University of Wisconsin School of Veterinary Medicine. "As you get more and more (vaccines), the possibility that a vaccine is going to cause an adverse event increases quite a bit."
Less frequent vaccines could reduce that risk, Schultz reasoned. Having observed that humans got lifetime immunity from most of their childhood vaccines, Schultz applied the same logic to dogs. He vaccinated them for rabies, parvo, kennel cough and distemper and then exposed them to the disease-causing organisms after three, five and seven years. The animals remained healthy, validating his hunch.
He continued his experiment by measuring antibody levels in the dogs' blood nine and 15 years after vaccination. He found the levels sufficient to prevent disease.
Fredric Scott, professor emeritus at Cornell University College of Veterinary Medicine, obtained similar results comparing 15 vaccinated cats with 17 nonvaccinated cats. He found the cats' immunity lasted 7.5 years after vaccination. In 1998, the American Association of Feline Practitioners published guidelines based on Scott's work, recommending vaccines every three years.
"The feeling of the AAFP is, cats that receive the vaccines every three years are as protected from those infections as they would be if they were vaccinated every year," said James Richards, director of the Feline Health Center at Cornell. "I'm one of many people who believe the evidence is really compelling."
Texas A&M's Wolf said the three-year recommendation "is probably just as arbitrary as anything else," and nothing more than a "happy medium" between vaccine makers' recommendations and the findings by Schultz and Scott aimed at reducing vaccine-related problems.
But many vets are uncomfortable making a drastic change in practice without data from large-scale studies to back them up. There is no animal equivalent of the U.S. Centers for Disease Control and Prevention, which monitors outbreaks of vaccine-preventable disease in people, thus keeping tabs on a vaccine's effectiveness.
Federal authorities require vaccine makers to show only that a vaccine is effective for a reasonable amount of time, usually one year. Richards notes that studies to get a feline vaccine licensed in the first place are typically quite small, involving 25 to 30 cats at most.
There is no federal requirement to show a vaccine's maximum duration of effectiveness. Arne Zislin, a veterinarian with Fort Dodge Animal Health, the largest animal vaccine maker in the world, said such studies would be expensive and possibly inhumane, requiring hundreds of animals, some of them kept in isolation for up to five years.
"I don't think anyone with consideration for animals would really want to go through that process," said Zislin, another vet who believes current data are insufficient to support an extended schedule.
Diane Wilkie, veterinarian at Rice Village Animal Hospital, said she tells pet owners that vaccines appear to last longer than a year, but her office hasn't officially changed its protocol yet. She said 20 percent to 30 percent of her cat patients are on the extended schedule.
"It's kind of a hard situation. The manufacturers still recommend a year, but they're the manufacturers," Wilkie said. "It's hard to change a whole professional mentality -- although I do think it will change."
In Houston, yearly pet examinations typically cost $50 to $135, with shots making up one-third to half of the expense. A dental check, heartworm test, fecal check and overall physical are usually included in the price. Without the shots, vets could expect to lose a chunk of that fee.
But an increasing number of vets are emphasizing other services, such as surgery. Wolf said savings on vaccines might prompt pet owners to get their pets' teeth cleaned instead. An in-house test to check antibody levels is in development.
"I definitely think there's a profit issue in there; don't get me wrong," Wilkie said. "(But) people are willing to spend money on their pets for diseases. Although vaccines are part of the profit, they aren't that big a part. We just did a $700 knee surgery."
Vaccination findings
Veterinary research challenges the notion that pets need to be vaccinated every 12 months. Some of the findings:
Dog vaccines/Minimum duration of immunity
· Canine rabies3 years
· Canine parainfluenza3 years
· Canine distemper (Onderstepoort strain)5 years
· Canine distemper (Rockborn strain)7 years
· Canine adenovirus (kennel cough)7 years
· Canine parvovirus7 years
Cat vaccines/Minimum duration of immunity
· Cat rabies3 years
· Feline panleukopenia virus6 years
· Feline herpesvirus5 or 6 years
· Feline calicivirus3 years
Recommendations for dogs
· Parvovirus, adenovirus, parainfluenza, distemper: Following initial puppy shots, provide booster one year later, and every three years thereafter.
· Rabies: At 16 weeks of age, thereafter as required by law.
· Bordatella: Use prior to boarding; may be repeated up to six times a year.
· Coronavirus: Not recommended in private homes. Prior to boarding, may be given to dogs 8 weeks or older, and repeated every six months.
· Lyme: Not recommended.
· Giardia: Not recommended.
Recommendations for cats
· Panleukopenia, herpesvirus (rhinotracheitis), calicivirus: Following initial kitten shots, provide booster one year later and every three years thereafter.
· Rabies: At 8 weeks of age, thereafter as required by law.
· Feline leukemia: Use only in high-risk cats. Best protection is two vaccines prior to 12 weeks of age, with boosters repeated annually.
· Bordatella: Use prior to boarding.
· Feline infectious peritonitis: Not recommended.
· Chlamydia: Not recommended.
· Ringworm: May be used during an outbreak in a home.
Sources: Ronald Schultz, University of Wisconsin School of Veterinary Medicine; Fredric Scott, Cornell University College of Veterinary Medicine; Colorado State University; University of California-Davis Center for Companion Animal Health.
When I used to do income taxes I was asked often if the dog/cat could be claimed as a dependent. The main reason was the big $$$ owners spent at the vet on their pets.
I've read this thread and I've thought about your responses and I have the following to say. You probably won't like it, but that's tough. Life is hard. Get used to it.
I was in practice in the 80's, in a state that is a big rabies state. Annual vaccinations, for most diseases, were recommended by the manufacturer and by my professors.
At the time, most people who owned pets would not spend a lot of money on them, particularly if they required diagnostics (blood tests, skin cultures, urinalyses, surgeries other than spay or neuter).
So mom and her 7 year old bring in their beloved dog, who has a broken leg which needs to be pinned (a surgical procedure) to heal correctly, but don't have the money to afford the surgery. What is a vet to do? We could have put down tons of animals in these situations. But that isn't why we went into vet med. We really care about animals. So we'd pin the leg, charge some low ball price that didn't cover our expenses so that dog could go home and be back playing with that 7 year old. How could we do this and make a living? We charged more for vaccines.
In my opinion, this was not the best approach, because people never really understood the true costs involved in surgery - anesthesia, prep, surgical expenses, the cost of the surgeon's expertise, etc. because we were too chicken to charge for it (and we knew that most people - at that time - would say "Gee, doc, I can go down the road and get another dog for $5. Why should I spend $700 to get his leg fixed?" and therefore just have the animals put down.)
Parvovirus was a "new" disease which reared its ugly head just as I was graduating from veterinary school. I saw its' ravages up close. I was the only vet in my practice that actually took on parvo cases and had a good success rate - mainly because I gave those patients incredible supportive care. They lived, but the bills were astronomical compared to what people were willing to pay at the time. So, did my partners say "don't spend all that time and energy on those parvo dogs because we end up in the hole?" NO they let me treat those animals, cut the bills to the bone and send home live dogs to happy people.
It appears that we're learning that current vaccines are viable (good) for more than one year. You people are all ready to sue your veterinarians because they are recommending annual vaccs. Let me tell you this, until someone of authority comes out and says that vaccs every three years are good enough, I doubt many vets will change from annual vaccs - and it has everything to do with lawsuits. One is judged in the legal community as to what is the standard of care in your area. If you've got vaccine manufacturers stating the efficacy of their product is for only one year, and you have no viable studies (conducted under accepted scientific conditions and statistically reliable) to show that the vaccines do, in the vast majority of cases, reliably provide protective immunity for up to 3 years, then how do you expect veterinarians to go out on a limb and tell you it's ok to only get that parvo shot once every three years?
I practiced in a state where rabies is a very present disease. When a rabies vaccine developed for 3 yr usage came out, my state still insisted on annual vaccs because of the high incidence of the disease. I just read something last week re: rabies - there is still a very high incidence of racoon rabies along the eastern seaboard. We worry about it making its way westward. Bat rabies is a real danger in many parts of the US. I believe 4 humans contracted rabies just last year in the US. If its true that the current vaccines are capable of providing protective immunity for a period of three years, and studies have been done which show that vaccinated animals close to the end date have been challenged with rabies and not succumbed, then those states which require annual rabies vaccs may want to consider moving that requirement to 3 yrs.
I haven't practiced for 10 years. I understand that vets have begun to see hideous sarcomas develop at vaccine injection sites in cats. No one knows why. I never saw it when I was in practice in the 80's. That makes me lean towards vaccinating less frequently for various diseases if the vaccines truly confer an immunity capable of protecting the cat longer than a year.
My point in all this is, step back a minute and understand where the veterinary profession has been, where it is now - damn fine therapeutic options for your pets that weren't there a decade ago, and think about the change in peoples' attitudes - people are much more inclined to provide excellent health care for their pets these days - much more so than they used to be. Pets in many cases, are child substitutes. People are more flush than they were 20 years ago. This means you get great care. It also means that it is time for vets to stop charging inflated fees for vaccs, to also look at U. of Wisconsin's vacc recommendation schedule and consider using it. It also means vets should be engaging in dialogues with their clients about new things we're learning considering vaccines, and let the client weigh whether they want to take the risk of vaccine reaction or the risk of getting the disease, when there is not a law mandating a particular vaccine. And it means that vets should start charging for the things that truly cost them money, and decrease their vaccine charges. It also means that you, the consumer/pet owner should stop expecting the moon without being willing to pay for it. And one last thing to the fella who complained about the cost of his elderly dog's specialty dog food - I've seen prescription foods make all the difference in not only the quality of life an animal has but also seen it extend the life of animals who require it. You pays your money and you takes your chances. Hope this at least explains some things from an old vet's point of view.
He's treated my other two several times each, or at least examined them, and hasn't even brought up the subject of shots. He knows that they live inside and respects my right to decide how to handle the shot situation.
And now for my main reason for posting to this thread:
These vaccines are not controlled like those used for humans.
For years and years, we've been told that our cats needed FLV shots, but now we are told they are very dangerous.
And look at the following paragraph. It shows the motivation of many vets, I fear:
The news has been slow to reach consumers, partly because few veterinarians outside academic settings are embracing the concept. Vaccine makers haven't done the studies needed to change vaccine labels. Vets, who charge $30 to $60 for yearly shots, are loath to defy vaccine label instructions and lose an important source of revenue. In addition, they worry their patients won't fare as well without yearly exams. "I know some vets feel threatened because they think, `People won't come back to my office if I don't have the vaccine as a carrot,' " said Alice Wolf, a professor of small-animal medicine at Texas A&M and an advocate of reduced vaccinations. "A yearly exam is very important."
Yes, I've also in the past year encountered a vet who was honest about this, and I was given the choice about whether to vaccinate or not, including for rabies, as my cats don't ever go out. But I'm sure they couldn't board at the vet's if I had to. Luckily a neighbor is kind enough to take care of them when I leave.
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