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Thumbs up The Vaccination Conundrum - New Protocols for Cats

The Vaccination Conundrum - New Protocols for Cats

How Do Vaccines Work, and Which are Necessary?

By Franny Syufy, About.com

Recent years have brought much discussion among veterinarians, breeders, and cat owners on the value, safety, and necessity of some vaccines. The resultant rumors mixed with fact have caused concern among cat lovers: Does my cat really need to be vaccinated every year? Are vaccines more harmful than helpful?Unfortunately, there is no one answer that would be applicable to all cats, but with a better understanding of the facts, you can work with your own veterinarian to work out a vaccination scheme that will provide the safest protection for your cat.

How do Vaccines Protect my Cat?

Vaccines do not inject a miraculous shield against disease. They work by fooling the body into thinking it is threatened, thereby stimulating the body's own defense system into producing antibodies to fight off the invader. Vaccines are made from either killed viruses or weakened viruses (modified live - MLV), and can be given individually, although some serums are often given as a group (multivalent), e.g. the "3-Way, " or FRCP. (See page 2 for more information on multivalent vaccines.)

Vaccines are most commonly given by injection, although several new intranasal vaccines have been developed, which are recommended by the VAFSTF where available.

After the initial "kitten shots," boosters are given to boost the cat's defense system. Traditionally, veterinarians have asked owners to bring their cats in for annual boosters, along with their annual well-cat checkup, however times are changing and many veterinarians are moving to an every three year protocol, with some exceptions.

In 1996, due to increasing concerns about tumors found at the sites of certain vaccinations, a Vaccine-Associated Feline Sarcoma Task Force (VAFSTF), consisting of representatives from American Association of Feline Practitioners (AAFP), American Animal Hospital Association (AAHA), American Veterinary Medical Association (AVMA), and Veterinary Cancer Society (VCS), researchers, clinicians, and government representatives, was formed to study this phenomenon. Their published results included certain vaccines as "core" (highly recommended for all cats).

Core Vaccines:

* Feline Panleukopenia Virus Vaccine (also called "Feline Distemper")
Panleukopenia is caused by a feline parvovirus (FPV), and is particularly vicious, capable of being spread rapidly, with a high mortality rate, especially in younger cats. After a one-year booster for kittens, this vaccination can be given every three years.

* Feline Calicivirus
This virus, along with the Feline Herpes virus, causes the majority of upper respiratory infections URIs in cats, and can be spread by "carrier" cats for years. This vaccine may be given at three year intervals after the initial series.

* Rhinotracheitis AKA Feline Herpes Virus
Rhinotracheitis has serious potential, especially in kittens. It has been estimated that 70% of kittens with severe Rhinotracheitis infections will die, and it can also cause permanent neurological damage to kittens.

NOTE: These vaccines will not provide total clinical immunity to the diseases, but will minimize the severity of upper respiratory infection.

* Rabies Vaccine
Rabies vaccinations are required by law in most states in the U.S. The interval depends on the jurisdiction, and can be from one to three years. Although the incidence of rabies in cats is relatively low, even indoor cats are at risk, as bats do enter homes. Rabies is always fatal in an unprotected cat, and both the VAFSTF and the AAFP highly recommend vaccination of all cats for this zoonotic disease.

The Rabies vaccine is one which is implicated as causing vaccine-associated sarcoma (VAS), and it is suspected that the adjuvant (carrier) used may be the culprit associated with this vaccine. A new non-adjuvanted vaccine (PureVax Feline Rabies Vaccine, Merial Ltd.) is available, but its reduced likelihood of association with VAS has not yet been proved by studies. This vaccine is presently licensed only for annual administration.

Live VS Killed Vaccines

Most vaccines are available in either version, and your veterinarian will be able to select the appropriate one for your cat, based on his health history. MLVs seem to be the current choice of favorite, but you'll want to discuss this matter thoroughly with your veterinarian.

* Modified Live Vaccines (MLV)

MLVs basically do their own "dirty work," in fooling the body into believing it has an outsider invader, thus encouraging it to create antibodies against the antigen. MLVs are believed to give a higher-quality immune response than that available from killed viruses. The downside is that cats with compromised immune systems (FIV or FeLV patients) may suffer from vaccine-induced disease from MLVs.
* Killed Vaccines
Killed vaccines need a helper to stimulate the natural immune system in the cat, so an adjuvant is added to irritate the immune system, thereby stimulating the creation of antibodies. Two problems arise with killed vaccines:
1. They are not as effective as MLVs and will need to be "boostered" more frequently.
2. Adjuvants have become suspect in the increase of VAS (Vaccine-Associated Sarcoma).

Because of the risks of infection related to MLVs, it is recommended that immunocompromised cats receive killed vaccines.

Vaccines Not Normally Recommended

The following vaccinations are only recommended in certain instances by the AAFP:

* Chlamydiosis
Because adverse reactions to the Chlamydia vaccine happen more frequently than adverse reactions to the disease, and because the vaccine does not prevent clinical infection, but just from severe symptoms, this vaccine is not routinely recommended. Households with multiple cats, catteries, or other environments where infections associated with Chlamydiosis have been confirmed, may consider this vaccine after consultation with a veterinarian. If deemed appropriate, annual revaccination is recommended.
* Feline Infectious Peritonitis (FIP)
The use of this vaccine has been controversial. The AAFP Guidelines indicate that, currently lacking sufficient proof that the vaccine induces clinically relevant protection, its use is not recommended.
* Bordetella
More commonly found in dogs, Bordetella (kennel cough) is found in shelters and other multiple-cat environments. The recently-approved vaccine has not yet been thoroughly tested as to the duration of its protection, and it it not recommended for routine use, although exceptions may be made for multiple-cat environments.
* Gardiasis
Another recently approved vaccine is not yet recommended for routine use by the AAFP, except where exposure is clinically significant, e.g. multiple-cat environments.

Other Vaccination Exceptions

* Sick cats, cats with chronic disease and/or weakened immune systems should probably not be vaccinated.
* Consult with your veterinarian before vaccinating a cat receiving cortisone therapy.
* Geriatric cats (10 years +) generally do not need booster vaccinations, but instead can be tested for titers during their annual physical exams.
* Vaccinations are not recommended for kittens under six weeks, except in extreme situations (orphaned kittens, or kittens in a high-risk environment.
* Some vaccines are believed to cause stillbirths in pregnant queens.

What About Vaccine-Related Sarcoma?

Much has been published about vaccine-related sarcoma recently, particularly on the Internet. This anomaly usually occurs resultant from the rabies or more often the FeLV vaccines given. Dr.Greg Ogilvie of Colorado State University, in a lecture on vaccine induced fibrosarcomas in cats, explained a possible link with the use of aluminum in certain vaccines. Dr Ogilvie also mentioned that there is some evidence that a cat must have a genetic predisposition to develop a tumor, which may account for the rarity of the incidence (3 in 10,000 to 1 in 1,000 cats). Because of the difficulty in establishing a clear relationship, the in 1996, the AVMA created the Vaccine-Associated Feline Sarcoma Task Force to study the true scope of the problem, the exact cause, and most effective treatment of vaccine-related sarcomas. Their findings have now been posted, and can be read in the last two links in the sidebar.

FeLV Vaccine

Because of the seriousness of this always fatal disease, and because the FeLV vaccine also carries risks of VAS, special guidelines have been issued for this vaccine. The disease is transmitted through saliva and nasal secretions, by biting, sharing food dishes, and other close contact. All cats should be tested for this disease at least once during their lives, and at any other time when they might have had contact with an infected cat. New cats to a household must always be tested prior to introduction to the environment. All cats with a positive ELISA screening test should be segregated from other cats.

The vaccine is not recommended routinely, but is recommended for all indoor-outdoor cats, and any other cats deemed "at risk." In those cases, it should be given annually, according to the AAFP guidelines. In addition, because of the risk of vaccine-related sarcoma, special vaccination site guidelines have been issued for all recommended vaccines:

Rabies: In the right rear leg
FeLV: Left rear leg
Panleukopenia, feline herpesvirus I, feline calicivirus (or 3-way): Right fore region (shoulder)

The reasoning behind this, unpleasant as it may sound, is that a VAS tumor on the leg can be treated by amputation, allowing affected cats to survive. Cats are wonderfully adaptive, and usually adjust quite quickly to navigating on three legs.

Fears about the possibility of vaccine-induced tumors have led many cat owners, particularly breeders, to refuse the FeLV vaccine for their cats. Presently there is no USDA standard for FeLV vaccines, therefore rating the effectiveness of the vaccines is difficult. Many veterinarians estimate the effectiveness to be between 75-85%, which lends some cat owners a reason to deny the vaccine. Personally, I'd rather risk the one in 1,000 chances of vaccine-related sarcoma against the 25% risk that the FeLV vaccination would not work. FeLV is such a deadly disease, so easily transmissable, that I would not want to put my cats' lives up against a statistical roulette wheel.

However, since my cats are considered "at risk," because the oldest one is still an indoors-outdoors kitty, the decision was an easy one for me and my veterinarian. People with entirely indoors cats may want to strongly consider eliminating this vaccination, after discussing the pros and cons with their own veterinarian, but testing should be done any time their cats come in contact with other "suspect" cats.

The New FIV Vaccine

This relatively new vaccination, approved for sale by the FDA on March 14, 2002, has met with resistance and controversy among both veterinarians and lay persons, for a number of reasons. For a more thorough discussion about the pros and cons of the FIV vaccine, see the companion article, "The FIV Vaccine - Friend or Foe?"

Multivalent Vaccines

Traditionally, kittens have been given a "3-way vaccine," which contains agents against feline calicivirus, herpesvirus and feline panleukopenia (FRCP), all given in one "shot." These are considered "core" vaccines, and are essential for all cats. A 4-way vaccine, adding Chlamydia is also available, for cats at risk of contracting the latter (primarily show cats.)

Controversy over multivalent vaccines is often almost as heated as the discussions over whether in fact to vaccinate or not. Some people believe that hazards attendant with multivalent vaccines are almost as great as those with adjuvants. On the other hand, a veterinarian with 28 years practice with small animals offers,

"Not a single person I queried would offer any irrefutable evidence that the multivalent vaccines actually harmed pets. There are stories, there are opinions, there are theories, there is conjecture ... even suggestions that veterinarians are knowingly using all those vaccines to further their financial gains! (On this point, you should know that giving a pet a single dose of a single vaccine, then giving subsequent single dose vaccines for different diseases spread out over a period of time could be more expensive for the pet owner and more revenue for the veterinarian than giving a multivalent vaccine.)"
Dr. T.J.Dunne, Jr., Vaccinations...Too Many, Too Often?

Although the VAFSTF and the AAFP protocols allude rather cryptically to the FRCP vaccine, I have found nothing within either of their protocols to indicate approval or disapproval. Since even the medical experts disagree, it is difficult for a lay person to seize upon the right answers for his or her own cat. Indeed, the summation of the VAFSTF mentions, "Vaccination should be viewed as a medical, rather than a routine, procedure. However, the profession lacks sufficient data to accurately assess the relative risk of administering a particular vaccine or antigen to an individual cat."

Decision Time

Before making any decision regarding the withholding of recommended vaccinations, it is suggested you do your homework. Don't use this article or any other single article as the basis for a decision, but read as many varying opinions as you can find. This article is not intended to definitively answer any questions, but to stimulate the reader into doing his or her own research. There is much more to be learned about vaccination pros and cons and I have only touched the tip of the iceberg.

The bottom line, as alway, is that these are issues you should discuss with your own veterinarian in deciding which vaccinations your cat needs and how often. Every household varies, and the decision is a very personal one, to be made in an informed manner rather than as a result of rumors and panic. In any case, if you and your veterinarian agree to forgo the annual vaccination scheme, make sure you still take your cat in at least once a year for a well-cat check-up and for needed dental cleaning, along with titer-checking, if that's in the plan.

Resources and Recommended Reading

* Colorado State University's Small Animal Vaccination Protocol
* The Immune System and Disease Resistance
* Vaccinosis
* Vaccines Linked to Increased Numbers of Tumors in Cats
* Rethinking Annual Vaccinations
* Vaccines and Sarcomas: A Concern for Cat Owners
* Feline Leukemia FAQ
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