Vaccine-associated adverse events

Feline Injection-Site Sarcoma and Other Adverse Reactions to Vaccination in Cats

Vaccine-associated adverse events (VAAEs), including feline injection-site sarcomas (FISSs), occur only rarely but can be severe. Understanding potential VAAEs is an important part of informed owner consent for vaccination. In this review, the European Advisory Board on Cat Diseases (ABCD), a scientifically independent board of feline medicine experts, presents the current knowledge on VAAEs in cats, summarizing the literature and filling the gaps where scientific studies are missing with expert opinion to assist veterinarians in adopting the best vaccination practice. VAAEs are caused by an aberrant innate or adaptive immune reaction, excessive local reactions at the inoculation site, an error in administration, or failure in the manufacturing process. FISS, the most severe VAAE, can develop after vaccinations or injection of other substances. Although the most widely accepted hypothesis is that chronic inflammation triggers malignant transformation, the pathogenesis of FISS is not yet fully understood. No injectable vaccine is risk-free, and therefore, vaccination should be performed as often as necessary, but as infrequently as possible. Vaccines should be brought to room temperature prior to administration and injected at sites in which FISS surgery would likely be curative; the interscapular region should be avoided. Post-vaccinal monitoring is essential.

Prophylaxe der kaninen Parvovirose

Obwohl Impfstoffe gegen das canine Parvovirus (CPV) weltweit eingesetzt werden, tritt die Parvovirose vor allem bei jungen Hunden nach wie vor vergleichsweise häufig auf. Der vorliegende Übersichtsartikel konzentriert sich auf die Ursachen für ein Impfversagen. Hierfür kommen unterschiedlichste Faktoren in Betracht, die den Hund selbst oder seine Umwelt betreffen. So gibt es genetisch bedingt Hunde, die keine Antikörper (Non-Responder) oder nur sehr niedrige Konzentrationen an Antikörpern (Low-Responder) nach einer CPV-Impfung ausbilden. Der Impferfolg kann auch durch andere intrinsische Faktoren (z. B. Gewicht, Alter, Reproduktions- und Ernährungsstatus, Krankheiten) und/oder extrinsische Faktoren (z. B. Stress, Belastung, Medikamente) beeinträchtigt werden. Neben Ursachen, die den individuellen Hund betreffen, kann ein Impfversagen auch durch eine reduzierte immunisierende Eigenschaft des Impfstoffs bedingt sein; hierfür kommt eine Vielzahl verschiedener Faktoren in Betracht (z. B. Herstellung, Lagerung, Applikation).

Vaccination of Immunocompromised Cats

Immunocompromise is a common condition in cats, especially due to widespread infections with immunosuppressive viruses, such as feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV), but also due to chronic non-infectious diseases, such as tumours, diabetes mellitus, and chronic kidney disease, as well as treatment with immunosuppressive drugs, such as glucocorticoids, cyclosporins, or tumour chemotherapy. In this review, the European Advisory Board on Cat Diseases (ABCD), a scientifically independent board of experts in feline medicine from eleven European countries, discusses the current knowledge and rationale for vaccination of immunocompromised cats. So far, there are few data available on vaccination of immunocompromised cats, and sometimes studies produce controversial results. Thus, this guideline summarizes the available scientific studies and fills in the gaps with expert opinion, where scientific studies are missing. Ultimately, this review aims to help veterinarians with their decision-making in how best to vaccinate immunocompromised cats.

Anaphylaxis after vaccination for cats in Japan

Severe adverse reactions in cats after vaccination were examined from 316 cases reported to the Ministry of Agriculture, Forestry and Fisheries (MAFF) in Japan during 15-year period from April 2004 to March 2019. We found that 130 (41%) showed anaphylaxis, and 99 (76%) of the 130 cases of anaphylaxis resulted in death. Veterinarians should be well prepared to deal with vaccine-associated anaphylaxis in cats. Bovine serum albumin (BSA) as indicator of purification was detected at high levels in commercially available feline vaccines. BSA might derive from fetal calf serum in culture media. This study provides useful information about anaphylaxis including critical details of the potential clinical signs associated with adverse events to feline vaccination.

[Prevention of canine parvovirosis - Part 3: Vaccine-associated adverse events]

Although nowadays vaccines, especially those against canine parvovirus (CPV), are considered to be safe, vaccine-associated adverse events (VAAEs) can occur in rare cases. Some VAAEs are mild and manifest shortly (within a few days) after vaccination (e. g. gastrointestinal signs, fever, reduced general condition, lymphadenopathy). These signs are likely a result of vaccine virus replication and indicate a good immune response. Anaphylactic reactions can also occur promptly following vaccine administration and might be life threatening. Affected dogs show clinical signs such as edema, salivation, vomiting, diarrhea, hypotension, and/or shock. Since it is often unclear which component of the vaccine carries responsibility for the anaphylactic reaction it is important to limit future vaccinations of these dogs to indispensable components only. When revaccination is unavoidable, e. g. because antibodies against CPV cannot be detected, combined vaccines should not be used and CPV (and other components, if needed) should preferably be vaccinated separately. Changing the vaccine manufacturer might also prevent further anaphylactic reactions. Finally, there are VAAEs occurring after a prolonged period of time. In dogs, it is discussed that autoimmune diseases, such as immune-mediated hemolytic anemia (IMHA), can be a consequence of excessive vaccination or in the least be triggered by vaccination. Numerous dogs with IMHA are reported to have a history of receiving a vaccination within a few weeks before the onset of clinical sings. In such dogs, further vaccinations should generally be avoided.

Anaphylaxis after rabies vaccination for dogs in Japan

Severe adverse reactions after rabies vaccination in dogs were examined from 317 cases reported to the Ministry of Agriculture, Forestry and Fisheries (MAFF) in Japan during 15-year period from April 2004 to March 2019. We found that 109 of the 317 dogs showed anaphylaxis (0.15/100,000 vaccinated dogs), and 71 of the 109 cases of anaphylaxis resulted in death (0.10/100,000 vaccinated dogs). We measured bovine serum albumin (BSA) in four commercially available rabies vaccines and found the levels ranged from 0.1 to 16.6 µg/dose. Our survey showed that the rate of anaphylaxis to rabies vaccines in dogs is rare, although some cases of anaphylaxis resulted in death. Veterinarians should be well prepared to deal with vaccine-associated anaphylaxis.

[Prophylaxis of canine parvovirosis - Part 2: Vaccines]

Vaccination is still the most effective measure to prevent canine parvovirosis. Therefore, vaccines against canine parvovirus (CPV) infection are considered core vaccines. Modified life vaccines (MLV) have been proven to be very effective and safe, since they are characterized by early onset (within a few days after vaccination) and long duration of immunity (several years). MLV do not contain adjuvants; they are also advantageous in terms of possessing less allergenic and toxic properties. Therefore, MLV are widely used as first line vaccines. In Germany and in most other European countries, only MLV are available on the market. MLV contain CPV-2 or (less often) CPV-2b and offer cross-protection against the variants CPV-2a, -2b, -2c that are relevant for dogs in the field. Revaccination with MLV should be performed in 3-year-intervals or longer intervals (only in case of lacking antibodies) even if the licensed MLV is registered for re-vaccination intervals of 1 or 2 years. MLV should only be administered to healthy dogs older than 4 to 6 weeks of age. A possible disadvantage of MLV is its interference with the diagnosis of a CPV infection.

Retrospective review of diphenhydramine versus diphenhydramine plus glucocorticoid for treatment of uncomplicated allergic reaction in dogs

OBJECTIVE

To report the outcome of treatment of uncomplicated allergic reactions in dogs with diphenhydramine vs diphenhydramine plus glucocorticoid and to determine the incidence rate of uncomplicated allergic reactions DESIGN: Retrospective study between January 1, 2012 and August 15, 2018.

SETTING

Privately owned, 24-hour emergency and specialty referral veterinary hospital.

ANIMALS

Eight hundred and eighty cases of dogs treated for uncomplicated allergic reaction with diphenhydramine alone or in combination with a glucocorticoid.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Two hundred ninety-nine dogs were treated with diphenhydramine alone, and 581 were treated with diphenhydramine plus Dex SP. There was no difference between the 2 groups for response to initial therapy, need for additional veterinary intervention after discharge, or persistent signs at follow-up. The cumulative incidence of emergency department presentation for uncomplicated allergic reaction in this hospital was 1.2%.

CONCLUSIONS

There was no difference in measured outcomes between dogs treated with diphenhydramine alone vs those treated with a glucocorticoid in addition to diphenhydramine in this population of dogs.

Adverse consequences of vaccination

The importance of adverse effects from vaccination must not be overstated. Vaccine benefits greatly exceed any risks from the procedure. Neither must they be minimized. Unnecessary vaccination must be discouraged. Hypersensitivity reactions to vaccine components are real and must be guarded against. Residual virulence, although a concern tends to be more a hypothetical than a real problem. Progressive improvements in animal vaccines have significantly reduced the chances of adverse effects occurring, although some issues persist. One such example is injection-site sarcomas in cats. Another issue is the influence of animal size on the prevalence of adverse events in dogs.

Antibody Response to Canine Adenovirus-2 Virus Vaccination in Healthy Adult Dogs

BACKGROUND

Re-vaccination against canine adenovirus (CAV) is performed in ≤3-year-intervals but their necessity is unknown. The study determined anti-CAV antibodies within 28 days of re-vaccination and factors associated with the absence of antibodies and vaccination response.

METHODS

Ninety-seven healthy adult dogs (last vaccination ≥12 months) were re-vaccinated with a modified live CAV-2 vaccine. Anti-CAV antibodies were measured before vaccination (day 0), and after re-vaccination (day 7, 28) by virus neutralization. A ≥4-fold titer increase was defined as vaccination response. Fisher's exact test and multivariate regression analysis were performed to determine factors associated with the absence of antibodies and vaccination response.

RESULTS

Totally, 87% of dogs (90/97; 95% CI: 85.61-96.70) had anti-CAV antibodies (≥10) before re-vaccination. Vaccination response was observed in 6% of dogs (6/97; 95% CI: 2.60-13.11). Time since last vaccination (>3-5 years, OR = 9.375, p = 0.020; >5 years, OR= 25.000, p = 0.006) was associated with a lack of antibodies. Dogs from urban areas were more likely to respond to vaccination (p = 0.037).

CONCLUSION

Many dogs had anti-CAV pre-vaccination antibodies, even those with an incomplete vaccination series. Most dogs did not respond to re-vaccination. Based on this study, dogs should be re-vaccinated every 3 years or antibodies should be determined.

Antibody Response to Canine Parvovirus Vaccination in Dogs with Hyperadrenocorticism Treated with Trilostane

It is unknown how dogs with hyperadrenocorticism (HAC) respond to vaccination. This study measured antibodies against canine parvovirus (CPV) in dogs with HAC treated with trilostane before and after CPV vaccination, and compared the immune response to that from healthy dogs. Eleven dogs with HAC, and healthy age-matched control dogs (n = 31) received a modified-live CPV vaccine. Antibodies were determined on days 0, 7, and 28 by hemagglutination inhibition. Univariate analysis was used to compare the immune response of dogs with HAC and healthy dogs. Pre-vaccination antibodies (≥10) were detected in 100% of dogs with HAC (11/11; 95% CI: 70.0–100) and in 93.5% of healthy dogs (29/31; 95% CI: 78.3–99.2). No ≥4-fold increase in antibody titer was observed in dogs with HAC while in 22.6% of healthy dogs, a ≥4-fold titer increase was observed (7/31; 95% CI: 11.1–40.1). Mild vaccine-associated adverse events (VAAEs) were detected in 54.5% of dogs with HAC (6/11; 95% CI: 28.0–78.8) and in 29.0% of healthy dogs (9/31; 95% CI: 15.9–46.8). There was neither a significant difference in presence of pre-vaccination antibodies (p = 1.000), or response to vaccination (p = 0.161), nor in the occurrence of VAAEs (p = 0.158). Immune function of dogs with HAC treated with trilostane seems comparable to that of healthy dogs.

SAFETY OF AND HUMORAL IMMUNE RESPONSE TO THE MERIAL RECOMBITEK CANINE DISTEMPER VIRUS VACCINE IN MANED WOLVES (CHRYSOCYON BRACHYURUS)

This study evaluated the safety of and humoral response to the Merial Recombitek^® recombinant canine distemper virus (rCDV) vaccine in maned wolves (n = 9, age 2-9 yr). All maned wolves had prior history of annual vaccination with the Merial Purevax^® ferret rCDV vaccine. Serum neutralization (SN) to CDV was measured prior to initial vaccination with the rCDV Recombitek vaccine followed by a booster vaccination at 4-6 wk. Final SN titers were obtained at 13 wk post initial vaccination. The maned wolves developed no observable adverse side effects through the study. Pre-Recombitek vaccination SN titers ranged from negative to 1: 8. Postvaccination CDV titers ranged from negative to 1: 8, and were therefore below the range of that considered protective in domestic dogs.

Basic Approach to Veterinary Care of Ferrets

The approach to preventive medicine and basic veterinary care in ferrets is very similar to that used in dogs and cats. Special equipment needs are minimal, and pet ferrets can be easily incorporated into a general small animal practice. This chapter describes the unique aspects of handling, restraint, and clinical and treatment techniques used in ferrets.

Systems Immunology Characterization of Novel Vaccine Formulations for Mycoplasma hyopneumoniae Bacterins

We characterized five different vaccine candidates and a commercial vaccine in terms of safety, immunogenicity and using a systems vaccinology approach, with the aim to select novel vaccine candidates against Mycoplasma hyopneumoniae. Seven groups of six M. hyopneumoniae-free piglets were primo- and booster vaccinated with the different experimental bacterin formulations, the commercial vaccine Hyogen® as a positive control or PBS as a negative control. The experimental bacterin was formulated with cationic liposomes + c-di-AMP (Lipo_AMP), cationic liposomes + Toll-like receptor (TLR) 2/1, TLR7, and TLR9 ligands (TLR ligands; Lipo_TLR), micro-particles + TLR ligands (PLGA_TLR), squalene-in-water emulsion + TLR ligands (SWE_TLR), or DDA:TDB liposomes (Lipo_DDA:TDB). Lipo_DDA:TDB and Lipo_AMP were the most potent in terms of serum antibody induction, and Lipo_DDA:TDB, Lipo_AMP, and SWE_TLR significantly induced Th1 cytokine-secreting T-cells. Only PLGA_TLR appeared to induce Th17 cells, but was unable to induce serum antibodies. The transcriptomic analyses demonstrated that the induction of inflammatory and myeloid cell blood transcriptional modules (BTM) in the first 24 h after vaccination correlated well with serum antibodies, while negative correlations with the same modules were found 7 days post-vaccination. Furthermore, many cell cycle and T-cell BTM upregulated at day seven correlated positively with adaptive immune responses. When comparing the delivery of the identical TLR ligands with the three formulations, we found SWE_TLR to be more potent in the induction of an early innate immune response, while the liposomal formulation more strongly promoted late cell cycle and T-cell BTM. For the PLGA formulation we found signs of a delayed and weak perturbation of these BTM. Lipo_AMP was found to be the most potent vaccine at inducing a BTM profile similar to that correlating with adaptive immune response in this and other studies. Taken together, we identified four promising vaccine candidates able to induce M. hyopneumoniae-specific antibody and T-cell responses. In addition, we have adapted a systems vaccinology approach developed for human to pigs and demonstrated its capacity in identifying early immune signatures in the blood relating to adaptive immune responses. This approach represents an important step in a more rational design of efficacious vaccines for pigs.

The serological response in dogs inoculated with canine distemper virus vaccine at the acupuncture point governing vessel-14: A randomized controlled trial

The improvement of immunity to vaccination has historically focused on manipulation of antigen presentation rather than the host. Immune modulation by stimulating specific acupuncture points along the Meridian System has been practiced in Traditional Chinese Medicine. The purpose of this study was to quantitatively determine whether acupoint vaccination, in which vaccine is administered at an acupuncture point in dogs, has the potential to enhance the immune response. A randomized controlled trial was conducted to compare the effectiveness of acupoint vaccination versus a conventional method, based on humoral immune response in dogs given Canine Distemper Vaccine (CDV). One hundred client-owned dogs were admitted to the study with following characteristics: (1) passed a routine physical exam, (2) aged between 1 and 10 years old, (3) had no history of chronic disease, and (4) were not on immunomodulating medications. Dogs were randomly assigned to either the Acupuncture group inoculated at the acupoint Governing Vessel (GV)-14, or to the Control group inoculated conventionally at a non-acupuncture site. Mean changes from Day0 to Day14 of the response to CDV vaccination, measured by serum neutralization (SN) titers with log-transformation for reducing outlier effects, were compared between groups. No significant difference was found between groups in age, weight, or sex (all p >0.2). Both groups had significant increases of CDV SN titer post-vaccination (p < 0.001). The mean increase in Acupuncture group (0.72; SD = 0.79) was significantly greater than that of the Control group (0.36; SD = 0.67); p = 0.019. Inference on percentage of change in raw SN titer data further revealed that the effects in the Acupuncture group was significantly greater than the Control group (242% vs. 83%; p = 0.02). This study demonstrated that Acupoint vaccination at GV-14 resulted in a significantly elevated humoral immune response to CDV vaccine compared to Controls, which suggests the potential of acupoint vaccination to enhance the immune response.

EVALUATION OF TWO CANINE DISTEMPER VIRUS VACCINES IN CAPTIVE TIGERS (PANTHERA TIGRIS)

Canine distemper virus (CDV) has caused clinical disease and death in nondomestic felids in both captive settings and in the wild. Outbreaks resulting in high mortality rates in tigers (Panthera tigris) have prompted some zoos to vaccinate tigers for CDV. In this study, six tigers received a recombinant canarypox-vectored CDV vaccine (1 ml s.c.) and were revaccinated with 3 ml s.c. (mean) 39 days later. Blood collection for CDV antibody detection via serum neutralization was performed on (mean) days 0, 26, and 66 post-initial vaccination. No tigers had detectable antibodies at days 0 or 26, and only two tigers had low (16 and 32) antibody titers at day 66. Eight additional tigers received a live, attenuated CDV vaccine (1 ml s.c.) on day 0 and were revaccinated with 1 ml s.c. (mean) 171 days later. Blood collection for CDV antibody detection via serum neutralization was performed on (mean) days 0, 26, 171, and 196. Seven of eight tigers receiving the live, attenuated vaccine had no detectable titers prior to vaccination, but all animals had titers of >128 (range 128-1,024) at day 26. At 171 days, all tigers still had detectable titers (geometric mean 69.8, range 16-256), and at 196 days (2 wk post-revaccination) all but two showed an increase to >128 (range 32-512). To determine safety, an additional 41 tigers were vaccinated with 2 ml of a recombinant vaccine containing only CDV components, and an additional 38 tigers received 1 ml of the live, attenuated vaccine, administered either subcutaneously or intramuscularly; no serious adverse effects were noted. Although both vaccines appear safe, the live, attenuated vaccine produced a stronger and more consistent serologic response in tigers.

Myofasciitis in the Domestic Ferret

Since late 2003, an inflammatory disease of muscle and fascia has been diagnosed in several ferrets at Northwest ZooPath, and this report describes the condition in 17 ferrets. It is a disease of young ferrets, characterized by rapid onset of clinical signs, high fever, neutrophilic leukocytosis, treatment failure, and death (or euthanasia). Gross lesions include atrophy of skeletal muscle; red and white mottling and dilatation of the esophagus; and splenomegaly. Histologically, moderate to severe suppurative to pyogranulomatous inflammation is in the skeletal muscle and the fascia at multiple sites, including esophagus, heart, limbs, body wall, head, and lumbar regions. Myeloid hyperplasia of spleen and/or bone marrow also is a prominent feature. Ultrastructural lesions include mitochondrial swelling, intracellular edema, disruption of myofibrils and Z bands. Bacterial and viral cultures, electron microscopy, immunohistochemistry, and polymerase chain reaction were negative for a variety of infectious agents. The clinical presentation and distribution of lesions suggests that polymyositis in domestic ferrets is likely a distinct entity. The etiopathogenesis if this condition is not known.

Assessment of safety and reproductive performance after vaccination with a modified live-virus PRRS genotype 1 vaccine in pregnant sows at various stages of gestation

The objective of the present study was to assess safety and efficacy of a new modified live-virus porcine reproductive and respiratory syndrome (PRRS) genotype 1 vaccine in pregnant sows at various stages of gestation under field conditions. A total of 505 sows and gilts were allocated to two treatment groups and maintained in separate facilities. Animals of group 1 were vaccinated with a commercial modified live genotype 1 PRRSV vaccine (control product, CP), while animals of group 2 were immunized with a new modified live genotype 1 PRRSV vaccine (investigational veterinary product, IVP) (ReproCyc® PRRS EU, Boehringer Ingelheim Vetmedica GmbH). Injection site reactions were noted to be significantly less frequent in the IVP group compared to the CP group for pain (p=0.039), redness (p=0.030), heat (p=0.016) and swelling (p=0.002). The mean total number of piglets alive at weaning did not differ significantly between both study groups (10.6 vs. 11.0, p=0.375). However, pre-weaning mortality was significantly higher (p=0.005) in piglets from the CP group (14.1% vs. 10.9%). Analyses of reproductive performance data for both groups did not result in statistically significant differences between CP group and IVP group for number of piglets alive (12.7 and 12.6, respectively), healthy live (11.9 and 11.8), weak (0.7 and 0.5), stillborn (1.0 and 0.8) and mummified piglets (0.3 and 0.2) per litter. No differences were detected between both groups for piglet birth weights, while body weights at weaning (7.2kg vs. 6.6kg, p=0.026) and average daily gain (0.2445kg vs. 0.2211kg, p=0.037) were significantly higher in piglets from the IVP group. In conclusion, the administration of a single dose of ReproCyc® PRRS EU to sows and gilts at various stages of gestation confirmed non-inferiority to a commercial PRRS vaccine regarding safety and efficacy parameters under field conditions.

2013 update on current vaccination strategies in puppies and kittens

Vaccines remain one of the practitioner's greatest tools in preventing disease and maintaining individual and population health. This article is an update to "Current Vaccination Strategies in Puppies and Kittens" published in Veterinary Clinics of North America, Small Animal Practitioner, in May 2006. There are now comprehensive guidelines readily available for small animal practitioners regarding canine and feline pediatric (and adult) vaccination recommendations. Perhaps more importantly, there is an increased dialogue regarding all aspects of preventive medicine, of which vaccination is only a small, yet significant portion; and an increased drive to provide scientific evidence for developing vaccination recommendations.

Origins of injection-site sarcomas in cats: the possible role of chronic inflammation-a review

The etiology of feline injection-site sarcomas remains obscure. Sarcomas and other tumors are known to be associated with viral infections in humans and other animals, including cats. However, the available evidence suggests that this is not the case with feline injection-site sarcomas. These tumors have more in common with sarcomas noted in experimental studies with laboratory animals where foreign materials such as glass, plastics, and metal are the causal agent. Tumors arising with these agents are associated with chronic inflammation at the injection or implantation sites. Similar tumors have been observed, albeit infrequently, at microchip implantation sites, and these also are associated with chronic inflammation. It is suggested that injection-site sarcomas in cats may arise at the administration site as a result of chronic inflammation, possibly provoked by adjuvant materials, with subsequent DNA damage, cellular transformation, and clonal expansion. However, more fundamental research is required to elucidate the mechanisms involved.

Safety of a non-adjuvanted therapeutic vaccine for the treatment of feline dermatophytosis

The safety of a non-adjuvanted inactivated fungal vaccine for the treatment of dermatophytosis in cats was investigated in two studies: a controlled laboratory study, and a placebo-controlled double-blind field study with a cross-over design in Europe. In the laboratory study, two groups of 10 cats each were administered an intramuscular twofold overdose, followed by five single 1 ml doses, of either vaccine or control product at 14-day intervals. In the field study, cats were treated with three intramuscular injections of 1 ml vaccine administered at 14-day intervals, as recommended by the manufacturer. A total of 89 cats were enrolled in the field study and divided into two groups to receive either vaccine or placebo for the first three treatments, followed by the opposite product for the final three treatments. The cats enrolled in the two studies were 12 weeks of age or older, as recommended by the manufacturer. All the cats were monitored closely for possible injection site reactions, systemic reactions (including changes in rectal body temperature) and adverse events. The results from both studies showed no significant differences between the vaccinated cats and the control or placebo-treated cats with regard to local or systemic reactions. A few mild to moderate local reactions were noted, but these were evenly distributed between the vaccinated and placebo-treated cats and resolved within a few days. No severe or serious adverse events related to the vaccinations were observed.

Duration of immunity induced by companion animal vaccines

Concerns about possible adverse effects from annual vaccination have prompted the reanalysis of vaccine protocols for cats and dogs. In the last decade, several veterinary advisory groups have published protocols that recommend extended revaccination intervals for certain ‘core’ vaccines. In addition, practicing veterinarians have been asked to consider vaccination as an individualized medical procedure, based on an analysis of risks and benefits for each vaccine in an individual animal. The calls for extended revaccination intervals prompted considerable debate in USA and internationally. Areas of concern include the amount of evidence to support prolonged immunity from various vaccines, the risk of poor responses in individual animals and the possible effects on population immunity. This review examines how the duration of immunity (DOI) to a vaccine is established in animals and humans. It reviews factors that can affect the DOI in an individual animal, including the types of immune defenses stimulated by the pathogen, and the vaccine, host factors such as age and the level of exposure to the pathogen. In addition, it examines DOI studies that were published for canine and feline core vaccines.

The senior ferret (Mustela putorius furo)

Ferrets are an increasingly popular pet in the United States. They are active, gregarious pets that delight their owners with playful antics. One of the issues that ferret owners and veterinarians have had to deal with is their shortened life span. Although literature cites the life span of the ferret as 8 to 10 years, most veterinarians see ferrets as "old" at as early as 3 years of age. Most information on senior ferrets has focused on neoplastic diseases. This article discusses husbandry and nutritional issues of the aging ferret, more commonly seen geriatric diseases, and diagnostic and treatment options.

FERRETS

This chapter familiarizes veterinarians with basic knowledge of ferret biology, medicine, surgery, and care. Ferrets have a long, slender body with short muscular legs, a long thin tail, small eyes, and short ears. The life span of the ferret is 5 to 8 years. Ferrets may be housed singly or in groups, inside or outside of a house. When kept outdoors, however, they must be protected from extreme weather. Ferrets have difficulty tolerating temperatures above 90°F or below 20°F, and appropriate precautions must be taken to prevent their exposure to these extremes. Ferrets are carnivorous and require a suitable diet. A diet that is high in good-quality animal protein and fat and low in complex carbohydrates and fiber is recommended. Ferrets are routinely immunized against canine distemper virus (CDV) and rabies virus. Ferrets are quite susceptible to CDV, and there is a 100% mortality rate in unvaccinated ferrets infected with CDV. When a new ferret is brought into the household, a quarantine period is recommended before introducing it to other animals, particularly other ferrets. The purpose of the quarantine period is to identify and prevent transmission of infectious disease potentially carried by the new ferret. The duration of this period allows for the development of any clinical signs in a seemingly healthy ferret following entrance into the new household.

Accidental introduction of viruses into companion animals by commercial vaccines

The use of biologics in veterinary medicine has been of tremendous value in safeguarding our animal populations from debilitating and oftentimes fatal disease. This article reviews the principles of vaccination and the extensive quality control efforts that are incorporated into preparing the vaccines. Examples of adverse events that have occurred in the past and how enhanced vigilance at the level of the veterinarian and the veterinary diagnostic laboratory help to curtail these events are discussed. Emphasis on understanding the ecology of viral infections in dogs and cats is introduced, together with the concepts of the potential role of vaccines in interspecies spread of viruses.

Adverse events after vaccine administration in cats: 2,560 cases (2002–2005)

OBJECTIVE

To determine the incidence of vaccine-associated adverse events (VAAEs) diagnosed within 30 days of vaccination in cats and characterize risk factors for their occurrence.

DESIGN

Retrospective cohort study.

ANIMALS

496,189 cats vaccinated at 329 hospitals.

PROCEDURES

Electronic records were searched for VAAEs that occurred after vaccine administration classified by practitioners as nonspecific vaccine reaction, allergic reaction, urticaria, shock, or anaphylaxis. Clinical signs and treatments were reviewed. The association between potential risk factors and a VAAE occurrence was estimated via multivariate logistic regression.

RESULTS

2,560 VAAEs were associated with administration of 1,258,712 doses of vaccine to 496,189 cats (51.6 VAAEs/10,000 cats vaccinated). The risk of a VAAE significantly increased as the number of vaccines administered per office visit increased. Risk was greatest for cats approximately 1 year old; overall risk was greater for neutered versus sexually intact cats. Lethargy with or without fever was the most commonly diagnosed VAAE. No localized reactions recorded in the 30-day period were subsequently diagnosed as neoplasia when followed for 1 to 2 years.

CONCLUSIONS AND CLINICAL RELEVANCE

Although overall VAAE rates were low, young adult neutered cats that received multiple vaccines per office visit were at the greatest risk of a VAAE within 30 days after vaccination. Veterinarians should incorporate these findings into risk communications and limit the number of vaccinations administered concurrently to cats.

The 2006 American Association of Feline Practitioners Feline Vaccine Advisory Panel Report

Vaccination is a medical procedure, and the decision to vaccinate should be based on a risk-based assessment for each cat and each vaccine.

Current vaccination strategies in puppies and kittens

Motivation in writing this article stems from many things: a lack of time spent in the veterinary curriculum discussing vaccines, a growing concern(by the general public and the veterinary community) regarding adverse reactions associated with vaccines, and a desire to prevent a recurrence of preventable infectious diseases resulting from a fear-driven cessation of vaccine administration. The objectives of this article are to present a basic review of immunology as related to vaccines, to discuss general guidelines for pediatric vaccines in canine and feline patients,and to offer suggestions as to how we can most positively influence our patients' health from the first visit.

Vaccine side effects: fact and fiction

The debate over adverse reactions associated with companion animal vaccination has considerably exercised the veterinary profession internationally over the past decade. A range of suspected adverse reactions to vaccines is reported including the onset of inflammatory, allergic, autoimmune or neoplastic diseases. Lack of efficacy, interference with diagnostic testing and other occasional suspected product-related issues are also reported. Available data suggest that the overall prevalence of true adverse reactions is exceedingly low and that vaccination does not significantly contribute to ill-health in companion animals. There is increasing public interest in vaccination issues with transfer of focus from publicity over human vaccine side effects to those perceived to occur in animals. We must not lose sight of the fact that vaccination is a safe procedure that has impacted significantly on infectious disease control. Reduced population uptake of vaccination leads to re-emergence of disease in both humans and animals. Nevertheless, there have recently been a series of practical recommendations produced to ensure reduced 'vaccine load' on our companion animals and vaccine manufacturers are moving towards developing non-adjuvanted products with an extended duration of immunity. These measures will further reduce the very small current risk of any adverse consequences to vaccination in our pet population.

A COMPARISON OF FREUND'S COMPLETE AND FREUND'S MODIFIED ADJUVANTS USED WITH A CONTRACEPTIVE VACCINE IN WILD HORSES (EQUUS CABALLUS)

Fifteen captive wild mares (Equus caballus) were treated with porcine zona pellucida contraceptive vaccine and either Freund's Complete Adjuvant (n = 7) or Freund's Modified Adjuvant (n = 8). All mares received a booster inoculation of porcine zona pellucida plus Freund's Incomplete Adjuvant a month later. Anti-porcine zona pellucida antibodies were measured over 10 mo following the initial inoculation. There were no significant differences in antibody titers at any point during the 10 mo, and seven of the eight mares in the Freund's Modified Adjuvant group were above the 60% level at the end of the study, which is considered to be the contraceptive threshold for horses. There were no significant differences in titers between pregnant and nonpregnant horses, nor was there a significant correlation between age and titers. One local injection site reaction occurred after booster treatment with Freund's Incomplete Adjuvant, and 11 healthy foals were born during the course of the study. These data suggest that Freund's Modified Adjuvant is an acceptable substitute for Freund's Complete Adjuvant in certain free-ranging and captive wildlife species.

Adverse events diagnosed within three days of vaccine administration in dogs

OBJECTIVE

To determine incidence rates and potential risk factors for vaccine-associated adverse events (VAAEs) diagnosed within 3 days of administration in dogs.

DESIGN

Retrospective cohort study.

ANIMALS

1,226,159 dogs vaccinated at 360 veterinary hospitals.

PROCEDURE

Electronic records from January 1, 2002, through December 31, 2003, were searched for possible VAAEs (nonspecific vaccine reaction, allergic reaction, urticaria, or anaphylaxis) diagnosed within 3 days of vaccine administration. Information included age, weight, sex, neuter status, and breed. Specific clinical signs and treatments were reviewed in a random sample of 400 affected dogs. The association between potential risk factors and a VAAE was estimated by use of multivariate logistic regression.

RESULTS

4,678 adverse events (38.2/10,000 dogs vaccinated) were associated with administration of 3,439,576 doses of vaccine to 1,226,159 dogs. The VAAE rate decreased significantly as body weight increased. Risk was 27% to 38% greater for neutered versus sexually intact dogs and 35% to 64% greater for dogs approximately 1 to 3 years old versus 2 to 9 months old. The risk of a VAAE significantly increased as the number of vaccine doses administered per office visit increased; each additional vaccine significantly increased risk of an adverse event by 27% in dogs < or = 10 kg (22 lb) and 12% in dogs > 10 kg.

CONCLUSIONS AND CLINICAL RELEVANCE

Young adult small-breed neutered dogs that received multiple vaccines per office visit were at greatest risk of a VAAE within 72 hours after vaccination. These factors should be considered in risk assessment and risk communication with clients regarding vaccination.

A space-time cluster of adverse events associated with canine rabies vaccine

Electronic medical records of a large veterinary practice were used for surveillance of potential space–time clustering of adverse events associated with rabies vaccination in dogs. The study population was 257,564 dogs vaccinated in 169 hospitals in 13 US metropolitan areas during a 24-month period. Using a scan statistic for population rate data, significant space–time clusters were identified involving the Atlanta and Tampa/St. Petersburg areas during a 4-month period. Separate spatial–temporal analyses of these cities using coordinates for individual address coordinates identified one significant patient cluster (P = 0.002), associated with a 23.26 km-radius area in Atlanta (20 adverse events in 702 dogs; 2.85%) from November 2002 through February 2003. This percentage of adverse events was significantly increased after adjustment for host-related factors and the number of concurrent vaccinations.

Incidence of and risk factors for adverse events associated with distemper and rabies vaccine administration in ferrets

OBJECTIVE

To determine incidence of and risk factors for adverse events associated with distemper and rabies vaccine administration in ferrets.

DESIGN

Retrospective cohort study.

ANIMALS

3,587 ferrets that received a rabies or distemper vaccine between January 1, 2002, and December 31, 2003.

PROCEDURES

Electronic medical records were searched for possible vaccine-associated adverse events. Adverse events were classified by attending veterinarians as nonspecific vaccine reactions, allergic reactions, or anaphylaxis. Patient information that was collected included age, weight, sex, cumulative number of distemper and rabies vaccinations received, clinical signs, and treatment. The association between potential risk factors and occurrence of an adverse event was estimated with logistic regression.

RESULTS

30 adverse events were recorded. The adverse event incidence rates for administration of rabies vaccine alone, distemper vaccine alone, and rabies and distemper vaccines together were 0.51%, 1.00%, and 0.85%, respectively. These rates were not significantly different. All adverse events occurred immediately following vaccine administration and most commonly consisted of vomiting and diarrhea (52%) or vomiting alone (31%). Age, sex, and body weight were not significantly associated with occurrence of adverse events, but adverse event incidence rate increased as the cumulative number of distemper or rabies vaccinations received increased. In multivariate logistic regression analysis, only the cumulative number of distemper vaccinations received was significantly associated with the occurrence of an adverse event.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that in ferrets, the risk of vaccine-associated adverse events was primarily associated with an increase in the number of distemper vaccinations.

Incidence of adverse events in ferrets vaccinated with distemper or rabies vaccine: 143 cases (1995-2001)

OBJECTIVE

To determine the incidence of adverse events in ferrets vaccinated with a modified-live avian cell culture canine distemper virus vaccine licensed for use in ferrets, an inactivated rabies vaccine licensed for use in ferrets, or both.

DESIGN

Retrospective study.

ANIMALS

143 ferrets.

PROCEDURE

Medical records were reviewed to identify ferrets that had an adverse event after vaccination.

RESULTS

Adverse events developed within 25 minutes after vaccination in 13 ferrets. One ferret developed an adverse event after receiving a distemper and a rabies vaccine simultaneously and developed a second adverse event the following year after receiving the rabies vaccine alone. Therefore, a total of 14 adverse events were identified. All adverse events were an anaphylactic reaction characterized by generalized hyperemia, hypersalivation, and vomiting. Ten of the 14 anaphylactic reactions occurred after ferrets received both vaccines, 3 occurred after ferrets received the distemper vaccine alone, and 1 occurred after a ferret received the rabies vaccine alone. Incidences of adverse events after administration of both vaccines, the distemper vaccine alone, and the rabies vaccine alone were 5.6, 5.9, and 5.6%, respectively. Ferrets that had an anaphylactic reaction were significantly older at the time of vaccination than were ferrets that did not.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that there may be a high incidence of anaphylactic reactions after vaccination of domestic ferrets. Ferrets should be observed for at least 25 minutes after vaccination, and veterinarians who vaccinate ferrets should be prepared to treat anaphylactic reactions.

Adjuvants in veterinary vaccines: modes of action and adverse effects

Vaccine adjuvants are chemicals, microbial components, or mammalian proteins that enhance the immune response to vaccine antigens. Interest in reducing vaccine-related adverse effects and inducing specific types of immunity has led to the development of numerous new adjuvants. Adjuvants in development or in experimental and commercial vaccines include aluminum salts (alum), oil emulsions, saponins, immune-stimulating complexes (ISCOMs), liposomes, microparticles, nonionic block copolymers, derivatized polysaccharides, cytokines, and a wide variety of bacterial derivatives. The mechanisms of action of these diverse compounds vary, as does their induction of cell-mediated and antibody responses. Factors influencing the selection of an adjuvant include animal species, specific pathogen, vaccine antigen, route of immunization, and type of immunity needed.