Improve your vaccine adverse event response with 3 practical tips

In this dvm360 interview, Christopher Lee, DVM, MPH, DACVPM, DACVM (Parasitology), shares 3 practical tips drawn from his upcoming sessions at the Fetch dvm360 Conference in Long Beach, California. Lee breaks down some of the most common pitfalls he sees in vaccine adverse event management and offers clear, actionable guidance for everyday practice.

Tip 1: Epinephrine for anaphylaxis

Lee: Vaccines save more lives than any other single thing that we do, and yet they become scary, right, especially when you have an adverse event, and there's several types, and sometimes it's always good to have a refresher on which type is which. But one of the most common ones, and the ones that we get so scared about, is anaphylaxis, which can lead to the death of a pet. And I will say that, having spoken across the country, talked to many veterinarians, nine out of 10 vets do not use the right medication. They miss the most significant medication. When I see, when you see anaphylaxis, right? You have a dog, swollen face, urticaria. Maybe they're in shock. You're worried that this is a life-threatening situation. It's most common for them to give Benadryl and [dexamethasone] and supportive care. And that's not wrong. But as you said yourself, Bob, for someone that carries an EpiPen, what is the thing that we carry if we have a risk [of] anaphylaxis? We carry an EpiPen. It's not...we don't have a little Dex pen. We don't have a little [Benadryl] pen. We have an EpiPen. And if we take a look at it from when you talk to immunologists, critical care people, what is the cornerstone medication? If you could give one medication, what would that be? It is epinephrine.

RELATED: Put epinephrine first in anaphylaxis management

Tip 2: Know your hypersensitivity reactions

Lee: Yeah, we need to be able to differentiate type one through four. We see them all within practice. Type I, of course, is anaphylaxis. Type II is the other really scary one: IMHA (immune-mediated hemolytic anemia) and IMTP (immune-mediated thrombocytopenia). When we think of those, are they truly from vaccines? Again, come to the lecture. Type III, we get those little bald spots secondary to some vaccines, and Type IV we get lumps. So what we do for those and how we address and prevent each of them is remarkably different.

Tip 3: Vaccine location

Lee: I, you know, many years ago, we just gave all vaccines [in this group], and we learned the hard way about the errors of that with cats, right? So now we spread them out and we put them very low on the body. We now are doing that with dogs. The problem is that it's very common when we are worried about, "Oh, I really don't want to have an adverse event with this. I really want to take care. I want to do the best medicine," and we have a in front of us. As a profession, I'm seeing a lot of people putting those vaccines low on the limbs, and that is problematic. That is not helping the pet. In fact, it's working against us. So if there's one thing that I would ask all of us to do: for cats, keep everything low. For dogs, keep everything high. It's going to be a lot more comfortable and you're going to have [fewer problems].