Another set of guidelines? Yes! This update will help keep dogs that frequent your veterinary practice footloose and disease-free.
"Do I really need this vaccine?" Yep! (Shutterstock)
We veterinarians out here on the front line always appreciate published guidelines to help us defend our recommendations to concerned clients. The last vaccination guidelines were published in 2011 and since that time, new vaccines have come on the scene. So what's a practicing vet to do? We asked and AAHA answered with an updated set of guidelines.
Of course, AAHA reminds us, all recommendations should be based on the needs of an individual patient. The guidelines help us in this endeavor by providing a “Lifestyle-Based Vaccine Calculator” (click here) to help veterinarians easily tailor their vaccine protocols to patients.
Different from years past, the guidelines now offer strategies for handling dogs that are past due for vaccinations. According to Link Welborn, DVM, DABVP, chair of the AAHA Canine Vaccination Guidelines Task Force, this is the first time practitioners have had official suggestions for how to handle these common cases. Also, there are pages devoted to shelter dogs and antibody testing.
Don't vex the vax!
When it comes to proper vaccine handling, keep these two vital ground rules in mind:
1. Avoid prolonged storage of vaccines in a box (or dorm) fridge because of freeze risk.
2. Be sure to administer a vaccine within one hour of reconstitution.
Let's get to the core (or noncore)
As in years past, a basic premise of the guidelines is that some vaccinations are considered core, or recommended for all dogs. Vaccines classified as noncore might be individually reclassified as core for some dogs based on region, lifestyle and other parameters.
CORE: Canine distemper virus, canine parvovirus and canine adenovirus
Similar to the guidelines in 2011, canine distemper virus (CDV), canine parvovirus (CPV), canine adenovirus-2 (CAV-2) and rabies (see below) are core vaccines. The first puppy vaccination for CDV may begin as early as 6 weeks of age and be boostered anywhere from two to four weeks later, as long as the final booster is given no earlier than 16 weeks of age. It's important to note that 16-week-old dogs receiving their first CDV vaccine must be boostered again in two to four weeks to ensure immunity. So whatever protocol your hospital chooses, be sure that you begin no earlier than 6 weeks of age and finish no earlier than 16 weeks. You might consider an additional dose at 18 to 20 weeks for those pups in a truly high-risk situation.
Dogs that are over 5 months of age at the time of their first vaccination for CDV/CPV may have adequate immunity with a single dose but can receive a booster two to four weeks after the initial dose. The protocol suggests that the next booster be given within a year of finishing the puppy boosters. And after the first adult yearly booster, the vaccine is expected to provide adequate protection for at least three years.
Because CPV is often a component of the combination puppy vaccines, it's important to note that as of 2017, all CPV vaccines on the market are intended to protect against all known field strains of the virus.
Because these combination vaccines require mixing before administration, it's important that they be considered nonviable one hour after reconstitution; they must be discarded.
Because of zoonotic potential, rabies vaccines are also considered core. Many states have laws governing the administration of this vaccine. You can check your state's individual laws by visiting www.aaha.org/CanineVaccineResources. The first rabies vaccine ideally should be given between 12 and 16 weeks of age, but the laws vary depending on the state. The second dose must be administered within one year, regardless of the patient's age. Usually veterinarians can choose whether to administer the one-year-labeled product or the three-year-labeled product, but be sure to consult your local laws. Always follow the label recommendations for the product you choose when advising the client of the interval for revaccination.
In most states, veterinarians are not allowed to exempt pets from rabies requirement laws, regardless of medical reasons, even in the case of allergic reactions.
NONCORE: Bordetella bronchiseptica/parainfluenza virus
This vaccine is intranasal (IN). Dogs and puppies that are likely to be exposed may be given the vaccine between 8 and 16 weeks of age. Because maternal immunity does not interfere with immune response to mucosal administration, this vaccine may be given as early as 3 to 4 weeks of age if the risk of infection is high. The vaccine is typically given at one of the puppy visits already planned for CDV/CPV combination vaccines. A booster is not required sooner than one year after the initial administration. More frequent boosters have been proven unnecessary.
Immunity can be expected as early as 48 to 72 hours after IN administration.
NONCORE: Bordetella bronchiseptica monovalent
Monovalent B. bronchiseptica is available in three options-a parenteral preparation administered subcutaneously, an IN vaccine that's an avirulent live product or an intraoral product administered in the buccal pouch of the mouth. Only the parenteral product is boostered, requiring two doses two to four weeks apart and then yearly. The other products are considered effective with a single dose that is repeated at yearly intervals if the dog is considered likely to be exposed. The oral and parenteral vaccines can be started at 8 weeks of age, but the IN vaccine may be given as early as 3 to 4 weeks of age in puppies thought to be at specific risk of exposure, like shelter or rescue animals housed in groups.
The oral and injectable products have no duration of immunity studies to indicate how long the immunity really lasts.
NONCORE: Four-serovar Leptospira (killed)
The first administration of this leptospirosis vaccine is allowable as soon as 8 weeks of age, and it must be boostered two to four weeks after the initial dose, regardless of the dog's age. In dogs deemed to be at risk for exposure, the vaccine should be administered one year after the initial series and then annually.
Lepstospirosis is a zoonotic disease, so protection can be especially important. Unfortunately, immunity to one serovar provides little protection from the others, so a four-serovar product is recommended to give the most immunity.
NONCORE: Borrelia burgdorferi (canine Lyme disease)
Dogs in endemic areas may be at risk for infection and may benefit from vaccination. The first vaccination may be given at 8 or 9 weeks of age (check the label for specific recommendations). Regardless of the dog's age at first vaccination, a second booster will be required in two to four weeks.
Travel to endemic areas may increase the risk to dogs not routinely exposed, so consider vaccination. In these cases, two doses should be given at two- to four-week intervals with the second dose given two to four weeks before travel.
NONCORE: Canine influenza virus (CIV) H3N8 and H3N2
The first dose can be given at 6 weeks of age or older. Vaccines containing either strain of CIV will require a booster two to four weeks after the initial dose. Yearly boosters are recommended for dogs in at-risk situations.
In dogs considered at risk, the first dose of the vaccine should be given four weeks prior to the challenge (e.g. boarding, daycare) to allow for the second dose to be given two weeks later and still allow for two more weeks so immunity can develop. A dog considered at risk should be given both strains, H3N8 and H3N2.
NONCORE: Crotalus atrox (western diamondback rattlesnake)
This vaccine is given subcutaneously. No specific guidelines are given beyond the label guidelines for this vaccine, though the guidelines note that it should only be administered to at-risk dogs.
Advice just a click away
These AAHA guidelines help all veterinarians have a jumping-off point for their own recommendations. At the end of the day, each practitioner knows the risks in their own area and knows how likely their clients are to follow all recommendations. It comes down to a balance between best care, individual risks, client communication and inventory costs. Note that these new guidelines have been reviewed by a panel of experts and compiled using the latest information.
My advice on the sometimes prickly topic of vaccinations: If you don't believe in something, you will never convince anyone else to. You owe each and every one of your canine patients your time in learning these guidelines and a risk assessment to offer individualized care. Because the guidelines are now available as an online educational resource, they can be readily updated and kept current, so we would all be well-served to bookmark the website.
Kathryn Primm, DVM, owns Applebrook Animal Hospital in Ooltewah, Tennessee, and has a growing career as a writer, speaker and online voice for veterinarians and pet owners alike. Dr. Primm is the author of Tennessee Tails: Pets and Their People. She was also the nation's first Fear Free certified professional.