Not long ago I saw Miss Lola, one of my cutest little Poodle patients. (Why are they all named Lola?) After spending the better part of her first year of life suffering from  various and sundry gastrointestinal maladies, she’d finally been free of us for over three months. And so it was that yesterday, during her first annual checkup (technically undertaken at sixteen months of age), Lola seemed in perfect health.

Today, however, is another story.

Last night, ‘round about 9 P.M., her owner called me, frantically describing symptoms that are typical of a mild vaccine reaction. No vaccine reaction is ever "mild" from a pet owner’s point of view, but this presupposes that said owner has never witnessed a severe reaction. (Everything’s relative, isn’t it?)

When I saw Lola today she was slightly feverish (102.4) and moderately painful all over — more so at the injection site. It was a classic, mild vaccine reaction for which I prescribed a small dose of Rimadyl after administering subcutaneous fluids. Her owner called later to report that Lola was already feeling better.

Lola’s experience notwithstanding, the lion’s share of vaccines seem to provoke no illness. The pet is vaccinated in hospital and goes home within fifteen minutes, where no untoward effects of the vaccine are typically noted.

Most reactions we do see include swelling of the muzzle and face, myalgia (muscle pain) and fever, and less commonly, vomiting. These are often treated with antihistamines and pain relievers. The most severe, life-threatening reactions are very rare indeed. The only one I have had the displeasure to attend occurred in vet school when a cat, vaccinated at a nearby hospital, suffered acute respiratory distress almost immediately after a vaccine was administered. The kitty died — very quickly, I might add.

Lest I forget, let me now mention another more common, if controversial, life-threatening reaction: the vaccine-related sarcoma. As the cat people among you probably already know, vaccine-related, highly-malignant tumors are sometimes seen in cats. Although it was difficult to prove, this disease has finally received its due respect as a phenomenon related directy to vaccination. Our hospital has only seen four or five possible cases in over thirty years, but it’s out there as a potential consequence of vaccine administration.

My goal here is not to scare the bejeezus out of you, just to inform you of how we vets think about vaccines. We know they’re potentially dangerous. We all worry about the possibility of a reaction. And that extends to our families, too. I didn’t have my own son vaccinated without trepidation either, but — believe it or not — I consider it my civic duty to vaccinate myself and my whole family, pets included.

If you want to discuss safety, here’s the reality: In a population where 100 percent of the individuals are vaccinated, the safest condition is to be the only unvaccinated one. The implication here is that vaccination has its risks. Best not to receive the vaccine. But if everyone opts out, no one’s protected. A conundrum, indeed.

Why else would we have Federal mandates for early vaccination in children? Why is rabies vaccination mandatory for our pets? Because if everyone is given free leeway to eschew vaccines, protection is not possible for the population as a whole.

Opting out is always possible — I, myself, sign "not in best interest" forms (for extreme geriatrics and ill patients) on a regular basis, but the government does everything in its power to thwart these efforts. And it should. Whatever your vaccine politics, it’s hard to deny that without this approach we’d still be suffering from smallpox and polio.

In our highly individualistic society, we’re trained to consider our self-interest in a positive light, regardless of connotation. And science has opened its doors to public scrutiny in ways heretofore unseen by our culture. It stands to reason that we might hesitate to expose our dearest loved ones to newly revealed risks.

With our newfound knowledge comes the need to understand the very real dangers of not vaccinating, as well as the responsibility to demand more safety from basic medical products like vaccines. But opting out is no answer to the dilemma — it only puts your child, your pet, yourself, and society at large in harm’s way.

Alternatives for the "no vaccine" movement are out there. For example, science demonstrates that antibody titers from vaccines remain active for many years beyond the previously accepted norms. In our hospital, this finding led us to change our vaccine protocols a couple of years back.

We vaccinate every three years with few exceptions. We don’t administer vaccines for illnesses not seen in our area (however, we do ask about travel plans). We don’t vaccinate for kennel cough unless a dog is at risk due to his habits (puppy park, day care, kennel stays, etc.). We give intranasal vaccines whenever possible. We don’t ever administer feline leukemia to indoor cats (it’s the one vaccine most closely associated with sarcomas). And we vaccinate every cat on its hind limbs (under the skin near the ankle) so that any potential tumors can be removed without removing the whole cat.

You can be sure that the same considerations are taking place in human medicine at all levels. Mercury, autism, cancer and other potentially immune-mediated diseases are too scary for parents to ignore. But what can we do? Failure to vaccinate means a failure to attend to society’s needs because we consider ourselves and our children more important than others. Even if that’s how we feel, our understanding of the science of vaccination should help us get past it.

 

Dr. Patty Khuly