Where’s the “Controversy” in the Vaccine Controversy?

By Jennifer Coates, DVM on Feb. 23, 2015

The ongoing human measles outbreak has brought the term “vaccine controversy” back into the news, but every time I hear it I want to scream. There is NO controversy. Vaccination against a myriad of diseases, including measles, has saved countless lives. To prevent children from benefitting from the benefits of vaccination is… I’m searching for a politically correct word here… illogical.

You might wonder what any of this has to do with veterinary medicine. Well, veterinarians run into vaccine naysayers all the time. Now before I get inundated with nasty comments, I want to be clear that I am not talking about owners who want (and deserve) to have a rational conversation about which vaccines their pets actually need. Current guidelines divide recommended vaccines into “core” and “noncore” categories.

Every animal should receive its core vaccinations. Exceptions should only be made when a serious health concern (e.g., a previously documented anaphylactic reaction) makes the risk outweigh the benefits of vaccination.

Noncore vaccines should be given to some individuals but not others. The decision is mostly made based on a pet’s lifestyle and the incidence of disease in the area. Examples of noncore vaccines include parainfluenza virus and Bordetella bronchiseptica for dogs and feline leukemia virus (FEV) for cats.

Core Vaccines for Dogs

Rabies
Canine Distemper Virus
Canine Adenovirus Type 2
Canine Parvovirus Type 2

Core Vaccines for Cats

Rabies
Feline Viral Rhinotracheitis (Herpes Virus)
Panleukopenia (Feline Distemper)
Calicivirus

Vaccine titers are available for owners who are interested in keeping the number of vaccinations their pets receive to an absolute minimum. Adult booster shots can be delayed until a titer reveals that the pet has inadequate antibody levels in their bloodstream.

This system does a great job of protecting pets from disease while simultaneously preventing the administration of unneeded vaccines, but it isn’t enough to convince everyone.

When I am faced with an owner who is reluctant to vaccinate, I try to explain my approach to medical decision making. Every choice involves risk. There is risk involved with action and there is risk involved with inaction. If you don’t vaccinate your pet, yes, you eliminate the chance of an adverse vaccine reaction, but you greatly increase the risk of that individual becoming ill or even dying from the disease in question. When a veterinarian designs an appropriate vaccination schedule for a particular pet, the risk from disease is always much higher than is the risk from vaccination.

And it’s important to remember that vaccination doesn’t just protect the pet getting the vaccine. Herd immunity develops when a large enough proportion of the population has been vaccinated against a particular disease. Vaccinated individuals prevent the disease from gaining a foothold in the community, which keeps individuals who cannot be vaccinated safe. Some pet vaccines can even protect people. Several years ago, one of my unvaccinated patients exposed me, a veterinary technician, and his owners to rabies.

We are currently seeing the devastating effect that poor vaccine decision making can have in the human measles outbreak, as well as an outbreak of canine distemper in Texas. It’s not surprising that these diseases have responded to a lack of herd immunity in similar ways; the causative viruses are closely related to one another (in the past the human measles vaccine was used to protect young puppies from distemper). Hopefully, these outbreaks will also fade in a similar manner and both parents and pet owners will renew our commitment to vaccination before the next outbreak occurs.