No shots for you!

So, let's say you are totally, completely against vaccines. Or you are the proud pet parent of a dog who has allergic reactions to vaccines. Now what?

This is where the art of medicine starts to play more of a role. Each pet is an individual. And we, as veterinarians, need to keep this in mind and be ready to tailor protocols to meet the individual's needs, keeping health and safety in mind at all times. This, folks, is the basis of the concept of holistic medicine- treating the whole patient. We vets do it almost without thinking every day. There is very little that is set in stone for us.

Vaccines are very important. They keep our pets protected from life-threatening diseases, and some diseases that may not be life-threatening, but can be debilitating. These same vaccines also help protect the people in our pets' lives, as well. There are several diseases that we can catch from the animals in our lives. Rabies is one obvious one. Leptospirosis, a bacteria that affects the liver and kidneys, is another. If a pet is able to get a recommended vaccine, I strongly urge owners to comply.



But some won't, and some can't. So now what?

There are a few options for vaccines. If you have a dog or cat that gets a mild reaction to the vaccine (like hives or mild vomiting) we can pre-medicate with a steroid and Benadryl, or a steroid or Benadryl. This helps to decrease the immune system's response to the perceived immune trigger. Most of the time this seems to help.

If, however, your pet has had a more severe reaction, or has had a reaction despite pre-medication, we may consider other options. One option is to choose to stop giving vaccines. I cringe a little as I type this, because discontinuing the vaccines carries inherent risks. Therefore, anytime I have this discussion with a pet's people, I try to make it very clear that we are balancing risks and benefits, and in choosing to not vaccinate we are incurring some risks that need to be known. We are knowingly leaving a gap in out pet's immunity. The risk of life-threatening parvo or distemper in an adult, otherwise healthy dog that has at least had the puppy series of vaccines is probably fairly low. But it does exist. There is always a risk of being exposed to, and contracting, kennel cough. Or lepto.

Choosing to stop vaccines means most kennels and pet resorts will not board your pet. You may need to make other arrangements when you go out of town. Some groomers require up to date vaccines for grooming appointments. Don't be mad at them- they have responsibility to keep all of the pets in their care safe.

There are tests for the level of immunity in a pet's system. You may have heard of titer tests. If you are against vaccines on principle, you may have discussed them with your vet. Titer tests can be helpful, but they are not perfect.

A titer is the concentration of something. A titer test is a test to determine the concentration of that thing. The way this works with immunity, a blood sample is drawn at the vet's and sent to a laboratory. The lab technicians (or a machine) place drops of the blood sample into small vials. They serially dilute each sample. In other words, the vials will have all blood, 1/2 blood. 1/4 blood, 1/16 blood, 1/32 blood, etc. They then check to see at what dilution the blood sample stops reacting to an analog for the disease. The last one to react is reported back to us. I get a report that says something like- titer IgG parvo 1:400 (making up the details here). Then I compare that ratio number to what is generally considered to be protective immunity. This gives us a yes or know answer to the question: is my pet protected from this disease?
Sounds cool, right? Blood test says yes, there is protection, then there is no need to vaccinate this year. Blood test says no, then we need the shot. Great. Next patient, please....

Problem is this- titer immunity does not necessarily correlate to true protection. UGH

We use the test anyway. I get titer tested periodically to see if my rabies vaccines I got a decade ago are still effective. We send blood to Kansas to be tested for pets going to Hawaii or Europe- they must be rabies titered. But I don't titer my own pets in place of vaccines. I give the shots.

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Why? I believe that the immunity given by the shots is important. I believe that the titers are useful, but not absolute. I believe that the risk associated with vaccines is much smaller than the risk of disease. I want to take advantage of the amazing, incredible protection modern medicine is able to provide. But that's my decision, for my pets. If you want to discuss the ins and outs of vaccines for your pets, I will. I have many pets that have altered vaccine schedules, a few that I do not vaccinate at all. Holistic. Individual. Tailored.

Enjoy your pets!