Vaccines, as I have mentioned many times on this blog, are perennially controversial. Many people worry that pets are vaccinated too often. Experts voice concerns that over vaccination may lead to autoimmune disease. Leukemia and rabies vaccines in cats have been linked to cancers at the injection sites.

The obvious goal for every veterinarian and conscientious pet owner should be to vaccinate pets neither too frequently nor too rarely. In an ideal world, we would vaccinate pets exactly as often as necessary. I predict that in the future this will be the norm. But as of 2009, it is impossible to say how often pets need vaccinations.

Some facts are clear. Juveniles (puppies and kittens) need vaccines more often than adults. Animals with different lifestyles need different vaccination protocols. And most important, every individual responds differently to vaccines. Every individual therefore has unique needs.

Measuring those needs is impossible. Blood tests called titers give some idea of a pet’s response to previous vaccinations, but titers measure only half of the picture. Titers measure antibody levels in the blood. However, antibodies cannot function without another component of the immune system called cell-mediated immunity. At this time there is no way to measure cell-mediated immunity. Therefore there is no way to measure a pet’s true level of immunity to disease.

I agree that many pets are vaccinated more often than necessary. On several instances I have treated animals for autoimmune disease and wondered whether vaccines might have contributed to the problem.

However, on hundreds of instances I have treated canine parvovirus. In every single one of these cases I knew with certainty that vaccination would have prevented the problem. I never have treated a properly vaccinated dog for parvo. The vaccine works.

I euthanized a 12-week-old puppy today because of parvo. A vaccine could have saved his life if it had been administered at the right time.

Over vaccination is a bad thing. Veterinarians and pet owners should work to prevent it. But don’t forget that under vaccination is even worse.

Your best option as a pet owner is to find a good vet who will take the time to discuss the controversies surrounding vaccines. Tailor a vaccination protocol to your pet based upon his or her needs, age, and lifestyle.

Share this entry with your pawple anywhere:

• Are Pets Being Over-Vaccinated?
• Where do Vaccine-Associated Tumors Develop in Cats?
• Why Aren’t Titers Used in Lieu of Vaccines?
• What are the Rationales Behind Rabies Vaccine Schedules?
• JAVMA Study Reveals Many Vets Aren’t Following Feline Vaccination Guidelines

Hi Dr. Barchas,
I know that the feline rabies vaccine has been associated with fibrosarcomas at the site of injection. Is it possible for the vaccine to cause tumors in other locations? Someone told me that the three-year rabies vaccine was more likely to cause cancer – is this true?

Tera
Columbus, OH

You have asked some very good questions. I’ll do my best to answer each of them.

Vaccine-associated fibrosarcomas are cancers that develop rarely at the site of rabies or feline leukemia vaccines. They appear to occur only in cats. The cause of the tumors is very poorly understood.

The cancers develop at the site of injection. I have not seen any reports of vaccines causing tumors in distant locations. Therefore, it is extremely unlikely that your cat’s abdominal tumor was linked to a vaccine. Fibrosarcomas can develop naturally, and if your cat suffered from a fibrosarcoma in her abdomen it likely occurred spontaneously. I sincerely doubt that your decision to vaccinate your cat contributed to her death.

Three-year rabies vaccines usually contain a component called adjuvant that is designed to help stimulate the immune system. One-year vaccines generally do not contain this component. Some people have hypothesized that adjuvant contributes to fibrosaroma development. These people therefore speculate that the one-year vaccine may be less likely to cause cancer than the three-year vaccine. I have not seen conclusive proof of this.

For instance, some studies have suggested that merely inserting a needle into the skin may trigger a cascade of inflammation that ultimately leads to cancer. This implies that the adjuvant is not to blame.

Also, remember that one-year vaccines must be given three times as often as three-year vaccines. The relevant question therefore is whether one-year vaccines are three times less likely to lead to cancer.

A few years ago I attended a lecture by a representative of a company that produces one-year, non-adjuvanted feline rabies vaccines. After the lecture I cornered her (literally–she was trying to get away and I backed her into a corner) and asked the following question. I remember it verbatim.

Can you provide quantitative evidence that three-year vaccines are three times more likely to cause cancer as your one-year, non-adjuvanted vaccine?

Her answer was no. To this day I have not seen any study that proves that three one-year vaccines are safer than one three-year vaccine (if anyone is aware of such a study, please let me know).

It is unlikely that your remaining cat will develop a fibrosarcoma from her rabies vaccine. Fibrosarcomas develop in approximately one out of every 3000 – 10,000 cats that receive the vaccine. I have no reason to believe that your cat is at increased risk.

Although vaccine-associated fibrosarcomas are not common, I still recommend that you never accept a one-size-fits-all vaccination plan for your pet. Good vets always are willing to talk about the risks and benefits of vaccination. Make an informed decision.

Photo: Myriah after removal of a vaccine-associated fibrosarcoma.

Share this entry with your pawple anywhere:

• Despite Controversy There is no Doubt That Vaccines Save Lives
• JAVMA Study Reveals Many Vets Aren’t Following Feline Vaccination Guidelines
• Why is it Fair for Dogs, but not Cats, to go Outside?
• Are Oral Tumors Common in Two-Year-Old Cats?
• Why Aren’t Titers Used in Lieu of Vaccines?

In 1991 veterinary medicine suffered a disturbing revelation. Two commonly used feline vaccines were linked to the development of malignant tumors at the site of vaccination. The tumors, called fibrosarcomas, are associated with the vaccines for rabies (in cats only) and feline leukemia. They are aggressive and difficult to remove. They occur in approximately one out of every 3000 – 10,000 cats who receives a rabies or leukemia vaccine.

The discovery of these so-called vaccine associated fibrosarcomas lead to the creation of a special task force (called, unsurprisingly, the Vaccine Associated Fibrosarcoma Task Force). The recommendations of the task force were supposed to cause a dramatic shift in the way cats are vaccinated.

Prior to the discovery of the fibrosarcomas and the formation of the task force, most cats were vaccinated against rabies and leukemia every year. The vaccines were administered between the shoulder blades because that is the easiest place to give injections to cats.

The task force recommended that the leukemia vaccine should be administered only to cats who spend time outdoors. The rabies vaccine should be administered as required by law. If possible, both vaccines should be administered no more frequently than once every three years.

Finally, the task force advised veterinarians to change injection sites. Fibrosarcomas between the shoulders are virtually impossible to remove. Therefore, the leukemia vaccine should be administered in the left rear leg, near the ankle. The rabies vaccine should be administered similarly in the right rear leg. If a fibrosarcoma develops in either of these locations, the cat’s life can be saved by amputating the leg–a less than perfect solution to the problem, but better than the alternative.

Vaccine associated fibrosarcomas are a source of angst for me. I have worked during my career to minimize the number of rabies and leukemia vaccines I give to cats. And I always give the vaccines in the rear legs.

However, a very disturbing paper published in the February 1, 2009 Journal of the American Veterinary Medical Association (JAVMA) indicates that many veterinarians are ignoring the recommendations of the task force and needlessly endangering the lives of their feline patients. According to the paper, significant numbers of cats are developing vaccine associated fibrosarcomas between their shoulder blades. This means that significant numbers of veterinarians are still giving rabies and leukemia vaccines in that spot.

Here are the conclusions of the paper.

Conclusions and Clinical Relevance–Despite publication of the vaccination recommendations, a high proportion of tumors still developed in the [region between the shoulder blades] . . . [v]eterinarians are complying with vaccination recommendations to some extent, but need to focus on administering vaccines as [far down] as possible on a limb to allow for compete surgical margins if amputation of a limb is required. (J Am Vet Med Assoc 2009;234:376-380)

What can you do to ensure that your vet is following the task force’s recommendations? Talk to him or her. Ask whether vaccination for leukemia and rabies is appropriate for your cat. If the vaccines are appropriate, ask where they will be administered. Never accept a one-size-fits-all approach to vaccination.

Photo: A vaccine associated fibrosarcoma between the shoulder blades of a cat, courtesy of Texas A&M’s School of Veterinary Medicine.

Share this entry with your pawple anywhere:

• Where do Vaccine-Associated Tumors Develop in Cats?
• Despite Controversy There is no Doubt That Vaccines Save Lives
• What are the Rationales Behind Rabies Vaccine Schedules?
• Vaccines Poised for a Comeback
• Are Oral Tumors Common in Two-Year-Old Cats?