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HEMOPET
W. Jean Dodds, DVM
938 Stanford Street
Santa Monica, CA 90403
; Fax
February 17, 2005
Representative
Peter Rines
334 Bradford Road
Wiscasset, ME 04578 |
Re:
LD 429 -- An Act to Require Veterinarians to Provide Vaccine
Disclosure Forms |
Dear Representative
Rines:
I am writing in support
of LD 429, An Act to Require Veterinarians to Provide Vaccine
Disclosure Forms. I do so as a veterinary research/clinician
scientist, who has been actively involved in vaccination issues
for more than 40 years.
Background
While vaccines have
significantly reduced the incidence of serious infectious diseases
over the years, increasing evidence implicates vaccines in triggering
immune-mediated and other chronic disorders. The duration of
immunity from vaccination is now accepted to be at least 5 or
more years for the clinically important diseases of dogs and
cats. Accordingly, new vaccine protocols are recommended: 1)
giving the puppy or kitten vaccine series followed by a booster
at one year of age; 2) administering further boosters in a combination
vaccine every three years or as split components alternating
every other year until; 3) the pet reaches geriatric age, when
booster vaccination is often unnecessary and may be inadvisable.
In the years between or instead of boosters, serum vaccine antibody
titers can be measured to determine the adequacy of immune memory.
Vaccine antibody
titer testing measures antibodies to certain diseases to determine
whether an animal’s immune system has responded to previous
vaccinations. This blood test helps determine whether or not
an animal will be protected from the infectious disease if he/she
were to be exposed. Titers do not distinguish between immunity
generated by vaccination and/or exposure to the disease, although
the magnitude of immunity produced just by vaccination is usually
lower. Reliable serologic vaccine titering is available from
several university and commercial laboratories and the cost
is reasonable. If a given animal’s humoral immune response
has fallen below levels of adequate immune memory, an appropriate
vaccine booster can be administered.
Duration of immunity
(DOI) from challenge studies
Cats
Challenge studies
in the cat from Cornell University following just two doses
of trivalent killed vaccine given at 8 and 12 weeks of age,
showed complete protection from feline panleukopenia virus for
more than 8 years, and good protection against feline calicivirus
and herpes virus for 4 and 3 years, respectively. Colorado State
University recently reported long term vaccinal immunity in
a large number of pet and laboratory cats.
Dogs
The 2003 report
of the AAHA Canine Vaccine Task Force indicated that the DOI
following challenge studies in dogs was equal to or greater
than 7 years for the three canine “core” vaccines
against distemper virus (CDV), parvovirus (CPV-2) and adenovirus
(hepatitis, CAV-1).
Challenge of immunity
studies have shown that the minimum DOI of modified live virus
(MLV) CDV vaccines are 7 and 5 years for the Rockborn and Onderstepoort
strains of CDV, respectively. Challenge of immunity studies
for CPV-2 vaccines have shown the minimum DOI with MLV CPV-2
vaccines to be 7 years. Challenge of immunity studies for CAV-1
have shown the minimum DOI with modified live CAV-2 vaccines
to be 7 years. Based on serologic data for sterilizing immunity,
the minimum DOI for CDV is 12-15 and 9 years, respectively,
for the Rockborn and Onderstepoort strains of CDV; up to 10
years for CPV-2; and at least 9 years for CAV-1.
In 2002, the AVMA
Council on Biologic and Therapeutic Agents (COBTA) published
a landmark report on cat and dog vaccines. Some key features
of that report were: “vaccination is a potent medical
procedure associated with benefits and risks for animals; considerations
of exposure probability, susceptibility, severity of the disease,
efficacy and safety of the vaccine, potential public health
concerns, and owners preferences are appropriate; individual
animals will require different vaccines and vaccination programs;
revaccination recommendations should be designed to create and
maintain clinically relevant immunity, while minimizing adverse
event potential; the practice of revaccinating animals annually
is largely based on historic precedent supported by minimal
scientific data; unnecessary stimulation of the immune system
does not result in enhanced disease resistance and may expose
animals to unnecessary risks; veterinarians should consider
creating a core vaccination program for most of the animals
in their practice area; core vaccines are defined as vaccines
appropriate to provide protection in most animals against diseases
that pose a risk of severe disease because the pathogens are
virulent, highly infectious, and widely distributed in the region;
current adverse event reporting systems need substantial improvement
in the capture, analysis, and dissemination of information;
practitioner commitment to reporting adverse events and practitioner
access to timely analyses of adverse event data are essential
to providing optimal animal care.”
In 2004, the following
statement was endorsed by all 23 members of the ACVIM Infectious
Disease Study Group and approved by the ACVIM Board: “The
American College of Veterinary Internal Medicine believes that
all dogs should have a routine health examination by a veterinarian
at least yearly. At that time, vaccination needs should be determined
and only those antigens deemed necessary should be administered.
We currently endorse the use of the AAHA [American Animal Hospital
Association] 2003 Canine Vaccine Guidelines as an aid in determining
the vaccination needs of individual dogs.“
Finally, because
of the potential legal liability for all medical procedures
including vaccination, veterinarians need to obtain informed
consent from their clients. This means that clients need to
be given information about the benefits and risks of vaccination
in order to permit them to make an appropriate decision about
the individual vaccine to be selected and the vaccination programs
of choice. Thus, obtaining informed consent and the client’s
signature on a consent form or patient chart is an important
aspect of following the legal standards of duty to inform ”what
any reasonable, prudent person would want to know about the
subject”.
I hope that this
brief summary of a complex issue will be helpful.
Sincerely,
<signature on
file>
W. Jean Dodds, DVM
President
www.Hemopet.com
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References
Cohen, A.D. and Shoenfeld, Y. Vaccine-induced autoimmunity.
J. Autoimmunity 9: 699-703, 1996.
Dodds WJ. More bumps on the vaccine road. Adv Vet Med 41:715-732,
1999.
Dodds WJ. Vaccination protocols for dogs predisposed to vaccine
reactions. J Am An Hosp Assoc 38: 1-4, 2001.
Duval D, Giger U. Vaccine-associated immune-mediated hemolytic
anemia in the dog. J Vet Intern Med 10:290-295, 1996.
Flemming DD, Scott JF. The informed consent doctrine: what veterinarians
should tell their clients. OJ Am Vet Med Assoc 224: ,
2004.
Grubb DJ, Chapman C. The vaccine quandary. AAHA Trends Magazine
Dec 2003, pp. 35-38.
Hogenesch H, Azcona-Olivera J, Scott-Moncreiff C, et al. Vaccine-induced
autoimmunity in the dog. Adv Vet Med 41: 733-744, 1999.
Hustead DR, Carpenter T, Sawyer DC, et al. Vaccination issues
of concern to practitioners. J Am Vet Med Assoc 214: ,
1999.
Klingborg DJ, Hustead DR, Curry-Galvin E, et al. AVMA Council
on Biologic and Therapeutiv Agents’ report on cat and
dog vaccines. J Am Vet Med Assoc 221: , 2002.
Lappin MR, Andrews J, Simpson D, et al. Use of serologic tests
to predict resistance to feline herpesvirus 1, feline calicivirus,
and feline parvovirus infection in cats. J Am Vet Med Assoc
220: 38-42, 2002.
McGaw DL, Thompson M, Tate, D, et al. Serum distemper virus
and parvovirus antibody titers among dogs brought to a veterinary
hospital for revaccination. J Am Vet Med Assoc 213: 72-75, 1998.
Moore GE, Glickman LT. A perspective on vaccine guidelines and
titer tests for dogs. J Am Vet Med Assoc 224: .
Mouzin DE, Lorenzen M J, Haworth, et al. Duration of serologic
response to five viral antigens in dogs. J Am Vet Med Assoc
224: 55-60, 2004.
Mouzin DE, Lorenzen M J, Haworth, et al. Duration of serologic
response to three viral antigens in cats. J Am Vet Med Assoc
224: 61-66, 2004.
Paul MA. Credibility in the face of controversy. Am An Hosp
Assoc Trends Magazine XIV(2):19-21, 1998.
Paul MA (chair) et al. Report of the AAHA Canine Vaccine Task
Force: 2003 canine vaccine guidelines, recommendations, and
supporting literature. AAHA, April 2003, 28 pp.
Schultz RD. Current and future canine and feline vaccination
programs. Vet Med 93:233-254, 1998.
Schultz RD, Ford RB, Olsen J, Scott F. Titer testing and vaccination:
a new look at traditional practices. Vet Med, 97: 1-13, 2002
(insert).
Scott FW, Geissinger CM. Long-term immunity in cats vaccinated
with an inactivated trivalent vaccine. Am J Vet Res 60: 652-658,
1999.
Scott-Moncrieff JC, Azcona-Olivera J, Glickman NW, et al. Evaluation
of antithyroglobulin antibodies after routine vaccination in
pet and research dogs. J Am Vet Med Assoc 221: 515-521, 2002.
Smith CA. Are we vaccinating too much? J Am Vet Med Assoc 207:421-425,
1995.
Tizard I, Ni Y. Use of serologic testing to assess immune status
of companion animals. J Am Vet Med Assoc 213: 54-60, 1998.
Twark L, Dodds WJ. Clinical application of serum parvovirus
and distemper virus antibody titers for determining revaccination
strategies in healthy dogs. J Am Vet Med Assoc 217:,
2000.
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W.
JEAN DODDS
RÉSUMÉ
Dr. Dodds received
the D.V.M. degree with honors in 1964 from the Ontario Veterinary
College, University of Toronto. In 1965 she accepted a position
with the New York State Health Department in Albany and began
comparative studies of animals with inherited and acquired bleeding
diseases. Her position there began as a Research Scientist and
culminated as Chief, Laboratory of Hematology, Wadsworth Center.
In 1980 she also became Executive Director, New York State Council
on Human Blood and Transfusion Services. This work continued
full-time until 1986 when she moved to Southern California to
establish Hemopet, the first nonprofit national blood bank program
for animals.
From , she
was a member of many national and international committees on
hematology, animal models of human disease, veterinary medicine,
and laboratory animal science. Dr. Dodds was a grantee of the
National Heart, Lung, and Blood Institute (NIH) and has over
150 research publications. She was formerly President of the
Scientist's Center for Animal Welfare; and Chairman of the Committee
on Veterinary Medical Sciences and Vice-Chairman of the Institute
of Laboratory Animal Resources, National Academy of Sciences.
In 1974 Dr. Dodds was selected as Outstanding Woman Veterinarian
of the Year, AVMA Annual Meeting, Denver, Colorado; in 1977
received the Region I Award for Outstanding Service to the Veterinary
Profession from the American Animal Hospital Association, Cherry
Hill, New Jersey; in 1978 and 1990 received the Gaines Fido
Award as Dogdom's Woman of the Year; and the Award of Merit
in 1978 in Recognition of Special Contributions to the Veterinary
Profession from the American Animal Hospital Association, Salt
Lake City, Utah. In 1984 she was awarded the Centennial Medal
from the University of Pennsylvania School of Veterinary Medicine.
In 1987 she was elected a distinguished Practitioner of the
National Academy of Practice in Veterinary Medicine. In 1994
she was given the Holistic Veterinarian of the Year Award from
the American Holistic Veterinary Medical Association. She is
an active member of numerous professional societies.
Today, Dr. Dodds
is actively expanding Hemopet's range of nonprofit services
and educational activities. The animal blood bank program provides
canine blood components, blood bank supplies, and related services
throughout North America. Hemopet's retired Greyhound blood
donors are adopted as pets through the Pet Life-Line arm of
the project. On behalf of Hemopet, she consults in clinical
pathology nationally and internationally, and regularly travels
to teach animal health care professionals, companion animal
fanciers, and pet owners on hematology and blood banking, immunology,
endocrinology, nutrition and holistic medicine. She was also
the Editor of Advances in Veterinary Science and Comparative
Medicine for Academic Press.
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