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What you should know about VaccinesHuman vaccine labeling is under FDA control, animal vaccination labeling is not. The FDA regulates human vaccines and does not invoke federal privilege to indemnify human vaccine manufacturers from liability in state courts. However, interestingly the government agency which oversees veterinary vaccines DOES invoke federal privilege to limit animal vaccine manufactures from liability in state courts. Therefore, when adverse reactions occur with veterinary vaccines there is no "deep pocket" to tap for liability. When veterinary doctors simply think their treatment is effective, medical fraud is hard to prove. Evidence based guidelines help separate those medical treatments based on science, from those treatments doctors wish were true. Doctors need to understand what an evidenced based guideline means. In order for a treatment to qualify for evidence based medicine, doctors should require that:
If a treatment guideline fails one or both of these criteria, doctors and patients cannot tell if the treatment application would result in good, harm, or squandered time and money. Some Veterinarians will say the reason why there are no evidenced based guidelines in the profession, similar to the large numbers found in human medicine, is because the veterinarian profession lacks quality evidence to issue Evidence Based Medicine ("EBM") guidelines. I do not buy this. If a treatment lacks quality evidence, then an EBM guideline can conclude at the end, after the evidence has been documented and analyzed, that the evidence is too weak make a recommendation and treatment remains unclear for guidelines and practice. Today there are barriers to EBM guidelines, including organizational, traditional, and legal. However, these barriers are often overcome in human medicine with money. It is my hope that we change the way my profession practices through eradicating the barriers that prevent the practice of EBM. Currently veterinarian organizations create non-evidenced based guidelines for treatments. These treatments are sometimes paid for by the very company selling the treatments. Treatment guidelines are often based on what has been traditionally done in the past with little or no scientific evidence to support the practice. Laws even may sometimes limit liability when animals have been injured by those treatments advised in non-evidence based guidelines. This can happen even when experts have concluded, in controlled published clinical trials, that those treatments advised in the guidelines are contradicted. Until independent EBM guidelines are written by veterinarian organizations, private practitioners will be forced to come together to write their own or do without the necessary guidelines needed to deliver quality patient care. As the first known "veterinarian evidence based medicine web site", an attempt will be made to "go where no man has dared go before" and create evidence based medicine veterinarian guidelines. For this to work these EBM guidelines must be shared and free to others in the profession to use. It will take time and a consensus from other practitioners, but hopefully cost will be limited to mostly ordering articles used to support the level of evidence upon which the guideline is based, so it can be linked to a specific citation. Opinion and help from other practitioners interested in helping to create EBM veterinary guidelines is requested. Anyone interested please email me at artjamie@aol.com Sincerely,
Dr. Art Malernee, DVM |
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