Subject: RE: Vets in UK Speak against annual shots -

[malernee]

Subject: RE: Vets in UK Speak against annual shots -


the following letter appeared in Veterinary Times, UK - late jan 2004



Dear Editor

We, the undersigned, would like to bring to your attention our concerns in the light of recent new evidence regarding vaccination protocol.

The American Veterinary Medical Association Committee report this year states that 'the one year revaccination recommendation frequently found on many vaccination labels is based on historical precedent, not scientific data'.

In JAVMA in 1995, Smith notes that 'there is evidence that some vaccines provide immunity beyond one year. In fact, according to research there is no proof that many of the yearly vaccinations are necessary and that protection in many instances may be life long'; also, 'Vaccination is a potent medical procedure with both benefits and risks for the patient'; further that, 'Revaccination of patients with sufficient immunity does not add measurably to their disease resistance, and may increase their risk of adverse post-vaccination events.'

Finally, he states that: 'Adverse events may be associated with the antigen, adjuvant, carrier, preservative or combination thereof. Possible adverse events include failure to immunise, anaphylaxis, immunosuppression, autoimmune disorders, transient infections and/or long-term infected carrier states.'

The report of the American Animal Hospital Association Canine Vaccine Taskforce in JAAHA (39 March/April 2003) is also interesting reading: 'Current knowledgte supports the statement that no vaccine is always safe, no vaccine is always protective and no vaccine is always indicated'; 'Misunderstanding, misinformation and the conservative nature of our profession have largely slowed adoption of protocols advocating decreased frequency of vaccination'; 'Immunological memory provides durations of immunity for core infectious diseases that far exceed the traditional recommendations for annual vaccination. This is supported by a growing body of veterinary information as well as well-developed epidemiological vigilance in human medicine that indicates immunity induced by vaccination is extremely long lasting and, in .most cases, lifelong.'

Further, the evidence shows that the duration of immunity for rabies vaccine, canine distemper vaccine, canine parvovirus vaccine, feline panleukopaenia vaccine, feline rhinotracheitis and feline calicivurus have all been demonstrated to be a minimum of seven years, by serology for rabies and challenge studies for all others.

The veterinary surgeons below fully accept that no single achievement has had greater impact on the lives and well-being of our patients, our clients and our ability to prevent infectious diseases than the developments in annual vaccines. We, however, fully support the recommendations and guidelines of the American Animal Hospitals Association Taskforce, to reduce vaccine protocols for dogs and cats such that booster vaccinations are only given every three years, and only for core vaccines unless otherwise scientifically justified.

We further suggest that the evidence currently available will soon lead to the following facts being accepted:

* The immune systems of dogs and cats mature fully at six months and any modified live virus (MLV) vaccine given after that age produces immunity that is good for the life of that pet.

* If another MLV vaccine is given a year later, the antibodies from the first vaccine neutralise the antigens from the subsequent so there is little or no effect; the pet is not 'boosted', nor are more memory cells induced.

* Not only are annual boosters for canine parvovirus and distemper unnecessary, they subject the pet to potential risks of allergic reactions and immune-mediated haemolytic anaemia.

* There is no scientific documentation to back up label claims for annual administration of MLV vaccines.

* Puppies and kittens receive antibodies through their mothers' milk. This natural protection can last eight to 14 weeks.

* Puppies and kittens should NOT be vaccinated at less than eight weeks. Maternal immunity will neutralise the vaccine and little protection will be produced.

* Vaccination at six weeks will, however, DELAY the timing of the first effective vaccine.

* Vaccines given two weeks apart SUPPRESS rather than stimulate the immune system.

This would give possible new guidelines as follows:

1. A series of vaccinations is given starting at eight weeks of age (or preferably later) and given three to four weeks apart, up to 16 weeks of age.

2. One further booster is given sometime after six months of age and will then provide life-long immunity.

In light of data now available showing the needless use and potential harm of annual vaccination, we call on our profession to cease the policy of annual vaccination.

Can we wonder that clients are losing faith in vaccination and researching the issue themselves? We think they are right to do so. Politics, tradition or the economic well-being of veterinary surgeons and pharmaceutical companies should not be a factor in making medical decisions.

It is accepted that the annual examination of a pet is advisable. We undervalue ourselves, however, if we hang this essential service on the back of vaccination and will ultimately suffer the consequences. Do we need to wait until we see actions against vets, such as those launched in the state of Texas by Dr Robert Rogers? He asserts that the present practice of marketing vaccinations for companion animals constitutes fraud by misrepresentation, fraud by silence and theft by deception.

The oath we take as newly-qualified veterinary surgeons is 'to help, or at least do no harm'. We wish to maintain our position within society, and be deserving of the trust placed in us as a profession. It is therefore our contention that those who continue to give annual vaccinations in the light of new evidence may well be acting contrary to the wefare of the animals committed to their care.

Yours faithfully

Richard Allport, BVetMed, MRCVS
Sue Armstrong, MA BVetMed, MRCVS
Mark Carpenter, BVetMed, MRCVS
Sarah Fox-Chapman, MS, DVM, MRCVS
Nichola Cornish, BVetMed, MRCVS
Tim Couzens, BVetMed, MRCVS
Chris Day, MA, VetMB, MRCVS
Claire Davies, BVSc, MRCVS
Mark Elliott, BVSc, MRCVS
Peter Gregory, BVSc, MRCVS
Lise Hansen, DVM, MRCVS
John Hoare, BVSc, MRCVS
Graham Hines, BVSc, MRCVS
Megan Kearney, BVSc, MRCVS
Michelle L'oste Brown, BVetMed, MRCVS
Suzi McIntyre, BVSc, MRCVS
Siobhan Menzies, BVM&S, MRCVS
Nazrene Moosa, BVSc, MRCVS
Mike Nolan, BVSc, MRCVS
Ilse Pedler, MA, VetMB, BSc, MRCVS
John Saxton, BVetMed, MRCVS
Cheryl Sears, MVB, MRCVS
Jane Seymour, BVSc, MRCVS
Christine Shields, BVSc, MRCVS
Suzannah Stacey, BVSc, MRCVS
Phillip Stimpson, MA, VetMB, MRCVS
Nick Thompson, BSc, BVM&S, MRCVS
Lyn Thompson, BVSc, MRCVS
Wendy Vere, VetMB, MA, MRCVS
Anuska Viljoen, BVSc, MRCVS, and
Wendy Vink, BVSc, MRCVS

[guest]

http://news.bbc.co.uk/1/hi/uk/3588457.stm

Vets issue animal vaccine warning



Veterinary surgeons are warning that cat and dog owners are spending tens of millions of pounds on unnecessary and sometimes dangerous vaccines. More than 30 vets have signed an open letter warning many vaccines for pets given in yearly doses last much longer. They have accused the pharmaceutical industry of "fraud by misrepresentation, fraud by silence and theft by deception". But drugs companies say they are bound by rules from licensing authorities. Because of a lack of research it can only give a minimum period of immunity - usually 12 months. Yearly vaccines The vets are warning the pharmaceutical industry and their own profession about the issue. The present practice of marketing vaccinations for companion animals may constitute fraud by misrepresentation, fraud by silence and theft by deception


Vets' group


In their letter they say that vaccinations for many conditions including distemper, cat flu and parva virus, last a lot longer than a year and sometimes for life. The letter said: "The present practice of marketing vaccinations for companion animals may constitute fraud by misrepresentation, fraud by silence and theft by deception." BBC correspondent Angus Stickler said that vets send out computer-generated letters telling people to take their pets in for vaccinations "every year, year in, year out". He said: "With £20 to £40 to pay and about 13m dogs and cats in the country it's an industry worth tens of millions of pounds." The letter also talks about an increase in the risk of "adverse post-vaccination events" including a list of problems such as auto-immune disorders, transient infections and a risk of cancer in cats.
<snip>

[group]

The British Small Animal Veterinary Association said the letter did not represent the views of most vets but that of a minority who had "sympathies with homeopathic medicine. Vaccination has provided the single greatest contribution to the health of our pets over recent decades."It is absolutely necessary if we want to prevent major epidemics of disease and the issue raised regarding over-vaccination of pets is simply not justified."

The public should know In scientific circles saying you are a homeopath is just the same as saying you are practicing health fraud.

http://evidencebasedvet.com/forum/viewt ... omeopathic

If I had signed that letter and the AVMA had promoted it was signed by homeopaths I would have lost much chance of getting anyone in the medical field to come to my practice. The homeopathic attack by the vet association in England against the vets who signed the letter was a warning to other vets what would happen to their practice if they became theft by deception revaccination whistle blowers. The public will not believe you are an honest vet and those who control your vet assciation are crooks. Its even more difficult to get the public to trust you when the national vet association you belong to tells the public you are practicing health fraud rather than attacking your message to the public. Its about about vet groups who organize to attack whistle blower messengers rather than address their message.

[guest]

Daily Telegraph Article (UK) 2nd April 2004

"Millions wasted on needless jabs for pets, say vets

Pet owners are wating millions of pounds each year on unnecessary
booster vaccinations for cats and dogs, it was claimed yesterday.

More than 30 vets have signed an open letter stating that many
vaccines for life-threatening diseases last for many years and
sometimes provide life-long immunity.

That made the annual boosters recommended by the manufacturers of
vaccines unnecessary, they said.

But the vets' professionalbody rejected the claims and warned that
animals would suffer if their owners rejected regular jabs.
Many vets send letters each year to pet owners, reminding them to
update their animals' vaccinations. A single booster can cost between
£20 and £40.

The letter published in the "Veterinary Times", claims that the
original vaccines for many diseases, including distemper, cat flu and
parvovirus last for many years.

Recent American researchstates that "there is no proof that many of
the yearly vaccinations are necessary and that protection in many
instances may be life-long".

It said that some vaccines could cause "adverse events",including
allergic reactions and cancer in cats. Vets stress the importance of
vaccinations in preventing disease but called for boosters to be
given every three years.

"Those who continue to give annual vaccinations in the light of new
evidence may well be acting contrary to the welfare of animals
committed to their care."

However animals should be examined by vets every year.

But vaccine manufacturers said they recommended yearly boosters
because they could not prove that all animals received long-term
immunity.

David Sutton, a spokesman for Intervet, a veterinary drug
manufacturer said: "We base our recommendations on the science and
the science tells us that we don't know how long immunity lasts in
individual animals."

The British Small Animal Veterinary Association said that the letter
did not represent the views of most vets but that of a minority who
had "sympathies with homeopathic medicine. Vaccination has provided
the single greatest contribution to the health of our pets over
recent decades.

"It is absolutely necessary if we want to prevent major epidemics of
disease and the issue raised regarding over-vaccination of pets is
simply not justified."

[guest]

Is Your Pet Dying From Over-Vaccination Due to Vet Economics?



Nationally and internationally, companion animals (pets) are being
over-vaccinated - a practice that is resulting in vaccine related deaths, severe
illnesses, reduced longevity and large monetary costs to guardians (pet owners).



The most common practice is the annual administration of rabies vaccine,
based upon the oft-stated supposition that an annual booster is necessary to
maintain the vaccine's effectiveness. In reality, there is no research
substantiating that practice, and veterinary schools and professional associations
increasingly are embracing a triennial administration standard.



A study of more than 1,000 cats and 1,000 dogs in the United Kingdom by
Canine Health Concern in March 2001 showed a 1 in 10 risk of adverse reaction from
vaccines! The study, which tracked over a seven-month period the health of
cats and dogs vaccinated by one UK veterinarian, found that 7.54% to 12.42% of
the dogs had adverse reactions within a 45-day period post-vaccination. An
almost-identical number of cats - from 7.56% to 12.44% -- also suffered adverse
reactions within 45 days. This is quite contradictory to the
vaccine-manufacturers' claim that less than 15 adverse reactions occur out of 100,000 companion
animals vaccinated. The UK study results were reported at the 99% confidence
level. Vaccine manufacturers rely on adverse-reaction statistics from the vets
themselves.



In our opinion many vets continue to cling to the annual rabies shot has less
to do with a cautious standard of care and more to do with their economic
dependence on vaccinations for fiscal solvency. This is especially true of a
substantial - if not vast - majority of small vet practices (1-3 people,
non-specialty, non-emergency practice).



A vial of rabies vaccine costs the veterinarian about 61 cents and is
typically administered at a cost to the guardian of from $15 to $38 - not including
the $35 office visit. In perspective, an 18-oz. package of Kellogg's Sugar
Frosted Flakes® is $2.20 to the grocer and approximately $2.75 retail. If the
grocer's mark-up were comparable to that of rabies vaccine, Frosted Flakes would
cost $137 without the office visit and more than $260 with it. To borrow Tony
the Tiger's expression, that size of a mark-up is "Gr-r-reat!"®



Take out 1 year of rabies vaccination and the consequential office visit--
just for dogs -- and the average small-practice vet's income drops from
approximately $87,000 to $25,000 -- and this doesn't include cats or other
vaccinations!



The Veterinarian "Shot-based Practice" Model is a systemically flawed
economic approach and potentially detrimental to companion animals. Bad
practice-management becomes bad medicine, resulting in unnecessary -- and widespread --
death, illness, reduced longevity of companion animals and unnecessary cost to
owners.





——————————————————————





Shot Based Practice Analysis



The vast majority of dog owners vaccinate yearly. There is an arguably safer
choice --the three year rabies vaccination option -- but many, many in the
veterinarian community are not informing the guardians (pet owners) to the
potential detriment of their animal companions’ (pets’) life, health, and
longevity.



Could economics be a factor in this lethargic effort on the part of many vets
to provide their clients with an opportunity for informed consent?



Yearly rabies vaccination is big business and materially impacts the
small-animal vet practice!



We can make these assumptions based upon various surveys and studies printed
by animal association groups and trade associations.

· Average vet has 2,500 dogs and cats (45% dogs).

· Cost of vial of rabies vaccine is 61 cents.

· Cost of inoculation is between $15 and $38 yearly not including office
visit.

· Cost of office visit is approximately $35.

· Price markup on rabies vaccine: 2400% to 6200% and again, this does not
include the office visit.



If 100% of the dogs in the average one-vet practice are annually given the
rabies vaccine= 2,500*.45 (dogs per practice) or 1,125 dogs.

The gross operating profit (after cost of goods, 61cents per shot) equals:

@$15 per shot, a net of $14.39 = $16,189.

@$38 per shot, a net of $37.39 = $42,064.



If the three year option is exercised (versus a yearly vaccination for
rabies), then each vet loses between $32,000 ($16,000 x 2 years) and $84,000
($42,000 x 2 years) of operating profit in each three-year vaccination period.



Adding office visits (1 a year for 2 years x 1,125 dogs x $35 per visit) =
$78,800 of potential lost revenue.

(Note: The guardian should see that his/her companion animal receives a
wellness exam at least yearly, which would extinguish this loss.)



Now, consider these figures. The:

· Median number of transactions per vet per year in 1997 was 5,102.

· Median gross income per vet in 1997 was $305,000 for a one- person practice.

· Net-income median for a one-vet practice before owner's compensation as a
percentage of gross income was 26.8%. Assuming $305,000, that would be$87,300
for the average 1-vet practice.

· Average transaction charge is $58.41 per vet in a one-vet operation.



If 1,125 transactions for rabies vaccine would be lost here is the impact on
the one-vet practice for the two years the dog doesn't get a rabies vaccine
(assuming no replacement revenue).



· Transactions go from 5,102 to 3,887 or a 22% decline.

· Gross income falls (at $20 per shot plus $35 for an office visit) by
$62,000 from $305,000 to $243,000.

· Net median-income per vet in a one-vet situation could drop from $87,000 to
$25,000 or by 71%!



And this is only if dogs were inoculated for rabies on a three-year cycle.
The impact magnifies with cats going three years on the shot.



Source: "Financial and Productivity Pulsepoints: Comprehensive Survey and
Analysis of Performance Benchmarks:Vital Statistics For Your Veterinary
Practice," published by the American Animal Hospital Association, 1998.



The Small Vet (Non-emergency, non-specialist) Shot Model's Systemic
Dependence on Transactions Assumptions:



- That a $25 rabies shot is eliminated for 1,000 dogs only in one year. (Cats
are not considered and parvo virus and distemper shots would still be
administered annually).

- Profit on the shot is $24.39 (the cost being 61 cents).

- 26% is the net profit margin.



Result: Instead of 1,000 transactions (shots) yielding $24,390, the vet would
have to gross $93,807 from other areas of the practice to replace that net
revenue. Furthermore, using a $54 average per transaction, the vet would have to
conduct 70% more transactions - 1,737 instead of 1,000 - which would mean a
15% increase in workload (the average vet has 5,100 transactions annually) just
to be at the same place. Then consider the loss of office-visit revenue and
take out cats, and parvo and distemper annually, and the Small Vet Shot Model
indicates red ink.



It appears that even at 20% of the gross revenue, rabies shots may constitute
100% of the net profits - or even worse, subsidize a net-deficit practice -
of average small-vet practices. The loss of two years of shots, on which these
practices seem dependent, would have a devastating economic impact if not
replaced.



It appears that the small-vet economic model is a "shot model," based
economically - by design or by evolution - on transactions rather than expertise.
Such a model needs to be reexamined for validity of purpose and economic
consequences.





· Vaccine-related cancer in cats: According to Colorado State University
Professor Dennis Macey, "the incidence of this often fatal cancer (sarcoma-cancer
development at the vaccine site) has been documented by several studies to be
1 to 3.2 per 10,000 cats receiving a rabies vaccine Š If all the cats in
Denver (estimated to be 400,000) were to be vaccinated yearly for rabies, the
unneeded additional vaccinations would result in an additional 26 to 84 vaccine
cancer sites per year! Š I estimate 22,000 vaccine-associated tumors per year.
Since surgery is usually unsuccessful, radiation treatment is necessary.
Treating all these cats would cost $66 million per year."

-- "Are We Vaccinating Too Much," Journal of the American Veterinary Medical
Association, 1995

· And this doesn't even consider vaccine related prolonged illness or vaccine
compounded deaths or reduced longevity for cats - and doesn't consider the
impact on dogs at all!



—————————————————



Mere Property or Next-To-Kin?



How much money would it take to persuade you to give up your television set?
$3,000? What's that? You say you have a 53" high-definition projection TV that
costs more that $3,000? Okay, would you give it up for $30,000?



Well, the pet food manufacturer, Iams Co., a division of Proctor & Gamble,
commissioned a Gallup poll, which found that 66% of the respondents would not
trade their dog or cat for $1,000,000! (Dog Fancy, May 2002 issue)



Here are some more facts to chew on:

•An annual American Animal Hospital Survey found that 83% of companion-animal
guardians (dog and cat owners) "were somewhat likely … likely … or very
likely" to risk their life for their companion animal; 70% said they would spend
$1,000 on treatment for a life-threatening illness or accident; 40% would spend
any amount necessary.

•Two other studies found that between 44% and 76% of companion animals sleep
in their person's bed.

• Midland National Life Insurance Company gives a discount on life insurance
for senior citizens who have a dog, as it has been shown that dogs reduce
stress (high blood pressure), routine visits to the doctor and, accordingly,
medical expenses.

•In a study by Dr. Karen Allen, assistance dogs were able to substitute for
paid-human assistance to the elderly or physically challenged in 68% of
activities, saving a net-$13,000 a year in costs.



"Dogs aren't my whole life, but they make my life whole," wrote the late
Roger A. Caras, noted broadcaster, writer and editor.



Yet, our laws still classify companion animals (domesticated non-farm
animals) as "mere property." In Great Britain dogs and cats are considered sentient
beings.



Constructively, we are moving to recognize domesticated non-farm animals as
beyond mere property in law. Several states now allow dogs and cats effectively
to be heirs – via trusts set up for their care after the primary guardian has
passed away.



It is time to declare companion animals (dogs and cats) to be "beyond mere
property" and recognize that they are not mere objects. The value of the
animal-human bond, and the companionship generated by that bond, should be legally
recognized beyond the depreciated value of the cat or dog. This is not "whack-o
animal rights" but simple protection both for the companion animal and for the
guardian.



By recognizing the value of companion animals to be "beyond mere property,
Next-To-Kin," the law could establish significant civil economic penalties for
the loss of that companionship through cruelty – be it of the gut-wrenching
variety or the silent, systemic, willful acts of over-vaccination by smiling
veterinarians. What else would one call economically driven acts that result in
unnecessary suffering, illness, reduced healthy life span, and death?



As long as these $1,000,000 companion animals are legally considered mere
property, there are no deterrents to over-vaccination and other types of
self-serving, non-informed consent activities.

[malernee]

5th May 2004.

Dear Sir or Madam,

Re the Recent debates as to whether annual booster vaccination of animals is necessary.

We appreciate that the recent developments (1) in the ongoing controversy regarding annual booster vaccines for dogs and cats has left the veterinary profession and the pet owning public in a dilemma as to the direction they should take, especially when considering the animal welfare and consumer protection issues involved.

It seems that on one hand you have the vaccine manufacturers, who appear to be hiding behind legislation and the advice of an industry report (2). Their stance that annual vaccination must be continued relies on the following points

(a) They do not know the actual duration of immunity

(b) Vaccines do not cause significant harm, so annual vaccination is acceptable.

This is also the stated view of the veterinary organisations i.e. the BVA and BSAVA (3)

However, the incoming President of the BSAVA Dr Ian Mason has been reported as saying  after due consideration of the evidence, the current recommendations on vaccination of animals may need to be refined (4). Vaccine manufacturers must have known about the changes in recommendations in response to detailed evidence in the US for some time, and have been affiliated to UK groups, such as the Cat Group (11) that have been looking at the work quoted (1). So far it seems the only action to be taken has been that of Intervet UK in extending their duration of immunity for Distemper, Hepatitis and Parvo to 3 years. While this is to be welcomed, no mention has been made yet of the Cat situation.

On the other side there is a small but growing number of veterinary surgeons and a strongly supportive public who are citing recent reports and research
(5,6,7,17,18) and conclude

(a) That duration of immunity for parvovirus, adenovirus, distemper
(5), and feline enteritis (18), is established as >7years, and for feline calicivirus and herpes (5,18) is established for at least 4 years, and it seems that giving booster vaccinations does not offer any further protection (6). Therefore, annual vaccination is not needed for dogs and cats (with the exception of Leptospirosis, discussed below)

(b) That vaccines can cause harm (5,8,9,11,14,18) and therefore unnecessary vaccination should be avoided if at all possible.

Additionally they also consider that information from the manufacturers is notable. These state that about 50% of dogs (10) and 2/3 of cats (10,11) in the UK are not vaccinated at all or only infrequently, but where are the reported outbreaks of the diseases one would expect if the duration of immunity were so short as to need annual Boosters?

While following the recent debate, there seems to have been only two arguments put forward for continuing annual booster vaccines in dogs and cats.

First there has been suggestion that the originating letter calling for cessation of booster vaccines was written by homeopaths and by inference should be ignored, in fact this was cited as relevant correspondence for the debate in a mailing from a vaccine manufacturer to all vets in the UK (12) and the profession is misguidedly it seems seeking to use this (13). Whilst it is true that some of the signatories have interests in this field, it is certainly not the case that all the signatories do. All are scientifically trained Vets in the first instance, all recommend initial vaccination, and they quote the recent published orthodo x research of others.

Secondly, and perhaps more significantly, is the argument for Leptospirosis vaccine, where it is claimed there is a poor duration of immunity and so annual vaccination of dogs only for this must continue. This has been the basis of much research in the USA, and it is appropriate that we in the UK are aware of the findings. We summarise them below

1. Immunity to Leptospirosis is complex and poorly understood. It can only be measured by challenge studies. This is ethically unacceptable so we have to examine what is happening in the field by epidemiological methods (5).

2. Kansas University reports that the Leptospirosis vaccine is THE major cause of vaccine reactions, so much so that they consider the risks outweigh the benefits. It is no longer considered a core vaccine and they even recommend it should not be given to puppies (9,14).

3. Another study found the vaccine highly immunosuppressive and recommended that the vaccine should not be given in conjunction with other vaccines (it is currently in the UK).

4. The Leptospirosis vaccine does not protect the dog from being infected with the disease; it just minimises the clinical symptoms. Hence there seems to be/have been a real risk of vaccinated healthy dogs shedding the spirochetes so possibly posing a threat to other dogs and humans. Although one manufacturer has recently claimed it has a new vaccine to prevent this, the clinical study conducted to test the vaccine was based on a sample of only 6 dogs (15). In our opinion a study so narrowly based cannot of course be scientifically credible.

5. The duration of immunity measurable by titre induced by the Leptospirosis vaccine can be as little as a few months (14,16) yet the advised interval for boosters is 1 year, which it seems has been an entirely arbitrary recommendation. By inference it may well be therefore that even vaccinated dogs have not been protected as their owners expect.

6. There is little protection between serovars (types). Use of the vaccine in the USA has led to a shift in the serovars such that the serovars now infecting dogs are not the ones used in the vaccines (14). Can we assume this is true also in the UK? Are we now vaccinating against a disease that barely exists in the form vaccinated for?

7. The vaccine efficacy seems between only 50 -70%, depending on the author (5).


The outgoing president of the BSAVA, Dr Freda Scott-Park, stated that when the science is there the profession would respond. The science is here, and the profession must respond now or lose all credibility in this debate. In the USA working parties have resulted in the removal of mass vaccination requirements in favour of individual vaccination programmes and consumer choice. This would answer the issues of insurance and kennels/catteries that are now being raised as well as restoring public faith in the industry.

Whilst we have no wish to presuppose findings in the UK, it is our desire to establish a truly independent working party under lay chairmanship critically to review the scientific data, to raise questions with the manufacturers and report as soon as practically possible to the profession and the public. We therefore invite interested parties (with no links to vaccine manufacturers) in the dog and cat world, the BSAVA, the BVA, FAB and individual veterinary surgeons to express their interest in participating by writing to us at the address below as soon as practical.

Yours faithfully




Mark Elliott BVSc VetMFHom MRCVS MIPsiMed John Saxton BVetMed VetFFHom MRCVS Sonya Winsor BSc(Hons) PhD BVetMed MRCVS

Address for correspondence: 22A East Street, Westbourne, West Sussex PO10
8SH.


Reference:
1. Allport et al, Letter in Veterinary Times 26-01-04 Call to cease the Policy of Annual Vaccination
2. Gaskell RM et al (2002) Veterinary Products Committee (VPC) working group of feline and canine vaccination  final report to the VPC. DEFRA, PB
6432.www.vpc.gov.uk
3. BSAVA/BVA joint statement on the vaccination controversy 2004. www.bsava.co.uk
4. Veterinary Review (2004) Looking Reality in the Eye. An interview with BSAVA President Ian Mason. Pg 20-22, April 2004.
5. Paul M et al, (2003) Report of the American Animal Hospital association
(AAHA) Canine Vaccine Taskforce: Executive Summary and 2003 Canine Vaccine Guidelines and Recommendations. Journal of the American Animal Hospital Association. 39,
119-131
6. Bohm M et al, (2004) Serum antibody titres to Canine Parvovirus, adenovirus and distemper virus in dogs in the UK which had not been vaccinated for at least 3 years. The Veterinary Record April 10, 2004. 457-463
7. Richards J et al (2001) 2000 Report of the American Association of Feline Practitioners and Academy of Feline Medicine Advisory Panel on Feline Vaccines. Journal of Feline Medicine and Surgery 3, 47-72
8. Meyer EK (2001) Vaccine Associated adverse events. Veterinary Clinics of North America  Small Animal Practice 31, 493-514
9. http://www.newss.ksu.edu/WEB/News/NewsR ... 11138.html
10. Intervet Mailing to Veterinary Surgeons
11. Report of the Cat Group on Vaccination. www.users.waitrose.com/~thecatgroup/vacc.html
12. Intervet Mailing to Veterinary Surgeons 22-03-04
13. Nelson M (2004) Freda shows the BVA what to expect. Vet Times 26-04-04 p5
14. Greene C et al (2001) Canine Vaccination. Veterinary Clinics of North America  Small Animal Practice 31, 473-492
15. Intervet Literature on Nobivac Lepto 2 at last. A lepto vaccine that inhibits renal shedding 2004.
16. Coyne MJ, (2001) Duration of Immunity in Dogs after vaccination or naturally acquired infection. The Veterinary Record 149, 509-515.
17. Vaccination in Cats: which ones and how often? Report in Vet Record April 10
2004, pg 452
18. Sparkes A. The Vaccination debate continues. Veterinary Review May
2004 38-39

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Liability Related To Vaccination

In the United States, licensed vaccines are subject to the Virus, Serum, and Toxin Act (VSTA) of 1913 (9 CFR § 101.2(w) [1991]). Consequently, use of animal vaccines is regulated by the United States Department of Agriculture (USDA), not the Food and Drug Agency (FDA). Regulations incorporated in the Animal Medicinal Drug Use Clarification Act (AMDUCA) do not apply to animal vaccines, so using a vaccine in a manner other than stated on the package insert is not considered extralabel use; a more appropriate term is "discretionary" use. The VSTA applies only to the preparation, sale, barter, exchange, or shipment of biologics.a It does not regulate use of vaccines by veterinarians. Although there are usage guidelines within specific state or federal eradication and control programs and perhaps as isolated rules within some state practice acts, there are no overarching federal regulations concerning the after-sale use of licensed animal vaccines by veterinarians or lay persons in the United States.

Even so, many veterinarians rely on the vaccine label to protect them. In the past, this was not an unreasonable approach, because by adhering to label instructions, veterinarians could, in most cases, shift the focus of litigation to the vaccine manufacturer. However, in 1996 the United States Supreme Court refused to review the Seventh Circuit Court's decision in Lynbrook Farms vs. SmithKline Beecham Corp (117 S.Ct. 178). In that decision, the Circuit Court upheld the contention by the USDA Animal and Plant Health Inspection Service (APHIS) that the VSTA preempted all state court tort remedies that would have the effect of imposing requirements different from or in addition to those imposed by the USDA regarding the safety, efficacy, potency, or purity of a product. In effect, this action eliminated vaccine manufacturers as defendants in all state vaccine tort cases unless it was alleged that the vaccine was improperly manufactured.b,c However, professional negligence and breach of warranty claims against veterinarians using these products were not preempted. As a result, future consumer claims involving vaccines will, in all likelihood, be centered around veterinary malpractice or the failure of veterinarians to adhere to prevailing standards of practice in selecting and administering vaccines, as well as claims that vaccines were given without the proper informed consent.

If, in a court of law, the quality of care provided by a practitioner is being called into question, the practitioner's actions will likely be compared with the prevailing “standard of care”, a legal term of art that, simply defined, is the care a practitioner of equal experience and training would deliver under the same or similar circumstances. The prevailing standard of care regarding the use of vaccines is in a state of flux, as exemplified by the recommendation of an increasing number of veterinary virologists, veterinary colleges, professional organizations, and practitioners to extend the revaccination interval for certain vaccine antigens. However, by and of themselves, a few published articles or stated opinions of recognized experts do not define a new standard of care; rather, it is their adoption and utilization by a substantial portion of the veterinary community. Vigorous debate within the profession will undoubtedly result in a new standard of care in the selection and use of vaccines. Although many veterinarians will, for various reasons, resist and delay adoption of new protocols, they should know that adherence to old protocols may, in the light of new knowledge, not protect them as "...conformity to custom is not in itself an exercise of care as a matter of law" (30 AmJur2nd Evidence § 1123). In this uncertain atmosphere, questions about a veterinarian's actions will likely focus on the following types of inquiry: Did the animal need the vaccine? If so, did the veterinarian select the proper agent? Was it in the proper form? Was it given in the proper manner and location? Was the vaccine handled properly? Was it administered aseptically? Was it administered at the proper interval? Did the client give informed consent before the veterinarian vaccinated the animal? Except in the case of herd or population medicine, the answers to these kinds of questions will be unique to the animal being treated.

The current informed consent standard is the "reasonable patient standard." Under this standard, the scope of disclosure is not measured by the physician's standards, but rather by the patient's needs and whether the information is material to the patient's decision (material information is that which a reasonable person in the client's position would use to make an intelligent decision to accept or reject vaccination).d Under this standard, a veterinarian should disclose the nature of the condition being vaccinated against along with any reasonable dangers within the veterinarian's knowledge that are incident to or may result from vaccination. When vaccination inherently involves a known risk of death or serious harm to an animal, it is the veterinarian's duty to disclose to the client the possibility of such outcomes and to explain in lay terms any significant potential complications that might occur. The veterinarian is also expected to provide information to the client regarding all reasonable alternatives to vaccination. It is the client's decision, not the veterinarian's, to approve or disapprove of vaccination. Once the veterinarian has provided the appropriate information and effectively communicated it to the client, he or she should specifically ask for and obtain the client's consent to the proposed vaccination. In fact, the failure to specifically obtain the client's informed consent could itself be negligent and result in legal liability. For this reason, veterinarians should consider developing consent forms to be signed by owners prior to vaccination of their animals (Appendix 2).

Veterinarians should be cautious in their statements regarding the safety or effectiveness of vaccines. If a veterinarian guarantees that a particular vaccine product is safe or effective, the veterinarian, not the manufacturer, may be liable for breech of warranty.e This cause of action may not be covered by veterinary malpractice insurance.

The lack of specific rules regarding use of animal vaccines by veterinarians leaves them especially vulnerable to litigation. A veterinarian's exposure to legal liability will be specific to the facts of the case, and though there is no absolute safeguard from litigation, practitioners can go a long way towards protecting themselves by conforming to the standards of practice as they apply to the use of vaccines, by closely adhering to the doctrine of informed consent, and by not providing undue warranty regarding the vaccines they administer.