Vaccinosis can kill your dog. Is your breed of dog at risk?

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Vaccination Protocols for Dogs Predisposed to Vaccine Reactions

W. Jean Dodds, DVM
Journal of the American Animal Hospital Association
May 1, 2001

W. Jean Dodds, DVMKeywords: Canine; Vaccination Protocols for Dogs; Vaccine Reactions

GUEST Editorial
There is increasing evidence in veterinary medicine that vaccines can trigger
immune-mediated and other chronic disorders (i. e., vaccinosis), especially
in certain apparently predisposed breeds. 1-6 Accordingly, clinicians
need to be aware of this potential and offer alternative approaches for pre-venting
infectious diseases in these animals. Such alternatives to current
vaccine practices include: measuring serum antibody titers; avoidance of
unnecessary vaccines or overvaccinating; and using caution in vaccinating
ill, geriatric, debilitated, or febrile individuals, and animals from breeds or
families known to be at increased risk for immunological reactions. 3,5-8
Fortunately, the most common effect of vaccine administration is the
stimulation of an immune response that conveys protection for that dis-ease.
This outcome has resulted in the widespread reduction in morbidity
and mortality from the many infectious diseases that have plagued both
animals and humans. An excellent example of this benefit is the global
eradication of smallpox as the result of a comprehensive immunization
program. Despite these intended benefits, however, vaccination does carry
with it attendant risks.


Adverse Effects of Vaccines
As the most commonly recognized adverse effect of vaccination is an
immediate hypersensitivity or anaphylactic reaction, practitioners are less
familiar with the more rare but equally serious acute or chronic immune-mediated
syndromes that can occur. The veterinary profession and vac-cine
industry have traditionally emphasized the importance of giving a
series of vaccinations to young animals to prevent infectious diseases, to
the extent that this practice is considered routine and is generally safe for
the majority of animals. Few clinicians are prepared, therefore, for encoun-tering
an adverse event and may overlook or even deny the possibility.
Beyond the immediate hypersensitivity reactions, other acute events
tend to occur 24 to 72 hours afterward, or 7 to 45 days later in a delayed-type
immunological response. 1,6,9,10 Even more delayed adverse effects
include mortality from high-titered measles vaccine in infants, canine dis-temper
antibodies in joint diseases of dogs, and feline injection-site
fibrosarcomas. 3,11 The increasing antigenic load presented to the host
individual by modified-live virus (MLV) vaccines is presumed to be
responsible for the immunological challenge that can result in a delayed
hypersensitivity reaction. 6,9
The clinical signs associated with nonanaphylactic vaccine reactions
typically include fever, stiffness, sore joints and abdominal tenderness,
susceptibility to infections, neurological disorders and encephalitis,
autoimmune hemolytic anemia (AIHA) resulting in icterus, or immune-mediated
thrombocytopenia (ITP) resulting in petechiae and ecchymotic
hemorrhage. 1-4,9,10,12-15 Hepatic enzymes may be markedly
elevated, and liver or kidney failure may occur by itself or
accompany bone-marrow suppression. 3 Furthermore, MLV
vaccination has been associated with the development of
transient seizures in puppies and adult dogs of breeds or
crossbreeds susceptible to immune-mediated diseases, espe-cially
those involving hematological or endocrine tissues
(e. g., AIHA, ITP, autoimmune thyroiditis). 1-3 Postvaccinal
polyneuropathy is a recognized entity associated occasionally
with the use of distemper, parvovirus, rabies, and possibly
other vaccines. 3,6,9 This can result in various clinical signs,
including muscular atrophy, inhibition or interruption of neu-ronal
control of tissue and organ function, incoordination, and
weakness. 3 Therefore, we have the responsibility to advise
companion animal breeders and caregivers of the potential for
genetically susceptible littermates and relatives that are at
increased risk for similar adverse vaccine reactions. 1-5
Commercial vaccines, on rare occasion, can also be con-taminated
with other adventitious viral agents, 6,16 which can
produce significant untoward effects such as occurred when a
commercial canine parvovirus vaccine was contaminated by
blue tongue virus. It produced abortion and death when given
to pregnant dogs 16 and was linked causally to the ill-advised
but all-too-common practice of vaccinating pregnant animals.
The potential for side effects such as promotion of chronic
disease states in male and nonpregnant female dogs receiving
this lot of vaccine remains in question, although there have
been anecdotal reports of reduced stamina and renal dys-function
in performance sled dogs. 3 Recently, a vaccine man-ufacturer
had to recall all biological products containing a
distemper component, because they were associated with a
higher-than-expected rate of central nervous system postvac-cinal
reactions 1 to 2 weeks following administration. 3
If, as a profession, we conclude that we are overvaccinat-ing,
other issues come to bare, such as the needless client
dollars spent on vaccines, despite the well-intentioned solici-tation
of clients to encourage annual booster vaccinations so
that pets also can receive a wellness examination. 5 Giving
annual boosters when they are not necessary has the client
paying for a service which is likely to be of little benefit to
the pet's existing level of protection against these infectious
diseases. It also increases the risk of adverse reactions from
the repeated exposure to foreign substances.
Polyvalent MLV vaccines, which multiply in the host,
elicit a stronger antigenic challenge to the animal and should
mount a more effective and sustained immune response. 5,6,9
However, this can overwhelm the immunocompromised or
even healthy host that has ongoing exposure to other envi-ronmental
stimuli as well as a genetic predisposition that
promotes adverse response to viral challenge. 1-3,9,13 The
recently weaned young puppy or kitten being placed in a
new environment may be at particular risk. Furthermore,
while the frequency of vaccinations is usually spaced 2 to 3
weeks apart, some veterinarians have advocated vaccination
once a week in stressful situations. This practice makes little
sense, scientifically or medically. 5
An augmented immune response to vaccination is seen in
dogs with preexisting inhalant allergies (i. e., atopy) to pol-lens. 3
Furthermore, the increasing current problems with
allergic and immunological diseases have been linked to the
introduction of MLV vaccines more than 20 years ago. 6
While other environmental factors no doubt have a contribut-ing
role, the introduction of these vaccine antigens and their
environmental shedding may provide the final insult that
exceeds the immunological tolerance threshold of some indi-viduals
in the pet population.


Predisposed Breeds
Twenty years ago, this author began studying families of
dogs with an apparent increased frequency of immune-medi-ated
hematological disease (i. e., AIHA, ITP, or both). 1,2
Among the more commonly recognized predisposed breeds
were the Akita, American cocker spaniel, German shepherd
dog, golden retriever, Irish setter, Great Dane, Kerry blue ter-rier,
and all dachshund and poodle varieties; but predisposi-tion
was found especially in the standard poodle, long-haired
dachshund, Old English sheepdog, Scottish terrier, Shetland
sheepdog, shih tzu, vizsla, and Weimaraner, as well as breeds
of white or predominantly white coat color or with coat color
dilution (e. g., blue and fawn Doberman pinschers, the merle
collie, Australian shepherd, Shetland sheepdog, and harlequin
Great Dane). 1-3 Recently, other investigators have noted the
relatively high frequency of AIHA, ITP, or both in American
cocker spaniels 10 and Old English sheepdogs. 13
A significant proportion of these animals had been vacci-nated
with monovalent or polyvalent vaccines within the 30-
to 45-day period prior to the onset of their autoimmune dis-ease. 1,2,10
Furthermore, the same breeds listed above appear
to be more susceptible to other adverse vaccine reactions,
particularly postvaccinal seizures, high fevers, and painful
episodes of hypertrophic osteodystrophy (HOD). 3 For ani-mals
that have experienced an adverse vaccine reaction, the
recommendation is often to refrain from vaccinating these
animals until at least after puberty, and instead to measure
serological antibody titers against the various diseases for
which vaccination has been given. This recommendation
raises an issue with the legal requirement for rabies vaccina-tion.
As rabies vaccines are strongly immunogenic and are
known to elicit adverse neurological reactions, 3,5 it would be
advisable to postpone rabies vaccination for such cases. A
letter from the primary care veterinarian stating the reason
for requesting a waiver of rabies vaccination for puppies or
adults with documented serious adverse vaccine reactions
should suffice.
As further examples, findings from the author's large,
accumulated database of three susceptible breeds are sum-marized
below.


Vaccine-Associated Disease in Old English Sheepdogs

Old English sheepdogs appear to be predisposed to a variety
of autoimmune diseases. 1-3,13 Of these, the most commonly
seen are AIHA, ITP, thyroiditis, and Addison's disease. 2,17
Between 1980 and 1990, this author studied 162 cases of
immune-mediated hematological diseases in this breed. One-hundred
twenty-nine of these cases had AIHA, ITP, or both
as a feature of their disease. Vaccination within the previous
30 days was the only identified triggering event in seven
cases and was an apparent contributing factor in another 115
cases. 2 Thyroid disease was recognized as either a primary
or secondary problem in 71 cases, which is likely an under-estimate
of the true incidence, as thyroid function tests were
not run or were inconclusive in most of the other cases.
Experience with a particular Old English sheepdog family
supported a genetic predisposition to autoimmune thyroiditis,
Addison's disease, and AIHA or ITP or bothÑ an example of
the polyglandular autoimmune syndrome. 2,17 Pedigrees were
available from 108 of the 162 Old English sheepdog cases of
autoimmune disease; a close relationship was found among
all but seven of the affected dogs. 2 Two of three pedigrees
available from the studies of Day and Penhale 13 were also
related to this large North American study group.


Vaccine-Associated Disease in Young Akitas
Akitas also are subject to a variety of immune-mediated dis-orders,
including Vogt-Koyanagi-Harada syndrome (VKH),
pemphigus, and heritable juvenile-onset immune-mediated
polyarthritis (IMPA). 3,14 Juvenile-onset IMPA occurs in
Akitas less than 8 months of age. Of 11 closely related pup-pies
in the author's case series, the mean age of onset was 14
weeks. 3 Initial signs appeared 3 to 29 days following vacci-nation
with polyvalent MLV or killed virus or both, with a
mean reaction time of 14 days. All had profound joint pain
and cyclic febrile illness lasting 24 to 48 hours. Hemograms
revealed mild nonregenerative anemia, neutrophilic leukocy-tosis,
and occasional thrombocytopenia. Joint aspiration and
radiography indicated nonseptic, nonerosive arthritis.
Despite treatment for immune-mediated disease and pyrexia,
all eight dogs had relapsing illness and died or were eutha-nized
by 2 years of age from progressive systemic amyloido-sis
and renal failure. Necropsies were performed on three
dogs, two of which had glomerular amyloidosis and wide-spread
evidence of vasculitis. The history, signs, and close
association with immunization suggested that juvenile-onset
polyarthritis and subsequent amyloidosis in these Akitas may
have been an autoimmune response triggered by the viral
antigens or other components of vaccines. 3
The vaccine-related history was reviewed for 129 puppies
belonging to the family of Akitas discussed above. Polyva-lent
MLV vaccine was given to 104 of them, with 10 (9.8%)
puppies showing adverse reactions and death. Another six
puppies received a polyvalent all-killed vaccine product (no
longer commercially available) with no reactors, and 19 pup-pies
received homeopathic nosodes initially followed by
killed canine parvovirus (CPV) vaccine, with one reactor
that died and one that became ill but survived. 3
A genetic basis for immune-mediated diseases and


immunodeficiencies states is well known. 1,2,12,13,15,17,18 The
mechanism for triggering immune-mediated disease is poorly
understood, but predisposing factors have been implicated
when genetically susceptible individuals encounter environ-mental
agents that induce nonspecific inflammation, molecu-lar
mimicry, or both. 3,17 The combined effects of these
genetic and environmental factors override normal self-toler-ance
and are usually mediated by T-cell imbalance or dys-regulation. 17


Since the modern Akita arose from a relatively small gene
pool, understanding the potential environmental triggers of
juvenile-onset IMPA has immediate importance. Numerous
agents have been implicated, including drugs, vaccines,
viruses, bacteria, chemicals, and other toxins. 1-3,10,11
Although the littermates from affected families typically end
up in different locales, all undergo relatively standardized
immunization procedures at a similar age.


Vaccine-Associated Disease in Young Weimaraners
The Weimaraner breed appears to be especially prone to both
immune deficiency and autoimmune diseases, which have
been recognized with increasing frequency in related mem-bers
of the breed over the past 15 years. 3 Autoimmune thy-roiditis
leading to clinically expressed hypothyroidism is
probably the most common of these disorders, along with
vaccine-associated HOD of young Weimaraners. 2,3,17
During a 2-year period (1986-1988), Couto evaluated 170
related Weimaraners, including affected puppies and their
relatives, and the findings were relayed in a breed newsletter
as discussed in an earlier reference. 3 Clinical signs of the
affected dogs included high fevers, polyarthritis with pain
and swelling typical of HOD, coughing and respiratory dis-tress
from pneumonia, enlarged lymph nodes, diarrhea, pyo-derma,
and mouth ulcers. In most cases, clinical signs were
first detected shortly after vaccination with a second dose of
polyvalent MLV vaccine when the puppies were between 2
and 5 months of age. This author has studied more than 60
Weimaraners with vaccine-associated disease. In 24 cases
described in a previous article, 3 the mean age of onset of
clinical signs was 13.5 weeks, with a mean reaction time of
10.5 days postvaccination. Males were predominantly
affected. All affected puppies showed high-spiking fevers,
cyclic episodes of pain, and polyarthritis (HOD)Ñ a group of
signs identical to those of the affected young Akitas
described previously. Most affected puppies also showed
leukocytosis (with neutrophilia or neutropenia), diarrhea,
lethargy, anorexia, and enlarged lymph nodes. Some puppies
also had levels of immunoglobulin A, immunoglobulin M, or
both below those expected for their age, and one puppy had
immunoglobulin G (IgG) deficiency as well. Other signs
included coughing, pneumonia, depression, seizures or
"spaced-out" behavior, refusal to stand or move, and hyper-esthesia
(" walking on eggshells"). The outcome for half of
these cases was good (12 of the 24 are healthy adults),
although two died, three were euthanized as puppies, and
three remained chronically ill as adults. Another four cases
were lost to follow-up.
Management of this clinical syndrome is best accom-plished
with an initial dose of parenteral corticosteroids fol-lowed
by a tapering course of corticosteroids over 4 to 6
weeks. Systemic broad-spectrum antibiotic may be given
prophylactically, and vitamin C (500 to 1,000 mg daily) can
be included to promote immune support. Recurring episodes
are treated by increasing the corticosteroid dosage for a few
days until the flare-up has subsided. The response to initial
corticosteroid treatment is always dramatic, with fever and
joint pain usually subsiding within a matter of hours.
Serological titers for canine distemper virus (CDV) and
CPV were determined in 19 of the 24 affected Weimaraner
puppies, and all were adequate. Upon reaching adulthood,
serum antibody titers were reevaluated, and detectable CDV-and
CPV-specific IgG persisted. Several of these dogs have
subsequently developed hypothyroidism and are receiving
thyroid replacement. 3,4,17 Thus, to avoid recurrence of
adverse effects, which has been shown to be even more
severe if another vaccine booster is given, serological titers
for CDV and CPV are measured. 7
Another approach recommended by Weimaraner breeders
and this author is to modify the vaccination protocol, espe-cially
for puppies from families known to have experienced
adverse vaccine reactions. Examples would be to limit the
number of antigens used in the vaccine series to those infec-tious
agents of most clinical concern (i. e., CDV, CPV, and
rabies virus), separating these and other antigens by 2-to 3-
week intervals, and giving rabies vaccine by itself at 6 months
of age. A booster series is administered at 1 year by separating
the CDV, CPV, rabies virus, and other vaccine components,
where possible, and giving them on separate visits at least 2
weeks apart. Thereafter, serological antibody titers can be
measured (except for those vaccines required by law, unless a
specific exemption is made on an individual case basis).


Recommendations
Practitioners should be encouraged during the initial visit
with a new puppy owner or breeder to review current infor-mation
about the breed's known congenital and heritable
traits. Several databases, veterinary textbooks, and review
articles contain the relevant information to assist here. 2 For
those breeds at increased risk, the potential for adverse reac-tions
to routine vaccinations should be discussed as part of
this wellness program. Because breeders of at-risk breeds
have likely alerted the new puppy buyer to this possibility,
we should be mindful and respectful of their viewpoint,
which may be more informed than ours about a specific
breed or family issue. To ignore or dismiss these issues can
jeopardize the client-patient relationship and result in the
client going elsewhere for veterinary services or even turning
away from seeking professional care for these preventive
health measures. As a minimum, if we are unaware of the
particular concern expressed, we can research the matter or
ask the client for any relevant scientific or medical documen-tation.
The accumulated evidence indicates that vaccination
protocols should no longer be considered as a "one size fits
all" program.
For these special cases, appropriate alternatives to current
vaccine practices include: measuring serum antibody titers;
avoidance of unnecessary vaccines or overvaccinating; using
caution in vaccinating sick, very old, debilitated, or febrile
individuals; and tailoring a specific minimal vaccination pro-tocol
for dogs of breeds or families known to be at increased
risk for adverse reactions. 3,5-8 Considerations include starting
the vaccination series later, such as at 9 or 10 weeks of age,
when the immune system is more able to handle antigenic
challenge; alerting the caregiver to pay particular attention to
the puppy's behavior and overall health after the second or
subsequent boosters; and avoiding revaccination of individu-als
already experiencing a significant adverse event. Litter-mates
of affected puppies should be closely monitored after
receiving additional vaccines in a puppy series, as they, too,
are at higher risk. Altering the puppy vaccination protocol, as
suggested previously for the Weimaraner, is also advisable.
Following these recommendations may be a prudent way
for our profession to balance the need for individual patient
disease prevention with the age-old physician's adage, for-warded
by Hippocrates, of "to help, or at least do no harm."


References

1. Dodds WJ. Immune-mediated diseases of the blood. Adv Vet Sci Comp
Med 1983; 27: 163-196.
2. Dodds WJ. Estimating disease prevalence with health surveys and
genetic screening. Adv Vet Sci Comp Med 1995; 39: 29-96.
3. Dodds WJ. More bumps on the vaccine road. Adv Vet Med
1999; 41: 715-732.
4. Hogenesch H, Azcona-Olivera J, Scott-Moncrieff C, Snyder PW, Glick-man
LT. Vaccine-induced autoimmunity in the dog. Adv Vet Med
1999; 41: 733-744.
5. Schultz R. Current and future canine and feline vaccination programs.
Vet Med 1998; 93: 233-254.
6. Tizard I. Risks associated with use of live vaccines. J Am Vet Med
Assoc 1990; 196: 1851-1858.
7. Twark L, Dodds WJ. Clinical use of serum parvovirus and distemper
virus antibody titers for determining revaccination strategies in healthy
dogs. J Am Vet Med Assoc 2000; 217: 1021-1024.
8. Tizard I, Ni Y. Use of serologic testing to assess immune status of com-panion
animals. J Am Vet Med Assoc 1998; 213: 54-60.
9. Phillips TR, Jensen JL, Rubino MJ, Yang WC, Schultz RD. Effects of
vaccines on the canine immune system. Can J Vet Res 1989; 53: 154-
160.
10. Duval D, Giger U. Vaccine-associated immune-mediated hemolytic
anemia in the dog. J Vet Intern Med 1996; 10: 290-295.
11. Cohen AD, Shoenfeld Y. Vaccine-induced autoimmunity. J Autoimmun
1996; 9: 699-703.
12. May C, Hammill J, Bennett, D. Chinese shar pei fever syndrome: a pre-liminary
report. Vet Rec 1992; 131: 586-587.
13. Day MJ, Penhale WJ. Immune-mediated disease in the old English
sheepdog. Res Vet Sci 1992; 53: 87-92.
14. Dougherty SA, Center SA. Juvenile onset polyarthritis in akitas.
J Am Vet Med Assoc 1991; 198: 849-855.
15. Scott-Moncrieff JCR, Snyder PW, Glickman LT, Davis EL, Felsburg
PJ. Systemic necrotizing vasculitis in nine young beagles. J Am Vet
Med Assoc 1992; 201: 1553-1558.
16. Wilbur LA, Evermann JF, Levings RL, et al. Abortion and death in
pregnant bitches associated with a canine vaccine contaminated with
blue tongue virus. J Am Vet Med Assoc 1994; 204: 1762-1765.
17. Happ GM. ThyroiditisÑ a model canine autoimmune disease. Adv Vet


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[cornelgingarasu]

RISKS ASSOCIATED WITH THE VACCINATION OF VERY YOUNG PUPPIES

Introduction

Generally, dogs immunization follow several schedules that are not very different. It is for sure that vaccination is a basic treatment and the most routine procedure performed in veterinary clinics. It can also be considered the most important medical moment in a dog’s life, a non-immunized dog having, at least in Romania, very few survival chances.
This was obvious before 1990 when no vaccines were produced or imported, thus 80% of the dogs died in their first year of life. Although vaccination is an important and obligatory step, sometimes there may appear reactions which make the owner doubt the necessity, or even to refuse the immunization schedule.

When dog’s vaccination became current practice among Romanian veterinarians they recommended the first shot to be given when the puppies are 3 months old. In a few years they noticed that the probability for the dogs aged 2 months to get distemper, parvovirosis, infectious hepatitis increased. Thus the necessity to vaccinate puppies at an early age became obvious.

Currently the immunization schedule starts when the puppies are 44 days old, different Romanian or imported vaccines being used (mono or polyvalent produced by Intervet, Fort Dodge, Merial or Biocan).
However, in spite of the strict immunization schedule with vaccines from well known companies, preceded by a clinical examination and deworming, veterinarians have been confronted with severe vaccine reactions in a number of dogs. The frustration felt by many veterinarians and the necessity to understand the reason for vaccine reactions in puppies aged 44-56 days suggested this study.




Epidemiologic data

663 cases of puppies who were immunized at the age of 2 months, with a good general condition, were investigated.
The result are presented in Table 1



Table 1. Vaccine reactions in dogs fist immunized at 44-45 days of age
Immunization age – days 44 45 46 47 48 49 50 51 52 53 54 55 56 TOTAL
Immunized dogs 121 7 56 80 72 59 90 10 62 9 15 4 7 663
Dogs with vaccine reaction 12 3 6 4 1 5 1 1 - - 3 - - 53
7.9%



Clinical data concerning the vaccine reactions

I would like to underline the fact that the reactions were not of an allergic type as described by all vaccine producers and that are normally treated with adrenalin.

In 50 dogs the sickness appeared abruptly, 24-30 hours after vaccination. The symptoms started with the lack of appetite, vomiting, and then diarrhea and dehidratation. Their body temperature was within normal limits, at the end the patients becoming hypothermic. The stool was yellowish, never with blood. After 2, max. 3 days, even under strong treatment (fluids i.v., antibiotics, blood transfusions) 46 patients died. In 4 cases there was a complete recovery in 6-7 days. In 3 cases, the reactions appeared abruptly, in 15-20 hours after administration, but only with fever, low appetite, lack of movement and of response to stimuli, but no digestive symptoms were present. After 24 hours of antithermic medication, the symptoms were alleviated, and in max. 2 days the dogs were back to normal.



Immunologic and hematologic data

Unfortunately, none of the 663 puppies had had any laboratory tests before and none of the 53 with vaccine reactions were monitored properly, because of the rapid evolution of the disease.
Usually, there is only a clinical examination before immunization and no hematologic tests.

Taking into consideration the post-vaccinaton accidents and the hypothesis that maybe the first shot at an early age (under 2 months) is inappropriate, I proceeded to a randomized general examination.
A number of 32 puppies aged 40-45 days were subject to a immunological and hematological evaluation.
They were of various breeds: German pointers-6 German Shepherd-9, cross-breds-3, Great Dane-2, Boxer-7, Schnauzer-1, Rottweiler-4

The results are presented synthetically in Table 2



Table 2. The results of the hematological and immune evaluation in puppies aged 40-45 days
Wbc/µl 5600
Limphocytes/µl 1132
Neutrophocytes/µl 4015
Monocytes/µl 181
Tcell total 109/l 0.43
Thelper (CD 4 +) 109/l 0.67
Tcytotoxic (CD 8 +) 109/l 0.63
Zymogen (serum) - µg/ml 6.12



The values showed a weakened and immature immune system, even if the physical development was very good.



Discussions and clinical relevance

The percentage of vaccine reactions (7.9%) is quite significant, a reason for veterinarians, owners and vaccine producers to be worried.

At first sight the anamnetic and clinical data show that the puppies who had a severe reaction after vaccination were immunosuppressed, with immunologic deficiencies, the vaccinal virus acting like a wild virus. On the other hand, the evaluation of the immune system of 32 dogs randomly chosen show a low immunity under the age of 60 days.

The Council on Biologic and Therapeutic Agents (COBTA) considers that there can not be established a single or best immunization schedule.
Even if it is good for the first shot to be given as close to weaning as possible, it would be necessary to diagnose the dog’s capacity for an immunologic response before the first vaccination.

The immune evaluation has at least two shortcomings.
1. it is rather expensive and it is possible for many owners not to agree with it;
2. the identification of an unusual immuno-hematologic background can not show with precision if the vaccine-body interaction will end up in vaccine reactions or not. It would be better to evaluate the immune response by using an inoffensive challanger, and then, by measuring the response, the competence can be diagnosed.

As for the things that can be done to avoid the vaccine reactions we can suggest:
-the first shot should be postponed till the dog is 2 months old, keeping it as insolated as possible, if there is any suspicion of an immunologic deficiency
• treatments for immunological stimulation by general or non-specific means (bacteries, immunoglobulin etc.)
• the use of mono-valent or bivalent vaccines which are better tolerated by young dogs
• the dog’s general preparation by providing brest feeding for 21-30 days from a healthy, well-immunized mother, weaning it with quality food, proper deworming, avoiding external stress ,etc.


Conclusions

• 663 puppies were observed to see the adverse reactions after the first vaccination
• 53 dogs (7.9%) suffered of vaccine reaction, of which 50 with an acute gastroenteritis and 3 with a benigne febrile syndrome
• the vaccine reactions at the age of under 2 months were mainly due to low immunity
• it is recommended that the dogs be tested for a possible juvenile immunodeficiency and the postponing of the first vaccination till the puppies are at least 60 days old.

[Siberian]

I'm sorry to say my Siberian husky seems to have a problem with distemper inoculations. We had blood work done and I await the vet's phone call to see if it shed any light on the neurological symptoms she is having. Prednisone has it under good control now, but it started while we were on vacation, when one of my two 7-year-old Siberians attacked my other one and tore her ear. All the attention went to the one with the torn ear at the time, and nobody thought to examine the dog that attacked. When we got home we started observing scary neurological signs. It started with eyes that were nearly closed with a strange, swollen look. Maybe that's what facial weakness looks like; I'm not sure, but she had a terrible time opening her eyes and was sensitive to light. She was also hypersensitive on and off to being touched on the abdomen. The facial symptoms progressed slowly (by Monday) to pacing, circling, confusion, getting stuck in corners. She would sink into what seemed to be near coma state. Naturally this started on Saturday evening. Since it started with her eyes, I put eye ointment in her eyes Saturday night. The ointment had steroids in it. Two hours after doing that, she came out of her stupor, her eyes looked better, and she was fairly normal. Sunday was the same. She would start going down, and two hours after using the ointment, she was better.

As I said, by Monday was it was obvious that these symptoms were progressing and were neurological in nature. Because I just started a new job and had to work, and Misha was weak enough that riding in the car was hazardous, I took her to a vet less than a mile from my house. This vet was mystified. She took blood work to check liver, etc. I don't think she started the prednisone tabs; I think that was the emergency vet my husband took her to later in the week. Once prednisone was started, she started doing better, but she was still sinking to near coma by 7:00 p.m., as if the medicine wasn't staying in her system long enough. Finally we had a day off and made a trip to our regular vet on Thursday. He upped the prednisone and discussed lupus, tick-borne illnessses (thought she is on good prevention) encephalitis, meningitis, lympha and brain tumors. He drew more blood to check for all of these.

Now the results are on his desk, but he hasn't called us yet. Naturally I have continued my research, and what makes the most sense to me is that this is a reaction to her distemper booster. This clues I wish we'd thought about were the fact she has terrible feet with thick skin. She's had surgery to clean out an infection she had. But the pathologist's report didn't say anything about distemper feet, and from my reading here, it seems like it should have shown up. But maybe my vet only sent the fluid and didn't send a tissue biopsy.

Now the only other clue we might have noticed was that she has inhalant allergies. We've kept her on top-rated foods with no wheat, corn or soy. So I did everything I knew to help her immune system. We have now added a good air cleaner to the house to try to help her also.

So now that I am convinced it is probably a distemper reaction, I wonder if my vet is thinking that too and thinks I'm going to sue him or something, and that's why he's putting off the call. Oh I know, he's very busy, but I'm surprised he didn't have his staff ask us to come in this afternoon since he has the results. I already called to let the office know we are available and waiting to hear.

It's very disappointing to discover the possibility that protecting our pet from a deadly disease turned around and attacked her immune system.

If it turns out to be true, my dogs will have titers checked before they get boosters, and they won't be getting modified live viruses unless it's rabies and that's the only option (I have no idea).