TOO MANY SHOTS?
Bonnie Washuk, Staff Writer - February 20, 2005
AUGUSTA - Like many pet owners, when Kris Christine of Alna got cards from her veterinarian reminding her that Meadow's and Butter's shots were due, she brought in her lovable Labs.
Her vet recommended that her pets have rabies shots every other year and distemper shots every year, Christine said.
But months after Meadow's biannual rabies shot in the fall of 2003, she noticed something. "He had this weird thing on his back hind side," she said. "Every time he'd run, it would swell, then it would go away."
Meadow eventually was diagnosed with mast cell cancer, which Christine believes resulted from the vaccination injection at that same spot on his leg. "It's not something you want," she said. "It's an aggressive cancer."
Veterinarians say the likelihood is very small that Meadow's cancer stemmed from the shot. However, while taking care of Meadow's cancer, Christine stumbled on a hot debate in the animal health field: How often should dogs and cats be vaccinated?
While experts stress that vaccines are vital to the health of pets, mounting research indicates vaccines can no longer be considered harmless. Research shows they can cause adverse health effects - everything from lower immunity against viruses, bacteria and parasites, to cancer - and that some vaccines do not have to be given as frequently as once thought.
In response, the American Animal Hospital Association in 2003 began recommending less frequent vaccinations for cats and dogs.
Christine, who began researching the subject after Meadow's cancer was detected, quickly became an energetic crusader, spreading information about vaccinations and questioning frequency guidelines. She believes that by following her veterinarian's recommendations, "Meadow was being over-vaccinated for years."
In the process, Christine said she discovered that Maine law required a rabies shot for dogs and cats every two years, despite the fact that the vaccine's manufacturer says it is good for three.
She questioned the law in early 2004, and it was changed last fall, according to state public health veterinarian Dr. Robert Gholson. The state now mandates that rabies shots be given every three years. (Saying not all veterinarians have gotten the word, Gholson is sending out a second reminder.)
Christine now hopes she will be equally successful with her next effort: to get the Legislature to pass a law requiring Maine veterinarians to disclose the pros and cons of vaccines.
Rep. Peter Rines, D-Wiscasset, is sponsoring L.D. 429, and said that since introducing the bill, the outpouring of e-mails and letters in favor has been overwhelming.
"In my tenure as a legislator I've never had this kind of response," he said. Pet owners are thanking him, and some people outside Maine have said they hope his bill will lead to similar laws in other states, he said.
"Everyone wants to do the best thing for our four-legged friends," said Rines, noting his bill is intended only to give consumers information.
But some Maine veterinarians plan to voice their opposition to the bill at its public hearing on Feb. 28. Saying they feel like they're under attack, the opponents say they see no need for disclosure forms.
The Making of a Crusader
After Meadow was diagnosed with cancer last year, he underwent two operations. A chunk of his back thigh was removed.
On the bottom of one of Christine's veterinarian bills in April for cancer treatment was a reminder that Meadow's distemper shot was due in November and his next rabies shot in 2005.
It upset Christine. "I said, 'He's not going to be alive then.'"
Christine said her veterinarian said the cancer did not come from the vaccine, but Christine was skeptical. She grew even more doubtful after learning that the law required dog immunizations every two years even though the rabies vaccine lasted three.
When she got the bill, Christine told her vet she had a problem giving her dog vaccinations every year or every other year.
"Here's my dog lying at my feet, suffering with a huge chunk of his hind leg removed. I thought, 'You were giving him medication that you know he doesn't need.'"
Christine found a new veterinarian and became an advocate for changing the laws and making pet owners more aware of the potential health risks posed by vaccinations. "We need the tools," she said, she is not the only one that feels that way.
Among those concerned about pets receiving vaccinations too frequently are AKC judge and former breeder Arnold Woolf of Lewiston and Larry Doyon of Munster Abbey Kennels in Minot, breeders of German shepherds. Both say they support the legislation.
Experts: Risks are low, but...
Christine's efforts have also met angry opposition. Last week the Maine Veterinary Medical Association came out against L.D. 429. In a Feb. 2 letter to lawmakers, MVMA President Matt Townsend did not directly spell out why the organization is opposed to the bill.
But Townsend complained that such a law would mandate "cumbersome disclosure and consent procedures for every vaccination and medication dispensed by veterinarians." It also said Christine "has launched what can only be described as an aggressive scare campaign, designed to drive a wedge of distrust between pet owners and their veterinarians."
Actually, the law makes no mention of medication other than vaccines. The law says veterinarians must provide disclosure forms informing consumers about the advantages and disadvantages of vaccines.
MVMA Executive Director Bill Bell said there is no Maine protocol on how often vaccines should be administered, and that even top researchers disagree. "The bill is vague to the point of being ridiculous," he said.
Veterinarians are worried a disclosure form would scare away some pet owners from having their dogs and cats vaccinated, which would lead to diseases coming back, Bell said. He added that the bill will increase paperwork for veterinarians without doing any good.
One nationally recognized vaccine researcher, Dr. Ronald Schultz, favors the law.
While rare, vaccines can cause adverse health affects in cats and dogs, said Schultz, an expert in animal vaccinations and chair of the department of pathobiological sciences at the University of Wisconsin School of Veterinary Medicine.
"I favor anything that would better inform the potential buyer of what they need and what they're getting," he said in a telephone interview from his Wisconsin office.
A majority of veterinarians are already providing that information, but some are not, he said.
The thinking that vaccines are harmless is changing, Schultz said, adding that annual vaccinations don't help pets, and can hurt them. "For years we worked under a philosophy of 'if it doesn't help, (at least) it won't hurt.'"
What he called "an awakening" began in the 1980s when healthy cats given vaccines were getting cancer. "The odds were small, but if the odds are 1 in 1,000 that doesn't matter if it's your pet," he said.
The probability of dog vaccines causing cancer is lower than cats, he said. "But we're constantly learning. The wake-up call to the veterinarian profession was that vaccines create a risk. ... No matter how rare the adverse effects are, we don't want to give a product that's not needed."
Schultz said the veterinary profession has been using annual or biannual shots as a way to bring clients through the door for the more important exam. Convincing pet owners to come in by telling them their pets' annual or biannual shots are due should no longer be practiced, he said.
Schultz cited the newest guidelines from the American Animal Hospital Association, which in 2003 went from recommending annual distemper shots to one every three years. Under the guidelines, dogs and cats should receive core shots for rabies and distemper beginning at 12 weeks, a booster at one year, then boosters no more frequently than every three years. (Some central and western Maine veterinarians are following the recommendations, others are not. See related chart.)
All other vaccines are "optional," according to Schultz and the AAHA, and are based on the animal's lifestyle and risk. For instance, annual Lyme disease and heartworm vaccines may be important for pets living in areas where those diseases have been prevalent, but may not be necessary where they have not, he said.
Maine vets are already informing.
While not all researchers or veterinarians agree with Schultz, many acknowledge that the thinking regarding vaccines has changed in recent years, and that more vets are giving vaccinations less frequently.
"There's been a paradigm shift to greater focus on trying to encourage clients to see the importance of an examine and not vaccines, that vets aren't just for shots anymore," said Dr. Bill Bryant, past president of MVMA. Physical examinations at least once a year are important, he stressed, especially when considering that dogs and cats "age seven years on average for every year we age."
Part of that examination, Bryant said, involves making a recommendation on what vaccines a pet should have, based on the pet's lifestyle. For instance, a dog that is never with other animals may need less vaccine protection than one that goes to a doggie day care. An indoor cat needs less than one that roams outdoors.
In part because of that important relationship between a veterinarian and a pet owner, Bryant and at least some other Maine veterinarians remain wary of Christine's legislation. Veterinarians are already giving clients information on the risk of vaccines, he said. Central Maine Veterinary Hospital in Turner, for instance, asks pet owners to sign a vaccination consent form that outlines the concerns.
Dr. Susan Chadiman of Androscoggin Animal Hospital in Topsham said L.D. 429 is well intentioned and that the veterinarian's office "is the place for dialogue, for education." But she said she's against the bill because a mandated disclosure form would not enhance that.
"It would create a tremendous amount of paperwork," Chadiman said. "And a real concern is that it leaves wide open who's going to decide what is science, what is fact."
Christine, whose dog Meadow is now doing "very well," counters that science has already proven that the protective effects of pet vaccines last longer than even the newest recommendations. But she said her legislation is simply about a consumer's right to know.
"I think pet owners have a right to know what veterinarians know" about the effects and effectiveness of vaccines, she said.
No one would advocate giving a human a 10-year tetanus shot every two years, she said. Pet owners are consumers. "They need to know there's no benefit in giving their dogs booster shots more often ... and it does put them at increased risk for adverse side effects," she said.
What: The bill says veterinarians "shall provide a vaccine disclosure form to the owner of a dog or cat before vaccinating that dog or cat. The vaccine disclosure form must provide information regarding the advantages and disadvantages of vaccines."
When: L.D. 429 will be heard before the legislative Committee on Agriculture, Conservation and Forestry. The public hearing has been scheduled for 1 p.m. Monday, Feb. 28, in Room 206 of the State Office Building.
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