If you don't vaccinate for everything annually

Re: If you don't vaccinate for everything annually

James Allsop — Tue, 26 Jan 2010 15:01:40 GMT

Back to charges.

I looked at our pricing structure when we started doing alternate vaccinations and I personally felt that a fixed rate was unclear and didnt re-inforce the difference to clients from full boosters every year. We therefore charge a booster fee (annual health check - call it what you will) and then itemise the vaccine stock used at the appropriate price. this way the invoice clearly shows what has been paid for and helps to reinforce the importance of the health check not just a booster

Re: If you don't vaccinate for everything annually

ruths — Sat, 23 Jan 2010 21:24:21 GMT

Ok, I've read some of the other posts and fair enough. I shan't discuss further on here.

Shall carry on talking with my friend who has her PhD and post doc reasearch in autism and her autistic kids to discuss it with-

And shall restrict myself to dog and cat vaccine related stuff!

Re: If you don't vaccinate for everything annually

ruths — Sat, 23 Jan 2010 21:13:11 GMT

Thanks Niall, I'll have a look at the other threads when i have time.

But

There IS a vaccine damage payment scheme set up by this government and it covers children vaccinated against MMR who then become damaged.

I can't do a link- but you can see the details here:

http://www.direct.gov.uk/en/DisabledPeople/FinancialSupport/OtherBenefitsAndSupport/DG_10026664

they will pay around £120k.

Re: If you don't vaccinate for everything annually

Vikki Moran — Wed, 20 Jan 2010 21:49:48 GMT

yes i don't want to pull this off at much more of a tangent, BUT as the mmr thing goes andrew wakefield who was the author of the article which pointed the finger at mmr and sutism was charged with disgraceful conduct by the GMC for falsifying the results he used and for completely fabricating the whole thing:

http://www.timesonline.co.uk/tol/life_and_style/health/article1027636.ece

http://en.wikipedia.org/wiki/MMR_vaccine_controversy

apparently his fitness to practice case is being heard this week and is expected to be finished in the next few weeks.

Re: If you don't vaccinate for everything annually

Niall Taylor — Wed, 20 Jan 2010 10:57:41 GMT

[quote user="ruths"]Nial, I'm not sure If really that the MMR was found not to be associated with autism.[/quote]

OK, now we're seriously off topic - the MMR vaccine has been discussed a couple of times before, mainly in this thread - http://www.vetsurgeon.org/forums/p/1945/2936.aspx

The supposed link between MMR and autism has been thoroughly discredited - you'll find links on the other thread. I have heard the theories about groups of at risk children but never any firm evidence - it's as if the MMR/autism lobby are now moving on to find another condition they can blame the vaccine for instead .

Regarding 'compensation payments' the US legal system will pay out to some claimants without having to prove a conclusive link to the suspect treatment so a court case has no bearing on the safety profile of MMR. Besides this was a single case compared with the millions that anti-MMR campaigners were originally claiming and the condition wasn't even autism!

Anyway, it's an interesting topic but probably best, if you want to revive it, to post on the original thread - http://www.vetsurgeon.org/forums/p/1945/2936.aspx (don't want to incur the wrath of Arlo now, do we?).

Cheers,

Niall

Re: If you don't vaccinate for everything annually

ruths — Tue, 19 Jan 2010 21:59:21 GMT

Thanks- I thought it was a recent thing.. my mistake!

Re: If you don't vaccinate for everything annually

Ian Mostyn — Tue, 19 Jan 2010 21:46:16 GMT

[quote user="ruths"]I'm interested to see that fort dodge are bringing out a 3yrly parvo booster and I'm thinking quite hard about the implications of all of this.[/quote]

Errr, Durammune DAPPi +L(C) is already licensed for every 3 years, alternating with Pi +L(C) . We have been using it like that since last May when we made the move to Fort Dodge.

Ian

EDIT - From Duramune DAPPi +LC datasheet

Administer a single dose by subcutaneous injection one year after completion of the primary vaccination schedule. Subsequent booster vaccinations should be administered at intervals of not less than one year and not more than three years. If intervals longer than one year are implemented, immunity against the canine parainfluenza virus, leptospiral antigens and canine coronavirus should be assured by administering a suitable combined canine parainfluenza, L. icterohaemorrhagiae, L. canicola and canine coronavirus vaccine at intervals of not more than one year.

Re: If you don't vaccinate for everything annually

ruths — Tue, 19 Jan 2010 21:42:33 GMT

Oh, and in the last year I belive the USA gvmnt awarded damages to a vaccine damaged child......

I have 2 kids, both of whom have had their MMR but I didn't take the decision lightly.

Re: If you don't vaccinate for everything annually

ruths — Tue, 19 Jan 2010 21:40:28 GMT

Nial, I'm not sure If really that the MMR was found not to be associated with autism.

I think there are a good numebr of people looking into a number of aspects of atusom triggers and why kids seem to regress.

As I understand it (from a post doc researcher with an autistic child) there is a theory that there is a groupf of children who are in a risk group and a number of things can tip them over the edge. One of the implicated drugs was augmentin that is commonly used for ear infections, another was vaccines. i believe that it is thought that about 7% of autistic children fall into the vaccine damaged category. If you google there is a form that one can fill in for gvmnt compenstaion for vaccine damaged children- so it is recongised thatit exists.

It's just that it got all daily mailed and ben goldachered so there is a big load of politics on top of some quite interesting research.

There is some thoguth that these kids may have mitochondrial disorders.

But I bet you won't find any mainstream newspapers reporting on this stuff anymore- it's a political hot potato!

Re: If you don't vaccinate for everything annually

ruths — Tue, 19 Jan 2010 21:40:26 GMT

Nial, I'm not sure If really that the MMR was found not to be associated with autism.

I think there are a good numebr of people looking into a number of aspects of atusom triggers and why kids seem to regress.

It's just that it got all daily mailed and ben goldachered so there is a big load of politics on top of some quite interesting research.

There is some thoguth that these kids may have mitochondrial disorders.

But I bet you won't find any mainstream newspapers reporting on this stuff anymore- it's a political hot potato!

Re: If you don't vaccinate for everything annually

ruths — Tue, 19 Jan 2010 21:32:56 GMT

Lol, I suppose that I am more accepting of the "hunches" made by such people that sit on these boards and am willing to listen to their opinion as I feel they have more information and experinece and are more suitably qualified than me to advise on the vaccination schedules.

I have looked at alot of the papaers reagrding antibody testing 3-5 yrs post vaccination in cat sna dogs.

I'm interested to see that fort dodge are bringing out a 3yrly parvo booster and I'm thinking quite hard about the implications of all of this.

Is there a published argument to promote vaccination? Is there a groups of academics advising that the WSAVA are mistaken?

Or is it practicioners and vaccine companies not wanting to change the status quo?

Re: If you don't vaccinate for everything annually

Niall Taylor — Tue, 19 Jan 2010 12:23:01 GMT

[quote user="ruths"]I agree that there is at this point no overwhelming evidence to say that there is a big problem with vaccinating yearly - BUT, if and when that evidence is found, then I'd prefer to be in the group of people who did less vaccinating as recommended.[/quote]

What if, when "the evidence is found" it shows that there is more risk from undervaccinating? You'd be in the wrong group then!

Cheers,

Niall

Re: If you don't vaccinate for everything annually

ruths — Tue, 19 Jan 2010 00:32:45 GMT

This is very interesting- and I'm more guided by the WSAVA and the BSAVA vacc guidlines published in JSAP sept 2007.

THier strapline is that we should vaciinate more animals, but that we should vaccinate each animal less frequently.

I agree that there is at this point no overwhelming evidence to say that there is a big problem with vaccinating yearly - BUT, if and when that evidence is found, then I'd prefer to be in the group of people who did less vaccinating as recommended.

(i hope that makes sense- First do no harm)

Re: If you don't vaccinate for everything annually

Evelyn Barbour-Hill — Sun, 17 Jan 2010 17:36:29 GMT

[quote user="Andrew Kent"]I wouldn't at all say you were ripping people off as your costs are averaged, but I take more of an issue with those who say they have kept their costs as they were when all was full vaccination even during interim years when costs are lower![/quote]

A fair point, but, I would submit, a minor one: if you are making what I would call a fair and proper charge for the consultation element, the couple of pounds difference in cost between the two vaccine formulae is barely noticeable.

Re: If you don't vaccinate for everything annually

Andrew Kent — Sun, 17 Jan 2010 17:30:21 GMT

[quote user="Niall Taylor"]Doubtless Andy would say we were ripping people off during the Pi+L years, whereas I would say we're giving a generous disount during the DHP years ![/quote]

Hi Niall,

I'm good thanks, hope all is ok with you.

I wouldn't at all say you were ripping people off as your costs are averaged, but I take more of an issue with those who say they have kept their costs as they were when all was full vaccination even during interim years when costs are lower!

Andy

Re: If you don't vaccinate for everything annually

Niall Taylor — Sun, 17 Jan 2010 11:30:44 GMT

[quote user="beldather"]I dont think I'm pushing the causative theory that far[/quote]

I would respectfully beg to differ. It is not possible to make generalisations about vaccine risk from 2 anecdotal cases. Shocking, occasionally life threatening events happen, occasionally they can happen in association with other events such as vaccination but, no matter how anxious we might be to come up with a reason why, such coincidences don't allow anyone to come to a conclusion about cause and effect.

The prime example is the story of the MMR vaccine - many parents reporting a shocking event (onset of autism) associated with vaccination but when the evidence was looked at properly and dispassionately no such association was found to exist.

The reference about IMHA is interesting, thanks but it is a single paper which says little about the risk of vaccination to a whole population as the POOCH report (Vaccine, Volume 22, Issues 25-26, 3 September 2004, Pages 3270-3273) does in its survey of several thousand owners when it reported no observable risk from vaccination in dogs. You also mention "a number of papers" about the human situation which you don't reference, so no conclusions can be drawn.

I agree that no intervention can be 100% safe and I also agree with you that we should not be using any medication (including vaccines) more than is necessary. Where I disagree is with your perception and portrayal of the risk and the evidence you base it on. The reason that drug companies have changed vaccination intervals is not because of the level of properly reported adverse events but because of public pressure from a vocal and well marketed anti-vaccination lobby, particularly the dreadful survey by Catherine O'driscoll (only available if you buy her book ).

This aspect of the debate is a bit of a derail, so to get back on topic and address the original point - we use intervet vaccines and stick to data sheet recommendations giving Pi+L every year and DHP(arvo) every third year after the 1y course is completed.

We charge the same each year. We used to charge differently for each type of vaccination but the hassle as people quibbled about what they were supposed to have had and when just wasn't worth the trouble over a few quid so we ended up taking an average price and charging that. Doubtless Andy would say we were ripping people off during the Pi+L years, whereas I would say we're giving a generous disount during the DHP years ! How's it going Andy?

Cheers,

Niall

Re: If you don't vaccinate for everything annually

beldather — Sat, 16 Jan 2010 21:52:54 GMT

Niall,

Anaphylaxis to vaccinations are quite well evidenced and since the dog/cat (had both do it) blow up and start gasping for breath within 5 minutes of administering a vaccination, I dont think I'm pushing the causative theory that far. Now obviously anaphylaxis can occur with any medication etc so this isnt a vaccine only problem, but that doesnt mean we shouldnt be trying to reduce the incidence as low as possible (even though its very low to start with).

Regards to Immune mediated stuff, the only useful paper that I'm aware of in dogs is:

Vaccine-associated immune-mediated hemolytic anemia in the dog
J Vet Intern Med. 1996 Sep-Oct;10(5):290-5.
D Duval¹, U Giger ¹ Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia 19104-6010, USA.

There is a number of papers in the human world with sound evidence towards vaccinations and encephalopathies and other immune mediated disease. Now granted all of these have a very low risk of occuring but they are there.

The debate is not vaccination risk vs not vaccinating (thats easy to answer) so the anti-vaccinating crowd is irrelevant to the discussion. It is whether the benefits of vaccinating less outweighs the risks.Its hard to see where they dont in most urban areas (rural I think are a different matter).

The whole idea of a vaccination is to inject a foreign material into the body to cause a response, that is never going to be 100% safe, so why do it more then you have to?

I dont give antibiotics out without evidence of infection, nor dispence beta blockers without evidence of a heart problem, so why are we vaccinating when we have good evidence that it's not going to do anything beneficial (and to be honest this is probably the most important thing!) and evidence that it can cause (albiet at a very low rate) problems.

Regards

Blair

Re: If you don't vaccinate for everything annually

Hanna Bennett — Sat, 16 Jan 2010 18:47:44 GMT

well just to confuse everyone, we use the Merial vaccines (admittedly because they have the best cat vaccine) and they don't produce a PiL component so we do full vaccs every year. We also vacciante at 8 and 12 weeks still - in an area where we still have regular parvo outbreaks i'd love proof that maternal immunity drops before 12 weeks before changing this.

Re: If you don't vaccinate for everything annually

Vikki Moran — Sat, 16 Jan 2010 17:22:21 GMT

because that had already been stated earlier! i didn't think it necessary to repeat, but was merely trying to point out that the data sheet isn't actually as specific as to say that it is ESSENTIAL to vaccinate with the full complement annually. recommended is not the same as essential. and therefore, is it in fact correct to say that giving a different booster annually is contrary to the data sheet?

Re: If you don't vaccinate for everything annually

Rob Loxley — Sat, 16 Jan 2010 16:06:33 GMT

[quote user="Vikkivet"]and for the record, on vanguard 7:[/quote]

Your quote from the datasheet however omits the first sentence: "Annual booster vaccination is recommended"

Re: If you don't vaccinate for everything annually

Niall Taylor — Sat, 16 Jan 2010 16:01:31 GMT

[quote user="beldather"]I have seen a number of immune mediated diseases, and a few anaphylactic reactions post vaccines, so I have seen the negative effects of vaccines.[/quote]

It is impossible to tell whether these conditions are related in any way to vaccination - correlation doesn't equal causality. That sort of statement is just a gift to those of an anti-vaccination bent. After all 25% of all conditions seen in general practice occur withing 3 months of annual vaccination .

[quote user="beldather"]We have strong evidence that vaccines can cause problems.[/quote]

Would you be able to provide a link to this evidence?

Cheers,

Niall

Re: If you don't vaccinate for everything annually

Vikki Moran — Sat, 16 Jan 2010 15:29:13 GMT

and for the record, on vanguard 7:

"should Veterinary Surgeons conduct a risk-benefit analysis for individual animals to determine the frequency of revaccination with Vanguard 7, they should be aware of the following information. Serological data has indicated that most dogs, when given at least the first annual booster, can maintain protective levels of immunity to the viral components of Vanguard 7 for up to 4 years" (taken from the data sheet)

one of the practices i work in uses Vanguard, and an alternating policy. i presume this was after discussion with Pfizer.

Re: If you don't vaccinate for everything annually

Vikki Moran — Sat, 16 Jan 2010 15:21:35 GMT

I've been thinking about all this sort of thing for a while now. I first did work experience in 1992. and the practice i went to I specifically remember that they were using different booster schedules then. dhppi/l twice for primary course, dhppi/l for first booster, and then alternating ppi/l and dhppi/l. that's nearly 20 years ago now, so maybe they were just very progressive! I don't know, but i do remember being taught the difference between the colours of the bottles!

anyway, I prefer to alternate, and it's not difficult to do. in fact most of the computer systems available can do it for you. i'm using jupiter in one practice and ventana in another and they certainly do. type in the booster code, and it pops up with what they need this time. easy peasy and doesn't involve any time or inclination on my part.

in both practices the same price is charged regardless of the type of booster, because it saves trying to explain why one year costs more than another, and also it saves having to explain over the telephone, to a client ringing for a price check, what the difference is.

for clients who are interested in the vaccination protocol it's clearly explained to them, so they understand that we are not "over-vaccinating".

whether or not "over vaccination" is an issue is largely irrelevant I think. I believe it may be an issue which is never fully resolved, but i think it's important for the clients to see that we as a profession are taking their concerns into account. probably more important now than it's been before!

as for KC - well I think that's a different matter - by and large it's easy to treat, and the vaccine (as we ALL know) isn't 100% reliable - my own dog has been kept up to date with KC vaccine but has still had it several times in his 8 year life. So I don't push it, but if clients ask what else their dog can be vaccinated against i try to give them the info and let them make the choice, and of course i strongly recommend dogs that are ever kenneled, or go into high risk situations are kept vaccinated.

cats - well everything gets flu/ent if possible. i did have a client yesterday ask me about their 19 year old indoor cat, who has always had the flu/tet/felv (neither practice i work in has pentofel). I recommended that felv was certainly un-necessary for the cat - as i don't think it is necesary for any indoor cats (we see a fair few of those), and informed them that they and their dog do pose a potential infection risk as far as flu/ent go, but that i personally think, in reality that risk is very low. so we agreed to forgo vaccination for the cat, however she does come in for 6 monthly health checks instead.

In my area we are currently vaccinating rabbits on a 6 monthly basis for myxo. one practice charges a rabbit booster rpice which includes both myxo and vhd - obviously with a 2 week gap, just as we charge for the full primary course at the first appointment. doing it that way means there is a high uptake of vhd vaccine. I may suggest the same tactic to the second practice.....

Re: If you don't vaccinate for everything annually

beldather — Sat, 16 Jan 2010 00:52:19 GMT

I work from a fairly basic thought. I have seen a number of immune mediated diseases, and a few anaphylactic reactions post vaccines, so I have seen the negative effects of vaccines. We have strong evidence that vaccines can cause problems. Now these reactions are rare, but we should be taking every reasonable step to reduce them further. Vaccinating less is an obvious and easy step to take, especially when we know there is no increase in risk from doing so.

On the other hand I really dont think there should be a signficant price difference between the vaccinations (regardless of which ones are used) as the emphasis shoudl be on the exam, not the vaccinations.

Regards

Blair

Re: If you don't vaccinate for everything annually

Julian Earl — Fri, 15 Jan 2010 22:54:40 GMT

An "anecdote" to chuck into the discussion:

I am pretty certain that I still have the letter from a vet in a very large vaccine manufacturer stating that the most important vaccinations are the initial course, the first booster, and a subsequent booster four to five years later (in that person's opinion). No evidence was cited, just an opinion given that adequate protection was provided.

When was the letter written? Approximately 1984 if I recall correctly.