AAFP Revising Feline Vaccination Guidelines
The AAFP guidelines will be packed with data supporting every recommendation.
The first installment of feline vaccine guidelines released by the American Association of Feline Practitioners (AAFP) in 1997 caused uproar within the veterinary community. As the organization weaned practitioners off of manufacturers’ annual vaccination recommendations and onto a three-year core booster regimen, veterinarians were uncertain about whose advice to follow.
Also in the guidelines’ inaugural year, standardization of injection site location for vaccines was introduced, which made identifying vaccine-induced sarcomas possible. The initially questioned guidance of the panel has now become most veterinarians’ staple.
The AAFP is revising its feline vaccine guidelines–the fourth revision—and they are due this year. The group’s international and multidisciplinary panel comprises experts in immunology, infectious disease, internal medicine and clinical practice, and the guidelines will be packed with data supporting every recommendation.
“Ten panelists are working on the revision,” says Margie Scherk, DVM, Dipl. ABVP (feline), editor at the Journal of Feline Medicine and Surgery and a past president of AAFP.
“The rationale for including international specialists was to ensure that we are capturing a broader and more global base of knowledge, ideas and approaches that may not be commonly considered locally. This will also allow the recommendations to be relevant globally.”
Follow the Leader
Because AAFP comprises specialists dedicated to feline medicine, some might assume that its vaccination recommendations are practically gospel. But despite earned clout over the past 15 years, only recently has the association been seen as the clear leader.
“We here at OSU follow the AAFP guidelines,” says Susan Barrett, DVM, clinical assistant professor the Veterinary Medical Center at The Ohio State University. “In my experience, there is a significant variance from the guidelines, but more practitioners are starting to follow the guidelines more closely.”
Veterinarians like Orla Mahony, MVB, MRCVS, Dipl. ACVIM, Dipl. ECVIM, of Tufts say the guidelines are tailored to each individual cat’s needs.
“I make decisions based on age and life style—indoor/outdoor, owner serially adopting cats of unknown retroviral status, older cat with chronic diseases, indoor cat at minimal risk of contracting infectious disease,” Dr. Mahony says. “Most indoor cats should not be receiving FeLV vaccines.”
The panel maintains that a cat’s living situation dictates which vaccines it should receive. Some veterinarians say clients hesitate to specify that their cat is actually a “hybrid” of indoors and out or they fail to consider the activities of other cats or pets in the household when discussing vaccines with their veterinarian.
“Sometimes owners forget to say, ‘Fluffy disappeared for three days last month,’ they just say he’s an indoor cat,” says Richard Ford, DVM, MS, Dipl. ACVIM, Dipl. (Hon.) ACVPM, emeritus professor at North Carolina State University’s College of Veterinary Medicine and an AAFP vaccine panelist. “If there is any risk of exposure, a cat should receive a leukemia vaccine, for example–because if they’re exposed to it, it’s too late.”
Under the 2006 AAFP guidelines, feline viral rhinotracheitis, calici virus and panelukopenia (or FVRCP) and rabies are considered core vaccines and after kittenhood should be given every three years.
While every state has specific laws about rabies vaccines for dogs, they are not always mandated for cats. Dr. Ford says since 1986, more rabies cases have been diagnosed in U.S. cats than dogs, probably due to their exposure to terrestrial animals–a statistic that should be considered regardless of local laws.
“I believe that veterinarians who are dogmatically attached to vaccinating for every disease every year are practicing questionable medicine,” says Robin Downing, DVM, Dipl. AAPM, owner of Windsor Veterinary Clinic and The Downing Center for Animal Pain Management in Windsor, Colo. “With what we now know about infectious diseases and the vaccines we have available, there is excellent evidence that our vaccine practices of a decade or more ago are simply out-dated.”
Non-core vaccines are currently left up to the discretion of the veterinarian with owners’approval, but veterinarians say non-core vaccines can be just as vital as core vaccines.
“Whether a cat is [kept] indoors or outdoors determines how non-core vaccines are given,” Mahony says. “If outdoor, whether it has much contact with other cats (always getting into cat fights); if indoor, living in a multicat household, living in a household with new cats constantly being brought in, multicat household with history of bordetella or Chlamydia problem, if yes, non-core vaccines should be administered.”
Even veterinarians who modify the AAFP recommendations say being familiar with the guidelines is important in efforts to stay up to date with the newest science, considering client reliance on their recommendations.
“The topic of vaccination in our companion animals is an ongoing issue,” says Ira G. Roth, MS, DVM, director of the Community Practice Clinic of the College of Veterinary Medicine at the University of Georgia. “New knowledge, vaccines, vaccine delivery mechanisms and epidemiological data keeps the topic in the forefront of our overall wellness concern for our pets. We must constantly strive to keep up with the most current scientific information to be able to keep our clients informed about the wellbeing of their pets.”
While reading every study conducted on every vaccine is an unrealistic goal for any practitioner, reading the AAFP recommendations can offer processed, equivalent knowledge.
“My clients rely on me to decide [which vaccines to give],” Mahony says. “I will usually discuss with an owner the decisions that go into recommending a particular vaccine for their cat and then they can decide whether they want it (e.g., the decision between the yearly canarypox virus-vectored rabies vaccine versus the three-year adjuvanted rabies vaccine). I think the owners who self educate usually are owners who are thinking about declining vaccination.”
Dr. Downing says a strong veterinary/client relationship will encourage clients to see veterinarians as having their pet’s best interest in mind when making recommendations
“We do have clients who seek out information from Dr. Google, but fortunately we have created a learning culture in our practice, so we encourage dialogue,” Downing says. “We want to be able to answer their questions and direct them to reliable sources of information.”
While the current AAFP recommendations don’t specify a reduction or alteration in three-year boosters for senior cats, many veterinarians take age, health and risk into consideration before maintaining the routine.
“Sometimes if an older cat has concurrent health problems, vaccination plans may be modified,” Dr. Barrett says.
Ford says animals’ size and other factors have prompted some veterinarians to use less than the entire vaccine vial per patient. He says this is dangerous and wrong.
“When veterinarians are given the same amount of vaccine for a 180-pound animal as a 4-pound animal, they start questioning if they’re protecting the animal adequately or giving too much,” Ford says. “Although weight might not be the only rationale behind administering less than all of the vaccine, there is no logic behind the practice. Veterinarians should not be arbitrarily reducing the volume of vaccines.”
Ford says reducing vaccine volume has never been recommended. However, many veterinarians know of veterinarians doing this.
“I have absolutely heard of veterinarians reducing the amount of a vaccine given to a patient based on weight, and this is ridiculous, bogus and indefensible,” Downing says. “It puts the patient at grave risk for infection with a disease that is preventable and has a high potential to be fatal. After all, that’s why we have developed vaccines. This is illegal when it comes to rabies vaccine.”
While veterinarians engaging in this practice are acting under the assumption it is harmless and because they might fear repercussions from over-vaccination, others are comfortable with the current three-year protocol
“We feel that current recommendations address the previous concern that we may have been over vaccinating cats prior to the current recommendations,” Dr. Roth says. “That being said, most veterinarians (and pet owners) would prefer to err on the over-vaccination side rather than leave the cat open to preventable infectious diseases.”