Earlier this year the American Assn. of Equine Practitioners announced its new vaccination guidelines, replacing those established in 2001.
“The new guidelines emphasize that considered judgment is key to designing an effective vaccination program; a ‘cookbook’ approach to infectious disease prevention may leave some horses vulnerable to disease,” says Mary Scollay, DVM, chairwoman of the AAEP’s Infectious Disease Committee during the development of the guidelines. The AAEP also wanted to make sure the information was relevant on the ground level as well as on a theoretical level. So the committee comprised 16 of the best and brightest in the world of infectious disease, including both researchers and clinicians.
What Prompted Revisions?
Past guidelines were available through the website in a condensed form for non-veterinarians as well as in a published form for the member veterinarians. There have been many advances in vaccine technology since then and AAEP needed to update some of the information.
“We also felt that the AAEP website was an opportunity to keep the guidelines much more fluid,” Dr. Scollay says. “Advancements are moving along at such a pace, if a new state-of-the-art vaccine comes out tomorrow we have the opportunity to update in a timely manner on the website.”
The core vaccination designation is one of the changes. It is based on the American Veterinary Medical Assn.’s definition of core vaccines. The committee wanted to stress that there were certain vaccinations that every horse should receive regardless of where it lived. This was because of either the uncontrolled risk of the disease or the concern that the outcome of infection would be harmful.
“Rabies has always been considered core for small animals,” Scollay says. “We did have some extensive discussions as to whether to include rabies as core for horses. Certainly not many horses get infected, so the risk of exposure may be fairly low. But once contracted, it is fatal and there is significant public health concern. There was an incident in Tennessee at the Walking Horse Celebration in 2006 where a horse was ultimately identified as being rabid. Possibly up to 150,000 people could have been exposed during the show. If the horse had been vaccinated it would have been a different story. So rabies is now included in the core vaccines.”
For risk-based vaccinations, anthrax is a new addition. This was added because of a new effective vaccine and because in certain parts of the country, mainly where alkaline soil is prevalent, anthrax is a risk that needs to be considered in terms of preventative medicine.
The introductory documents are new and considerably expanded from the previous information. The website includes different categories, including principles of vaccination, infectious disease control, vaccine labeling, vaccine technology and adverse reaction. Each category gives information that can be used to develop vaccination programs.
Two Opinions in the Field
Christopher Keeley, DVM, from Southlane Veterinary Hospital in Valparaiso, Ind., feels the guidelines validate how he has been advising his clients for several years.
“There are so many vaccines on the market,” he says. “You just can’t vaccinate for everything and expect the immune system to respond. A better strategy is to evaluate an individual’s risk and vaccinate appropriately. When I first moved to Northwest Indiana from Michigan, I had some clients who wanted vaccinations for everything just to be on the safe side. I had to do a lot of client education to help them understand that those vaccinations could have some repercussions.”
“I think the new AAEP guidelines refocus a veterinarian’s attention on an individual horse’s health status and risk for certain diseases rather than giving all horses the same vaccinations,” he says. “This can only be a good thing for the horse.”
Craig Chandler, DVM, from East County Large Animal Practice in El Cajon, Calif., says modification of the guidelines is a necessity in his practice’s situation.
Although he feels the guidelines are comprehensive and valuable for specific categories, he says the guidelines for foals will be difficult for his clients to accept from a financial perspective.
“The schedule for vaccination for a foal in its first year would require us to see the animal seven times,” he says. “Our clients are mainly backyard breeders and they just can’t do that. So we modify the guidelines. If there is a history of pre-foaling vaccination and there is confirmation that the baby has absorbed the necessary antibodies, we will delay vaccination and see the foal at 6 months, 7 months and possibly 8 months and then as a yearling.”
“If the mare isn’t vaccinated, we start the foal at 3 months, then 4 months, 6 months and as a yearling,” Dr. Chandler says. “I do like that the guidelines offer a lot of data for individual horses, but complying with the first year of life is problematic in our situation.”
“It is directed at veterinarians but it’s written in such a way that a horse owner can understand it,” Scollay says. “There is a table, too, because everyone expects to see that, but I would urge everybody to read the introductory documents because the table is a streamlined version. There is information within each disease-specific guideline that may be highly relevant to the specific situation.”
Benefits to Horses
Many owners feel an injection is all a horse needs for protection, but this is highly flawed. Veterinarians should explain the difference between immunization and vaccination.
“You want to stimulate immunity in the horse so that when the horse is presented with the organism that causes disease, the horse’s own immune system will reject it,” Scollay says. “To achieve that requires more thought than just pulling a vial out and jabbing the horse with a needle. Vaccine timing is one of the things. If the disease is transmitted by insects and you live in Wisconsin, there is little reason for you to vaccinate for Eastern-Western equine encephalomyelitis in the winter. On the other hand, if you live in Florida you may need to consider vaccinating more than once a year because of the year-round insect population. Also, vaccinating the horse before travel or an event in enough time is important for adequate protection.”
Above all, the guidelines are tools for veterinarians and not standards of practice or recommendations. They provide information that practitioners can share with their clients to make the best decision for each specific situation. The AAEP stresses it is not trying to tell anyone what to do or how to practice, but rather would like to offer the information to help veterinarians make the best choices.
Click here for a complete list of guidelines.