News Release: American Animal Hospital Association (AAHA)
Opinion Paper: Vaccination Guidelines
American Animal Hospital Association
PO Box 150899
Denver, Colorado USA 80215-0899
303/986-2800
Fax: 303/986-1700

FOR IMMEDIATE RELEASE
August 12, 1999
Contact: Derek Woodbury or Cheryl Kolus, AAHA

AAHA Releases Opinion Paper on Vaccine Issues
Denver -- In response to recent concerns, and to help veterinarians make
wise decisions about small animal vaccination, the American Animal
Hospital Association's Board of Directors approved AAHA's "Opinion
Paper on Vaccine Issues" in June.

"The intent of the opinion paper is to encourage veterinarians to consider
vaccination procedures as medical decisions and not automatic actions
prompted by a calendar," said AAHA President Michael Paul, DVM.
"With this paper, AAHA is providing its members with the tools necessary
to address the issues they face in their practices."

The opinion paper considers arguments for reduced frequency of
administration, evidence of extended duration of immunity and the
understanding that vaccines provide risks as well as benefits. The paper
encourages the formation of a task force to consider the issues and
support studies in this area. It also acknowledges that deviance from
the traditional annual vaccination protocol is becoming more common
and should be determined an acceptable standard of care in most cases.

Thus the opinion paper is offered as a means of support to veterinarians
who choose to follow manufacturers' recommendations as well as to those
who choose a less aggressive vaccination protocol in the best interests of
their clients. Throughout the paper, AAHA emphasizes that each veterinarian
should take all factors into consideration, include client input and make
vaccination judgments that are in the best interest of the patient.

-- begin opinion paper --

AAHA's Opinion Paper on Vaccine issues
AAHA recognizes that veterinarians are looking to organized veterinary
medicine for directions on the issues of duration of immunity and
discretionary uses of companion animal biologics. There is growing
professional and public awareness that vaccine products are not as benign
as generally believed and controversy as to duration of immunity and
frequency of administration.

The argument for continuing current historically practiced regimens is
based largely on tradition and the perceived paucity of proof supporting
extended duration of immunity. While arguments for reduced frequency
of administration are based in part on extrapolation from human medicine,
intuition and "it makes sense," there is a growing body of evidence to
support this point of view. Many veterinarians are under the misconception
that current recommendations were and are scientifically based when, in
fact they may have less of a basis than the arguments for change.

Industry is unlikely to try to document real maximum duration of immunity
due to issues including expense and time limitations.

The American Animal Hospital Association encourages the formation of a
high-level task force to consider the issue and propose and support needed
studies. We encourage appropriate government agencies to include duration
of immunity studies as a condition of product licensing. In addition, we
recommend that companion animal vaccine administration recommendations
ultimately be based on the most current and reliable information rather
than tradition.

AAHA has found that, while there is evidence to support extended duration
of immunity, it has not been globally embraced. There is definite evidence
that biologics carry with them risk and benefit. Vaccine administration is a
medical procedure in which, as with any medical decision, there are benefits
as well as attendant risks that must be weighed and a medical decision
regarding administration made. We feel strongly that, as with any medical
decision, the veterinarian involved should use his or her best judgment to
act in the best interest of the patient.

A growing number of academic institutions, experts respected in the field
and private practitioners are recommending reduced administration of
biologics to companion animals. This has the very real benefit of reducing
adverse reactions and reducing unwarranted expense to clients. On the
other hand, there is some degree of risk that in a given patient or group of
animals, a disease might occur that could have been prevented. Nonetheless,
such deviations from recommended administration are becoming more
common and more widely endorsed and, as such, should be considered
an acceptable standard of care.

We encourage veterinarians, in each case, to use clinical skill and
knowledge, along with client involvement in the decision to act in what he
or she believes to be the best interest of the patient. This would provide
flexibility and allow for deviations from labeled recommendations without
risk of liability or censure. The AVMA Professional Liability Insurance
Trust is on record that they will support and defend veterinarians who use
their clinical judgment and who are supported by a widely accepted
standard of care, as long as they are not doing anything considered illegal
or unethical. This assures that those administering biologics according
to manufacturers' recommendations would be on medically sound ground
should a given patient experience a serious adverse reaction to a vaccine.
It would also allow the benefit of a "standard of care" protection for those
who choose to deviate from recommended administration and follow a
protocol in line with less aggressive recommendations but in line with the
opinion of recognized experts.

-- end of opinion paper --

"This is a controversy that is not decided by any means," Dr. Paul said.
"However, the issue is one of patient care and medical indication, not of
practice management. It is the obligation of each veterinarian to act in
conjunction with their client, to stay informed, and to evaluate the risk of
each patient for each disease before administering a vaccine."

The American Animal Hospital Association is an international organization
of more than 16,000 veterinary care providers who treat companion animals.
Established in 1933, the association is well-known among veterinarians for
its high standards for hospitals and pet health care.

The AVMA is currently working towards issuing new feline and canine vaccination protocols with a target date of July 2001.  This link will take you to the "online" November issue of "DVM NEWSMAGAZINE" which includes a brief summary of the AVMA'a intent to issue these guidelines, which will be the first changes made since 1989.  It is also to be noted, for those interested in the "legal" aspect of vaccine related sarcomas, that the "print" version of the November issue of "DVM NEWSMAGAZINE" includes and article titled "Client sues practitioner over VAFS".

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