The
AVMA Vaccination Study
- continued
PRINCIPLES
OF VACCINATION
1. Vaccination is a potent medical procedure associated with both
benefits and risks for the patient. Adverse events, including
some that are potentially severe, can be unintended consequences
of vaccination.
2. The proper application of vaccines to animal populations has
enhanced their health and welfare, and prolonged their life-spans.
The risks to animal health from non-vaccination are significant.
3. The goal for a vaccination program is to prevent disease and
thereby promote optimal patient, herd, and/or public health.
4. Different patients require different vaccines and vaccination
programs.
5. Unnecessary stimulation of the immune system does not result
in enhanced disease resistance, and may increase the risk of adverse
post-vaccination events.
6. Vaccination protects a population of animals by providing a
level of resistance to a disease in those individual patients
that are able to respond. Vaccination does not protect every individual
patient even when they are properly vaccinated.
7. Disease carriers, including animals that shed the infectious
agent but do not show signs of illness, are local sources of infection
for susceptible animals. Sufficient immunity within a population
of animals is an important component of preventing high rates
of disease. Programs targeting immunization of unvaccinated animals
are critical to disease control.
8. Knowledge of immunology and vaccinology, including associated
benefits and risks, and the pathobiology of infectious diseases,
are necessary to implement an effective vaccination program. Consideration
of exposure, susceptibility, potential severity of disease, efficacy
and safety of vaccine, any potential public health concerns, and
the owner's preferences are appropriate.
9. Only those veterinarians with valid veterinarian-client-patient
relationships are in position to make recommendations customized
to the needs of the individual patient(s) and owner/client.
10. Revaccination recommendations should be designed to maintain
clinically relevant immunity while minimizing adverse event potential.
11. Additional information, including vaccine-specific, scientific
data on minimum, average, and maximum duration of immunity is
desired to craft optimal revaccination-frequency recommendations.
12. Vaccines, including polyvalent products, should be selected
to include only those antigens appropriate for the specific risk
needs of the patient, thereby eliminating unnecessary immune system
stimulation and lowering potential risks of adverse events.
13. Multiple-dose vaccine vials must be carefully managed to:
… Minimize the potential for delivering inappropriate levels
of antigen or adjuvant.
… Optimize the potential for maximum potency of the antigens
present.
… And minimize the opportunity for contamination with extraneous
microbes or chemicals.
14. Veterinarians should create a core vaccine program, intended
for use in the majority of animals in their practice area. Core
vaccines are those that protect from diseases that are widely
distributed in the region, virulent and highly infectious, thereby
posing a risk of severe disease. Core vaccines are efficacious
and exhibit patient benefit-risk ratios high enough to warrant
their use, and/or are of significant public health significance,
or required by law.
15. Veterinarians should consider creating non-core vaccine programs,
intended for a minority of animals in their practice area. Non-core
vaccines are those that target diseases that are of limited risk
in the region, and /or represent less severe threats to infected
patients, and/or vaccine benefit-risk ratios are too low to warrant
the use of these products in all circumstances, and/or scientific
information is inadequate to evaluate these products. Veterinarians
and owners/clients need to carefully consider the benefits and
risks of using these vaccine products on an individual basis.
16. Information about the benefits and risks of vaccination are
important in owners' decisions about individual vaccine selection
and vaccination program choices.
17. USDA licensed products have had the manufacturer's claims
about vaccine performance substantiated by a variety of testing
methods. Careful evaluation of labels and other information is
necessary to compare and contrast between the available products.
18. There is a critical need for more fully developed, scientifically
based, and statistically valid evaluations of vaccine products
to provide practitioners with a basis for developing vaccination
programs that maximize benefits and minimize associated risks
for patients under their care.
19. Current adverse-event reporting systems used need significant
improvement in the capture, analysis, and reporting of adverse
events. Practitioner commitment to adverse event reporting, and
timely access for practitioners to current analysis of adverse
event data, are essential to providing optimal patient care.
20. There is potential legal liability for all medical procedures
including vaccination.
1, 2, 3, 4
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