ALLERGIC REACTIONS

Allergic reactions are highly individual inflammatory responses against specific proteins entering the body. These proteins can be pollens, dusts, foods, medications, or even vaccines. Within the vaccine itself, reaction can be directed against the infectious organism, stablizers, preservatives, or residue from the vaccine organism’s laboratory tissue culture.

An allergic reaction might include hives,
facial swelling, or even nausea.

More serious reactions can include shock
or sudden death (“anaphylaxis”).

The time frame after vaccination can be immediate (the “Type I” reaction) or anytime in the next 48 hours (the “Type IV” or “Delayed Hypersensitivity” reaction.)

WHICH PETS ARE LIKELY TO HAVE VACCINATION REACTIONS?

In October 2005, a study by Moore et al was published in the Journal of the American Veterinary Medical Association where over 1 million canine medical records in over 350 separate animal hospitals were reviewed. In this study, approximately one in 250 dogs had some sort of vaccination reaction which translated to 13 reactions for every 10,000 doses of vaccine given.

The group at greatest risk for reaction were small breed young adult (age 1-3 years) neutered male dogs.  As a dog’s size increased, the risk of vaccination reaction dropped. Not surprisingly, the more vaccines were given at one time, the higher the risk of reaction. Some vaccine doses include vaccine against multiple organisms. These are called “multivalent” vaccines and include the basic Distemper-parvo vaccine for dogs and some Bordetella vaccines. Since giving more vaccines at once is associated with increased risk of reaction one might expect that the use of multivalent vaccines would also increase the risk of reaction, but surprisingly this was not found to be the case. Most reactions occur the same day as the vaccine is given.

WHAT TO DO DURING THE REACTION

If your pet is having a reaction more severe than just some general malaise or soreness, you should let your veterinarian know right away. If it is after hours, it is prudent to consult the local emergency clinic. Anti-inflammatory injections can be used to halt the inflammatory cascade before it gets dangerously out of hand. Be sure you know who to call in case of problems after your pet is vaccinated.

Vomiting may be a sign of an on-coming serious reaction,
or could represent something as mild as car sickness.
If vomiting is observed, let your veterinarian know right away.

WHAT TO DO IN THE FUTURE FOR THE PET WHO HAS HAD REACTIONS

There are many steps that can be taken to prevent allergic vaccine reactions in dogs known to have had reactions in the past:

• AVOID LYME DISEASE, LEPTOSPIROSIS, AND PERIODONTAL VACCINE

  The leptospirosis portion of the DHLPP (distemper) vaccine for dogs has a reputation for being the most likely portion to cause vaccine reactions. This is largely because of the size of the organism. (Most vaccine is directed against viruses which are barely bigger than complicated molecules. The leptospirosis organism is a bacterium, meaning it is enormous and more complicated than any virus. The more complicated the organism, the more likely the reaction. That said, in the aforementioned study of over one million dogs, the leptospirosis vaccine was not found to be more likely cause a reaction. This may be because of improved vaccine technology and using only portions of the organism rather than the entire bacterium. Other leptospirosis vaccine may not be as well produced as the one that happened to be used in this study so, as a precaution,you can request that this portion be left out of your dog’s vaccine.) The Lyme Disease organism is also a bacterium as is the Periodontal vaccine (the Porphyromonas vaccine). Again, larger vaccine organisms tend to produce more reactions.

• AVOID GIVING SEVERAL VACCINATIONS AT ONE TIME
  Keep in mind that vaccines given within two weeks of each other can interfere with each other so you do not want to separate vaccines by less than a two week period but separating vaccine can mean your pet has less stimulation to deal with at one time. Breaking up vaccines also helps determine which vaccine is the culprit.
• DO NOT HAVE YOUR PET VACCINATED AT A VACCINE CLINIC
  Vaccination clinics are designed to provide streamlined service for healthy pets in need of their regular immunizations. These clinics are generally not prepared for the individual attention required by a pet who has a history of vaccination reaction. A pet with a vaccine reaction history should receive some special attention in the form of observation in the hospital and/or pre-treatment with anti-inflammatory medication.
• BE SURE YOUR VETERINARIAN IS AWARE OF YOUR PET’S HISTORY OF VACCINE REACTION
  This sounds very obvious but I have seen many people at vaccination clinics wait until after the animal has been vaccinated before informing the veterinarian that the pet has a history of reactions.
• BE PREPARED TO PAY FOR EXTRA PRE-MEDICATIONS AND/OR OBSERVATION IN THE HOSPITAL
  Medications can be used to “head off” allergic reactions before they happen and with the use of these medications it is possible that a reacting pet can be vaccinated normally. To be safe, it is frequently recommended that the pet be observed for the rest of the day following vaccination, despite the medication. Consult your veterinarian regarding his/her recommendation. If a pet has suffered a severe or life-threatening reaction in the past, it is not worth continuing to expose the pet to the same allergen again.

Vaccination reactions severe enough to produce shock are EXTREMELY rare and are a function of an individual pet’s immune response. Vaccination is an important part of responsible pet ownership and should not be omitted without specific veterinary guidance. Every hospital has its own policy regarding what vaccines are recommended for dogs and cats in general and what vaccines are required for boarding or grooming. Vaccine recommendations differ regionally and according to the pet’s lifestyle as well as according to the philosophy of the veterinarian in charge of defining a particular hospital’s policies. To view our hospital’s vaccination policy click here.

LUMPS THAT DEVELOP AT THE INJECTIONS SITE

Vaccine includes an infectious organism rendered harmless but still capable of stimulating the immune system. In some instances the organism is “live” but weakened in some way. In other instances, the organism is killed. Some vaccine is made from killed bacterial organisms rather than viral organisms and other vaccine (such as the rattlesnake bite vaccine) is made against proteins and no infectious organism is involved. The larger the organism and the more complicated the proteins, the more local inflammation results after the injection and this sometimes translates into a firm knot or bump at the injection site. Similarly killed virus vaccine is often “adjuvanted” meaning stabilizers are added to keep the dead virus concentrated in one spot for maximal immune stimulation. Adjuvanted vaccines tend to produce knots as well. These growths are typically noted a few weeks following vaccination and generally resolve on their own. These are not allergic reactions but are inflammatory reactions caused by the immune stimulation of the injection. If a lump persists longer than 3 months from the time of vaccination or is >2 cm in diameter any time after vaccination then it should be removed and biopsied. This is particularly true for cats as they have the potential to develop injection site tumors.

REPORTING A VACCINATION REACTION

The USDA (United States Department of Agriculture) is responsible for licensing animal vaccines. The agency within the USDA that is immediately responsible is the Center for Veterinary Biologics. This agency is responsible for reviewing vaccine reaction reports and considers whether or not the manufacturer must perform additional investigation. The CVB is also responsible for unannounced testing of vaccine-producing facilities. Vaccination reactions may be reported to the CVB directly or to the manufacturer, though the manufacturer is not required to pass vaccine reaction reports along to the CVB. The advantage of reporting reactions to the manufacturer instead of the CVB is that often the manufacturer will cover the costs of treatment as long as the reaction extends beyond the mild malaise that is a natural result of the vaccination process. Different manufacturers have different policies regarding reimbursement but if one finds oneself with a significant expense from a vaccine reaction, it may be worthwhile to have one’s veterinarian look into reimbursement from the manufacturer. To report a vaccine reaction to Center for Veterinary Biologics visit:

www.aphis.usda.gov/animal_health/vet_biologics/vb_adverse_event.shtml