Vaccines are designed to induce immunity and prevent disease development in the vaccinated party. They have made some diseases rare and others almost nonexistent. Through the use of vaccines we have saved an untold number of lives both human and animal. Unfortunately no vaccine is totally effective or completely free of adverse reactions
Clinical signs of vaccine reactions may vary with the type and intensity of the reaction. Four types of vaccine reactions may occur. Type I is known as an immediate hypersensitivity reaction or anaphylaxis (exaggerated allergic response). Type II called a cytotoxic reaction that may exhibit as hemolysis (the destruction of red blood cells) or thrombocytopenia (lack of platelets) both resulting in bleeding or bruising by the affected animal. Type III hypersensitivity occurs by immune complex formation, a typical example of which would be an anterior uveitis (inflammation in the anterior eye chamber). Reactions of this type were once seen after vaccination with canine hepatitis as clouding of the cornea or uveitis. This reaction has largely been eliminated with the newer vaccines. Type IV hypersensitivity is a delayed reaction leading to granulomas (lump) formations at the site of the injection.
Several studies have tracked vaccine reactions both in the dog and the cat. In a study published in the AVMA journal, it demonstrated adverse vaccine reactions occurred at a rate of 38 per 10,000 dogs vaccinated. According to this and other studies, the risk of reaction decreased significantly as the body weight of the pet increased. Vaccines in the dog are given at a one dose fits all basis; this means a Great Dane would receive the some dose of vaccine given a 5 pound toy poodle. Not surprisingly, the 5 pound poodle would be more likely to incur a reaction to vaccination. The risk of a vaccine reactions were also shown to increase significantly with the number of vaccine doses given concurrently during any one office visit. Each additional vaccine given to a dog less than 22 pounds increased the risk of a reaction by 27% and for those over 22 pounds a 12% increase in risk was incurred. A genetic predisposition to vaccine reactions has been documented for some particular breeds of dogs. Neutering a pet also appeared to increase the number of adverse vaccine events and was thought to be due to the protective effect of androgen hormones.
In cats a vaccine adverse event rate was shown to be 51.6 reactions for each 10,000 cats vaccinated. The risk was also shown to increase with the number of vaccines given per visit. Once again cats weighing less or neutered cats appeared to be more susceptible to the possibility of a reaction. The risk or reaction was greater for those cats over 1 year of age. In this study almost a half a million cats were tracked for up to 2 years with none of these cats developing a neoplastic lesion.
The overall rate of vaccine adverse events occurring within 3 days of vaccination was determined to be 0.48% in cats and 0.38% in the dog. The most common reactions were rather nonspecific reactions of anorexia (not-eating), lethargic, fever or local soreness.
Local vaccine reactions are common but are not true hypersensitivity reactions. Local reactions include discomfort upon injection, irritation, pain and swelling at the injection site. These types of reactions will usually resolve on their own.
The most severe type of adverse events are usually considered to be a type I hypersensitivity reactions. Clinical signs with a type I hypersensitivity may be as mild, as an elevation in temperature, to severe, which includes shock and subsequent death. Additional clinical signs of a type I hypersensitivity that may occur include; facial swelling or edema, pruritus, salivation, vomiting, diarrhea, difficulty breathing, or collapse and death. Vaccine reactions of this type are less commonly seen in the cat verses the dog. These types of vaccine adverse events are also commonly seen following vaccination in other species. Ferrets, in particular have a high rate of adverse events following vaccination.
Mild reactions usually respond to antihistamines and corticosteroids. Severe reactions will require hospitalization and aggressive therapy including the use of epinephrine.
Delayed Hypersensitivity reactions are not uncommon and are typically exhibited as a lump that forms near the injection site. Most will resolve within weeks of vaccination, especially when some moist heat or a warm compress is applied. Moist heat may be applied simply by placing a washrag under the warm water faucet, wringing out the rag and applying it the site of the injection, making sure it is not too hot to handle as to cause discomfort.
Vaccine-associated fibrosarcomas (VAS) would be considered a type IV reaction and are a severe complication of vaccination. Fibrosarcomas may occur in approximately 1 in 10,000 vaccinated cats. VAS may also occur in the dog but at a much less frequent level than that seen in the cat. The cause of fibrosarcoma development is still a matter of debate. Various vaccine components have been implicated but the research as to the cause has been inconclusive. There is a genetic mutation involving the p53 gene or the sis oncogene in cats that may predispose these animals to the formation of sarcomas.
Lumps occurring following vaccination should be subjected to the 3-2-1 rule according to the representatives at Merial. If a lump meets any of these three criteria then a biopsy is warranted:
- The lump persists for more than 3 months after the injection.
- The lump is larger than 2 cm in diameter.
- The lump continues to increase in size 1 month after injection.
In order to decrease the occurrence of adverse vaccine events the “Feline Vaccine Advisory Panel” suggests that only cats that may be at risk for a certain disease should be vaccinated for that particular disease. Each vaccine protocol should be tailored for each individual patient and their current lifestyle. Risks and benefits will vary among patients dependent on the number of cats in the household, whether they are allowed outside, how frequent their exposure is to other cats, and if the pet is altered or used for breeding purposes.
General recommendations for decreasing the possibility of vaccine reaction regardless of species includes: vaccinating only healthy animals that have just completed a through comprehensive examination, premedicating with antihistamines, corticosteroids or both, separating the number of vaccines given and limiting vaccination to those vaccines that the pet is at risk for exposure.
“Feline Adverse Vaccine Reactions”. The Compendium for Continuing Education for Veterinarians. Merial Limited. Vol. 29(10) October 2007. Pp.610 and 611.
“Vaccine Adverse Events”. Antech Diagnostics News. October 2007.
Kahn, Cynthia Editor. The Merck Veterinary Manual. 9th Edition. 2005. p. 637.