VACCINOSIS

Principal Natural Treatments
   Thuja, lyssin, homeopathic nosodes

Other Natural Treatments
   None

Vaccinosis is the term given to the chronic reaction of the body against repeated immunization. Many holistic veterinarians and owners are concerned about the frequent (and most likely unnecessary) immunization of pets for just about every disease imaginable.

Minor side effects often seen following immunization include fever, stiffness, joint soreness, lethary, and decreased appetite.

A number of more serious conditions have been proven or proposed to be the result of excessive immunization, and animals run the risk of adverse reactions as increasing amounts of foreign antigens are injected into them. Since vaccination involves altering the immune system, it is not surprising that occasionally adverse effects involving the immune system as a result of immunization also occur. These include:

The administration of vaccines may also interfere with the interpretation of various test results. For instance, dogs vaccinated for Lyme disease will be positive on the screening test for this disorder, necessitating a follow-up test to differentiate between the vaccine and the actual presence of the disease. Cats vaccinated against any disease may show a positive titer on the standard corona virus test, called the FIP test.

Both killed vaccines (containing adjuvant to stimulate a greater immune response) and modified live vaccines have been implicated in vaccine reactions. Many vaccine reactions seem to occur following booster immunization with vaccines containing a number of antigens (such as 5-way or 7-way vaccines).

Injection-Site Sarcomas

A recent phenomenon diagnosed in cats is a condition called injection-site sarcoma. This aggressive cancer is estimated to occur in 1:1,000 to 1:10,000 cats. The tumors usually occur between 3.5 months and 3.5 years following injection. Any vaccine (or injectable substance) can be associated with sarcomas; recently, the injectable flea-control product Program has been reported to possibly be associated with injection-site sarcomas in three cats.

Following injection, inflammation results—usually as a result of the adjuvant in the medication or vaccine (the adjuvant is a chemical added to increase local inflammation and a more intense immune reaction). The amount of chronic inflammation occurring at the site of the injection is related to the cat’s risk of developing injection-site sarcoma (the more inflammation the greater the risk). Since vaccines are often given annually in the same site on the cat’s body, it is no surprise that risk increases with the number of vaccines given on one site.

Not all cats will develop injection-site sarcoma as a result of an injection. Most cats do not develop injection-site sarcomas despite inflammation at the injection site. Apparently, there is some interaction between intense inflammation and tumor oncogenes, which ultimately results in tumor formation following injections. In fact, preliminary research has shown that sarcomas associated with vaccines had overexpression of the c-jun gene (a gene that is related to cancer development in animals species, an oncogene) when compared to sarcomas not related to vaccine injection. The working hypothesis as to why some rare cats develop injection-site sarcomas (and most cats do not) is that something in the injections (probably adjuvant) causes persistent inflammation at the injection site, which in some way stimulates the cat’s oncogenes to overreact and develop tumors. In other words, it appears that some cats may be genetically predisposed to developing injection-site sarcomas, and the inflammation following immunization is the trigger to set this reaction in motion.

Sarcomas in many cats may also appear unrelated to injections of medications or vaccinations. When compared to sarcomas that are not related to injections, injection-site sarcomas are typically more aggressive and are characterized by rapid growth and ulceration, are usually not encapsulated, and infiltrate and extend along fascial (surrounding connective tissue) planes. Complete removal is difficult, and local recurrence is common. As a result, an aggressive first surgery to remove as much of the tumor as possible is recommended. Cats with tumors located on the leg had a better prognosis than cats with tumors on the body (probably as a result of amputation of the affected limb as the surgical treatment). Median survival is approximately 576 days (most of these cats had additional therapy, such as radiation therapy, in addition to surgical removal of the tumor). Cats with injection-site sarcomas should never be revaccinated.

Currently, vaccine protocols are under review as manufacturers attempt to determine the maximum (and not just the currently published minimum) levels of duration. Additionally, while not proven, removing adjuvant from vaccines and using vaccines made from recombinant DNA technology (rather than from whole killed, or modified live, viral and bacterial organisms) may reduce vaccine-site sarcomas. However, early data from recombinant vaccines against human and mouse viruses has shown potentially dangerous side effects such as damage to T lymphocytes.

Current recommendations are for most immunizations to be given at least annually. This recommendation came about as a result of several findings. First, in the late 1950s, it was shown that ¾ of puppies immunized against distemper did not maintain protective titers at one year following immunization. Second, as vaccination became widespread and infectious diseases decreased, it was believed that there would be a lack of natural exposure needed to maintain a regular boosting of the immune system required to give long-term population immunity. Third, annual vaccination was shown to reduce the incidence of infectious diseases such as distemper.

Rabies is usually a 3-year vaccine, meaning that immunity lasts at least 3 years. Some state laws require annual immunization, even though the 3-year vaccine is used. Canine bordetella intranasal vaccine is usually administered every 6 months.

There are ongoing research projects where the goal is to attempt to determine the maximum duration of immunity of vaccines in pets. This presents quite a challenge, as there are a number of vaccine manufacturers whose vaccines must be tested. The results of these tests will most likely need to be repeated to verify their accuracy. Results of the tests (and retesting) will probably take at least 5 to 10 years or more. Not until then can current vaccination protocols be changed with confidence.

The Titers Tests

An alternative to routine vaccination of every pet is the use of vaccine (antibody) titers. These simple blood tests can give us information about an individual pet’s antibody status in relation to specific diseases.

In simple terms, antibodies are proteins made by the pet’s white blood cells (specifically B lymhocytes). These antibodies are made whenever a pet contacts an infectious organism (virus or bacteria, as a result of a natural infection) or is vaccinated (the vaccine uses low doses of infectious organisms, tricking the immune system to form protective antibodies without causing disease as might occur in a natural infection). Using a titer test reveals each pet’s antibody status. These results are then interpreted in an attempt to determine whether the pet is currently protected against a specific infectious disease or if the pet may require immunization.

There are both pros and cons to the use of vaccine (antibody) titers to determine the need to immunize pets.

Pros in Using the Titers Tests

Cons to Using the Titers Tests

  1. While inexpensive, the extra cost may prohibit some owners from taking advantage of the testing.

  2. Some diseases will not be titered; rather, automatic immunization will still be given. This is the case for the rabies vaccine. The 3-year rabies vaccine (used by most if not all practitioners) only needs to be given every 3 years. Some states require more frequent immunization regardless of the 3-year duration of immunity. These states may not accept titer information and would still require immunization, regardless of titer status.

  3. Not all diseases produce a measurable titer. For example, antibody levels have been shown to correlate with protection against canine distemper virus, canine parvovirus, canine adenovirus, feline panleukopenia virus, and Lyme disease. Serum titers do not correlate with protection for the following diseases: kennel cough (Bordetella bronchiseptica and parainfluenza), canine coronavirus, feline enteric coronavirus, and feline chlamydial infection. Cellular immunity (rather than antibodies) provide protection against feline rhinotracheitis virus and feline infectious peritonitis virus, making titers inaccurate in interpreting protection for these diseases. Antibody levels (IgG titers) do provide information about protection against canine leptospirosis, although immunity against this disease following vaccination with inactivated leptospirosis organisms is generally believed to be short-lived (6 to 12 months). There is still adequate protection due to the cellular immunity the vaccines for these diseases produce.

  4. Titers, like vaccines, are not perfect. There is no guarantee that a pet with an adequate titer (or an annual vaccination) will not become infected or become ill with a disease. The titer only tells us that the pet should have adequate antibodies to fight off the infectious organism and that the pet possesses the ability to mount a secondary antibody response (and fight off the disease).

  5. There is no agreed-upon correct titer level for determining protective titers. Currently, doctors must use all of the conflicting information available and make an educated decision regarding what constitutes an “adequate, protective” titer.

What Constitutes the “Correct” Titer?

Unfortunately, we do not have an adequate answer to this important question. The significance of titers depends on the disease, the state of vaccination, the time of exposure, and the immune system. The presence of titers does not guarantee protection, and likewise the absence of titers does not guarantee that a pet will become ill if exposed to an infectious organism. One study showed that transplanting memory cells (lymphocytic white blood cells) to native mice from exposed mice allowed the naive (unexposed) mice to adopt these memory cells, making the animal fully immune.

Titers are currently used by vaccine manufacturers as one way of proving that puppies and kittens immunized with their vaccines are protected against infection. After much research, companies have determined what constitutes a protective titer (for their vaccine) when the puppy or kitten is adequately immunized. Puppies and kittens properly immunized and exhibiting a protective titer would not be expected to develop a disease if they come into contact with an infectious organism.

The value of protective titers vary with individual vaccines. Additionally, these titers are adequate to ensure protection for vaccinated puppies and kittens. Are these same values appropriate for adult dogs and cats who have received numerous vaccinations over many years? Would lower values also be appropriate for these pets? The biggest question is whether animals with low or no titers and the possibility of memory cells, which might be able to develop antibodies upon disease exposure, should be vaccinated. Since we have no good, inexpensive test for the memory cells (and also the cellular immunity, which is also important to protect pets against infectious diseases), the use of titers, while helpful, is not perfect.

To date, the answers to these questions is unknown, and this complicates our use of vaccine titers until more information becomes available.

Common recommendations for protective titers vary with the study. For example, protective titers have been reported as follows:

Protective Titers

Canine Distemper: >1:5; >1:20, >1:96

Canine Parvovirus: >1:5, >1:80

Feline Calicivirus: >1:16, >1:24, >1.32

Feline Panleukopenia: > 1.40

Feline Herpes Virus >1:16

Currently, the use of titers is not perfect but gives us some information about each individual pet. Most holistic doctors will consider immunization if the pet fails to detect a titer of 1:5 or greater, although some will use the upper end of the titers as mentioned above. The presence of any titer for those diseases in which titer information correlates with disease protection indicates the ability of the pet to respond to immunization and possibly infection. More research is needed to determine which vaccines induce the longest lasting protection, and how titer levels correlate with these specific vaccines.

The best recommendations at this point are as follows:

Homeopathic vaccine nosodes can be used in place of immunizations, and homeopathic remedies such as Thuja can be given at the time of whatever immunization is needed in an attempt to minimize any “vaccine reaction.” While many doctors who practice homeopathy feel that nosodes are helpful in this regard, controlled studies showing their effectiveness in preventing disease is lacking. Drs. Christopher Day, John Saxton, and Richard Pitcairn have all reported positive effects when using nosodes in place of conventional vaccines. However, a recently conducted preliminary controlled trial failed to show effectiveness of parvo nosode protecting against a street virus challenge. For this reason, the routine recommendation of replacing vaccines with nosodes is controversial and not recommended by all holistic veterinarians. Owners who use nosodes as a replacement for conventional vaccinations may be required to sign a legal release indicating they understand the questionable effectiveness of nosodes as a replacement for vaccination.

Pets with chronic immune disorders (such as cancer, allergies, epilepsy, kidney disease, heart disease, liver disease, thyroid disease) may be at increased risk for further immune damage from the unecessary use of chemicals such as flea products, preservatives in most commercial pet foods, and vaccines. While controversial, most holistic doctors do not recommend ever administering vaccines to pets with any chronic, serious disorder, especially those involving the immune system. Pets with mild problems (such as wellcontrolled allergies) can probably be vaccinated safely. This is an individual decision, as many disorders seem to appear shortly after immunization, and chronic disorders may be exacerbated (such as more itching in allergic pets, more seizures in an epileptic pet) following immunization. While rare, pets in remission following a diagnosis of cancer have been known to relapse following immunization; as a rule, most doctors do not recommend ever revaccinating pets with cancer. Pets undergoing stress (illness) should not be immunized. Dogs and cats who have experienced vaccine reactions, as well as those whose closely related family members have a documented clinical illness following immunization should probably not be overvaccinated, and possibly not vaccinated at all. Pets undergoing anesthetic procedures should probably not be immunized in most cases.

The following recommendations seem prudent for pets who must receive vaccinations. This list is extrapolated from an article by P. Rivera in Journal AHVMA, titled, “Vaccinations and Vaccinosis.”

Recommendations for Vaccination

PRINCIPAL NATURAL TREATMENTS

Treatment and/or prevention of vaccine reactions utilizing the homeopathic remedy Thuja or lyssin (see Homeopathy) may help counteract any potential negative effects of immunization that might be contributing to the pet’s current disease. In place of conventional vaccines, homeopathic nosodes may provide protection (see warning). Pets at risk of vaccine reactions should have blood titers checked or possibly not be immunized.

Nosodes

For example, the distemper nosode is made from the distemper virus or secretions from a dog infected with distemper. A variety of nosodes are available, both for the treatment of infectious diseases and for vaccination against some of these diseases.

Other nosodes that have been used with success include bowel nosodes (useful in disorders that disturb the normal gastrointestinal bacterial flora), Morgan-Bach nosode (useful for disorders of the digestive and respiratory systems and in some skin disorders), Proteus-Bach nosode (for nervous system disorders), and the Gaertner-Bach nosode (useful in malnourished pets with gastrointestinal disorders and worms).

Many homeopathic physicians prefer to use nosodes in place of conventional vaccines as part of the annual immunization regimen. Vaccinations are somewhat homeopathic in the sense that they are made from altered infectious organisms, and are administered in a diluted form. By administering these infectious organisms, we attempt to stimulate the dog’s immune system to prevent against infectious diseases.

There are several concerns with conventional vaccines. First, it appears that many dogs may not need vaccinations each year against every infectious organism. Some dogs may have immunity that lasts longer than one year after vaccination with some of our current vaccines. These dogs would not really benefit from an additional immunization until their immunity had waned.

Second, we know that conventional vaccinations do cause both short-term and long-term side effects. Some of these are relatively benign, such as mild swelling or pain after the vaccination. Other reactions can be more severe or even fatal, including inducing immune-mediated diseases, such as anemia and low platelet counts. In cats, we are now seeing vaccine-induced cancers. While these have not been reported in dogs yet, we are still right to be concerned about this side effect developing in vaccinated dogs in the future (for more about vaccinations, see the guide Vaccination: What You Must Know Before You Vaccinate Your Dog).

Homeopathic doctors therefore usually recommend the administration of homeopathic nosodes in place of conventional vaccines. Since the nosodes do not contain measurable amounts of infectious product, they are without any side effects.

Nosodes Versus Vaccines

But do nosodes work? Some doctors seem to prefer nosodes manufactured by specific homeopathic pharmacies, as they feel there is a definite difference in the ability of nosodes to stimulate the immune system. In their opinions, the manufacturer of the nosode is important and some vaccination nosodes work better than others.

Nosodes are supposed to work in the same manner as conventional vaccines, namely by stimulating antibodies to fight off infections. While not opposed to using vaccine nosodes, I do question how effective they might be when compared to conventional vaccination protocols.

One way to test whether they work is to subject them to the same testing vaccine companies use. After vaccinating a number of dogs with nosodes, these dogs should then be exposed to the infectious organisms to see if they become infected or remain protected. While this technique may be acceptable in the laboratory, owners would not want to subject their dogs to potentially fatal doses of infectious organisms just to see whether nosodes work.

There is another way to evaluate the ability of nosodes to work. First, run antibody titers to see whether the pet’s immune system needs stimulation. If the titers are low, administer the nosode. After administering them to the dog, run antibody titers to see whether the nosodes have effectively stimulated the immune system. If the antibody titer is high, then the nosode has been effective. Otherwise, the nosode has failed to work properly.

In addition to or in place of homeopathic nosodes are topical vaccines. These vaccines may be administered orally or topically. In dogs, the kennel cough vaccine is a topical vaccine given intranasally. The benefit of this topical vaccine is that we stimulate the immune system topically, causing the formation of large amounts of local antibodies. Since the organisms causing kennel cough (parainfluenza virus and Bordetella bronchiseptica bacterium) enter via the nasal cavity, local immunity is probably preferred to systemic immunity that may occur with the injectable subcutaneous kennel cough vaccine. Another important benefit of topical vaccines is the reduced risk of side effects. While short-term sneezing may occur after intranasal administration, concerns over chronic systemic immune system stimulation are not usually warranted with intranasal vaccination. Additionally, the risk of accine-induced tumors (fibrosarcoma tumors, which may occur very rarely in cats and may become a problem in dogs in the future, but to date have not been reported in dogs) does not occur with topical vaccination.

This approach to running antibody titers is what I suggest as a new approach to our traditional practice of vaccinating dogs. Instead of routinely administering vaccines to dogs who may not need them and may suffer from their overuse, run antibody titers to see whether vaccinations are indicated.

I have not seen any conclusive studies showing that this approach of running titers, administering nosodes, and then doing follow-up titers to see if the nosodes were effective in stimulating the dog’s antibodies really works. Therefore, it is hard for me to give an unconditional recommendation to using nosodes in place of conventional vaccines. Still, some doctors do believe nosodes can be effective in protecting the pet against infectious diseases. It may be that the nosodes, like conventional vaccines, also stimulate the cell-mediated part of the immune system. This part of the immune system is also important in protecting dogs against infectious diseases like parvovirus and distemper. It is very difficult to easily and inexpensively measure this part of the immune system. Still, if nosodes work by stimulating the cell-mediated immunity, they could still offer protection despite the fact that measurable antibody titers are not detected.

Owners must discuss this matter with their doctors. I feel uncomfortable with using nosodes in place of vaccines if no measurable titer is detected, although I have no problem using them annually when antibody titers are detected, as an extra measure of protection (without the side effects of vaccinations). For owners who are totally opposed to annual vaccinations, nosodes should be administered. Titers can be run following nosode administration to evaluate whether the nosode was effective in stimulating this part of the immune system.

CONVENTIONAL THERAPY

There is no conventional therapy for vaccinosis. For pets with acute (allergic) vaccine reactions, treatment with corticosteroids, antihistamines, and/or epinephrine is curative in most cases. Pets with vaccine reactions should ideally not be revaccinated in the future (especially those with severe allergic reactions). If for some reason the pet must be revaccinated, vaccines should be split (one shot now, one 3 weeks later), and pretreatment with low-dose corticosteroid and/or antihistamine should be used, along with the homeopathic remedy Thuja.