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  Discussion on Vaccinations and Titers
Author Message
Member:
Lccsi

Posted on Wednesday, Nov 8, 2006 - 10:03 am:

Hi Dr. O
We had been seeing some weird symptoms in my 14 yo dutch following
vaccinations.. This happened over the last 2 years.. a short term
soreness and then varied things like from no where arthritis in the
neck (which I believe is auto-immune based) which was resolved with a
neck injection , Strange bladder problems - over filled bladder and
difficulty urinating that I treated with bethanecol) that eventually
resolved but came back following vaccinations.. This fall I had him
titered and to me (and our vet) some of these numbers seemed very
high. They were are follows:

EQU Herpesvirus (EHV-1) SN POS 1:96
EQU Herpesvirus-4 (EHV-4) SN POS 1:48
EQU Influenza(EIV) HAI A2 VA05 - POS 1:64 A2 NY99 POS 1:128
ITM AB Cpture Elisa WNV Neg 1:100
Potomac Horse Fever PHA IFA POS 1:640
West Nile Virus SN >= 1:8192
REF:Encephalomy, Eastern POS 1:80
REF Encephaloy Western POS 1:80

As you can see.. WNV is off the scale and Potomoc is very high as
well. Have you seen any research that will tell you what numbers you
don't want to DrOp below for titers so we can vaccinate only the
things that are necessary. I know there is not much published about
this..

Thx
Lori
Moderator:
DrO

Posted on Thursday, Nov 9, 2006 - 7:33 am:

You are right Lori, correlating titers and protection is risky unless specific correlations are found on research and when looked at carefully often there is not a good correlation. The reason is that titers measure a specific antibody created by the vaccine and does not consider other forms of immunity and other antibodies that may be more important in fighting off the infection. On the other hand I am not sure the absolute numbers are meaningful and have to be compared with respect to established controls.

I do think many of our horses are over vaccinated or given vaccines of questionable need and efficacy. If you think you are seeing severe reaction from vaccines, why not review the incidence of the diseases you vaccinate for in your area, consider the severity of the disease, and consider the frequency you have been giving the vaccines using our articles on vaccination and the specific disease as a guide. For instance do you really thing giving the PHF vaccine indicated given what is known about it?
DrO
Member:
Kbr1

Posted on Thursday, Nov 9, 2006 - 1:21 pm:

Dr.O,
So how do you feel about semi-annual vaccinations?
That is they way it's generally done in my area. And I actually have the horses fall shots in the fridge, but am thinking about not using them...
Moderator:
DrO

Posted on Thursday, Nov 9, 2006 - 6:46 pm:

It depends very much on the vaccine and risk of exposure to the disease, see the article on vaccine schedules for particulars.
DrO
Member:
Lccsi

Posted on Friday, Nov 10, 2006 - 11:22 am:

Hi Dr. O
Do you know of any studies or research that might be going on that might be evaluating titers as a measure for showing which vaccinations are required? I'm especially interested in this for WNV which is around in NJ but his titers are so high for.. When I discussed these results with one of the vet's in the practice who happened to be new there.. she agreed with me when I said I did'nt know why they were vaccinating for mosquito born anything in OCT.. it should have been done in August. and she also said the PHF was not effective.. which left us with Flu/Rhino which I passed on for the guy with the bad reactions but did do for my other horse who will be going off property to clinic this winter (intra-nasal form) . I hate to say it but vaccinations seem to be big business for vet's in our area (NJ).. I'm not sure they sit down and really think about what they are recommending for us.. nor do they take our observations very seriously.. I guess you really do need a scientific study to prove this anyway.. (vaccinosis in horses).

Thanks
Lori
Moderator:
DrO

Posted on Saturday, Nov 11, 2006 - 10:34 am:

No I have not seen such a study Lori. I think if you carefully review our articles on vaccination and take the time to review the disease information on the diseases of concern in your area you can come up with a minimal vaccine program that protects your horses against dangerous diseases.
DrO
Member:
Hally

Posted on Saturday, Nov 11, 2006 - 11:05 am:

Lori,

I wonder if this web site https://www.viim.org/home.asp, The Veterinary Inst of Integrative Medicine, could help you out with some of your questions.
Member:
Lccsi

Posted on Monday, Nov 13, 2006 - 3:51 pm:

Thanks Hally. That site is helpful and some of the sites it has links to are helpful as well. Dr. O we had decided that he was going on a limited as needed vaccination schedule.. It's just we really wanted to find out the meaning of the titers as our local vets did'nt have much info and they were calling around as well. The problem is with no actual studies it's hard to say what if any of the vaccinations is he having a bad reaction to or is this all just conjecture and it's coincidence that he declined following vaccinations.. sort of recovered and then set back again after the following shot series.. I guess I just have to keep my fingers crossed we are doing the right thing for him.. It is now 6 months past his spring shots when he fell apart and he is really coming back to himself.. (almost to much energy :-).. If I can find any useful meaningful, factual :-) info I'll post back..
Lori
Moderator:
DrO

Posted on Monday, Nov 13, 2006 - 6:40 pm:

And as this type information develops I will post it in the articles and newsletter as well.
DrO
Member:
Gailkin

Posted on Tuesday, Nov 14, 2006 - 3:21 pm:

Lori,
You have really opened Pandora's box with questions about vaccinations. At the last horse symposium I attended at UC Davis vet school, the expert in the field of vaccines, etc. was specifically speaking about whether or not to vaccinate a pregnant mare and when. However, in questioning he did admit that rabies and tetanus work for longer than one year and said you could give the shots every two years. But the med school continues to recommend a much more intensive shot program for horses. I cannot even find a vet here who has ever done titers! One of my vets uses a more holistic approach and does not vaccinate every year and then only some of the shots. I personally think horses are way over dosed and it causes more harm than good. I have a natural trimmer who said that WNV shots caused a problem in the hooves of over 90% of his clients (over 400 horses). His own horses reacted so strongly that he does not even give the shots to them anymore. We all have to make the decision as to what is best for our beloved animals. The info regarding pregnant mares was really fascinating in that if you vaccinate the mare before pregnancy, she develops antibodies, etc. But if you wait until she is pregnant and then vaccinate her, there is no response in her immune system to the vaccines, even repeated vaccines. So foals of prepregnant vaccinated mares have immunity from the mom, but foals of postpregnant vaccinate mares would not be passing antibodies to their foals so those foals should then be vaccinated sooner than those of the first group. Foals with antibodies from the mare should be vaccinated much later than the foals of nonvaccinated mares because they will be blocked by the mother's antibodies if you do it too soon. The exception was WNV which didn't seem to provide antibodies to the foals even from the prepregnant vaccinated mares. Thanks for reminding me about this study as I meant to fax it to Dr. O. for him to review. It sounds like you have a difficult decision to make regarding vaccines since you do not have a lot of support out in the vet community for limiting the amount of shots given. You have to go with what feels right to you for your horse. Good luck with your decision.
Gail
Moderator:
DrO

Posted on Tuesday, Nov 14, 2006 - 4:58 pm:

Gail, it is not true that pregnant mares do not respond to vaccines. Concerning vaccinations of foals and blocking maternal immunity we cover it on a vaccine by vaccine basis in the overview article.

Concerning your farriers observations, do they make any sense? I give hundred of WNV injections a year, including to my own horses, and have seen no increase in foot problems. This is not to mention the millions of horses given the vaccine yearly where we have not heard of increasing foot problems. Are we to believe there is something in this farriers practice that predisposes to WNV vaccination sensitivity? The articles on vaccinations and the diseases we vaccinate for give pretty detailed information on what we know about the efficacy and longevity of these vaccines. From them someone should be able to create a minimalist strategy to the issue that still gives good to excellent protection against the serious diseases for which their horses are at risk.
DrO
Member:
Hally

Posted on Tuesday, Nov 14, 2006 - 5:22 pm:

Dr O,

A friend of mine vaccinated her horse last year with the usual yearly vaccines plus WestNile. Shortly after that her gelding had a mild case of laminitis. The vet came out and said it was a reaction to the vaccinations. As the horse does not leave the property she (my friend) has decided to only vaccinate for WN (on the advice of her vet). So perhaps its like the flu shot we humans get every year. For most people there are no side effects, for a few unfortunates they come down with Guillain-Barre SynDrOme.
Moderator:
DrO

Posted on Tuesday, Nov 14, 2006 - 7:26 pm:

While vaccination reactions are a reality (see Horse Care » Vaccines, Vaccination, & Coggin's Vaccines and Adverse Reactions) this does not mean you should not vaccinate. That is like saying you should not ride horses because there is an increase risk of injury and death. Like all aspects of our lives, you have to evaluate the risk vs benefit. Every year tens (hundreds?) of thousands of equine lives are demonstrably saved by vaccination when you compare pre- and post- vaccination disease rates. You just have to be intelligent about weighing the risk and benefit, which is what our articles attempt to do and let you decide.

Concerning Guillain-Barre there have been studies that find weak, usually temporal, connections with this debilitating immune system related demyelinating disease of humans. The exact relationship remains uncertain and often complicated by other factors like concurrent administration of immune suppressing drugs. It should also be noted that often there are similar connections between infections and G-B. Some of these infections may have been prevented with vaccination. There is no known equivalent disease described in horses currently.
DrO
Member:
Ryle

Posted on Wednesday, Nov 15, 2006 - 12:23 pm:

Hally,
Why would she only vaccinate for WNV when the other encephalytic diseases that we vaccinate against are also transmitted by mosquitos and have a high mortality rate? Also what about vaccinating against tetanus?

The recommendation to vaccinate only against WNV just doesn't make sense to me, especially if she's worried that the laminitis is due to the addition of the WNV vaccine to her regimen.
Member:
Hally

Posted on Thursday, Nov 16, 2006 - 11:33 am:

Probably part of the reason is that the horse never leaves the farm and no new animals come in. We have had a few deaths in Alberta due to WN but not many other diseases which may be more common in a hot place like Texas. The cold up here tends to kill a lot of nasty things.


I personally think we way over vaccinate our animals and I wish there was a holistic large animal vet in our area to actually do titers. Again its a highly controversial topic that I feel strongly about. One of my horses is in a show barn so I dont have much choice as vaccinations are a must if you want to board there. But having said that they also dont go overboard like some barns do.
Member:
Ryle

Posted on Thursday, Nov 16, 2006 - 6:54 pm:

Hally,
I started to say that you guys are lucky, but I hate the cold ;) I didn't realize you were from Alberta--makes complete sense now.
Does she at least vaccinate against Tetanus?
Member:
Hally

Posted on Thursday, Nov 16, 2006 - 8:09 pm:

No I dont think so. She has certainly in the past. One think we also dont vaccinate at all for horses (at least no one I know) is for rabies for horses. I didnt even know it was available?? A rabid horse... now there is a scary thought.

Yes we Albertans are a tough lot.. fortunately a lot of creepy insects and bugs arent! We also dont have rats. Lucky us.
Member:
Gailkin

Posted on Friday, Nov 17, 2006 - 3:19 pm:

Dr. O,
In my previous post about pregnant mares I left out one very important fact about the vaccines not being effective if the mare is pregnant when the vaccines are given. The article and talk given by Dr. W. David Wilson BVMS, MS at UC Davis was specifically talking about WNV and rabies vaccines being ineffective if the mare were pregnant, but some others might be affected also. So it is strongly recommended to vaccinate for those two at least before the mare is bred if you want the immunity to be passed on to the foal. There is so much info in the article I had planned to fax it to you but got sidetracked with other things. The issues about when to start giving vaccines to foals is most interesting and depends again on the mare's vaccination history, but it appears that on average administering vaccines to foals under six months is ineffective for many inactivated vaccines and 9 months for or longer for inactivated influenza vaccines. The exception is WNV where foals as young as 3 months respond well. For other inactivated vaccines other than rabies, a better response in foals is obtained with 3 doses of vaccines rather than the 2 usually recommended with the third dose being 8-12 weeks after the 2nd dose. The schedule he recommended is not in the article but I wrote it down and it is for foals from vaccinated mares:
3 months - WNV
4 months - WNV
6 months - tetanus, WEE, EEE, rabies
7 months - tetanus, WEE, EEE, rabies, WNV
9-10 months - tetanus, WEE, EEE
11 months - Flu-IN or booster if flu given earlier
Foals from unvaccinated mares need to be given vaccines much earlier, of course. One other piece of info not in the article was that horses given Ft. Dodge WNV and followed by the Merial as a booster had a better immune response to WNV. I don't remember the exact dosing and spacing however, so if you were interested you might contact Dr. Wilson at Davis. My vet said he is the premiere authority on vaccines in our area anyway. If you let me know your fax number or address I can send you the article (it's 15 pages).
As far as the farrier's comments about WNV affecting the hooves, he said he can tell exactly when the dose was administered by looking at the feet; it causes a laminitic response and the ring shows up in the hoof wall. Other trimmers I have talked to have said the same thing. That doesn't mean you shouldn't vaccinate, but just be aware that it may affect the horse's hooves as does worming, etc.
Member:
Ryle

Posted on Friday, Nov 17, 2006 - 5:19 pm:

Hally,
Yeah, I looked it up and you have a really low incidence of rabies in Alberta. Here it's a real worry. So far we've had 10 cases of rabies in horses this year...more than 600 cases of rabies in animals this year. Vaccinating against rabies is definitely worthwhile in Texas.
Member:
Hally

Posted on Friday, Nov 17, 2006 - 5:44 pm:

I cant even imagine a horse afflicted with rabies. How do they act? And who has bitten them? I gather the only way to treat the disease would be to put the horse down.
I would certainly vaccinate against such a horrible disease if there was a need here. We have had snow on the ground and freezing temperatures already 2 weeks ago and we wont see spring till around mid April, so pretty well the only viral diseases we will see here with our horses is strangles and flu. Bad enough but nothing compared to rabies.
Moderator:
DrO

Posted on Friday, Nov 17, 2006 - 6:57 pm:

Gail, you will find the majority of your recommendations in our articles on vaccination and vaccine schedules, we update these articles regularly with the newest research information.

However I am not aware of any work that says pregnant mares do not respond to the WNV or rabies vaccine and would be interested in where this comes from. I just did a search on pubmed and this does not seem to be published information anywhere.
DrO
Moderator:
DrO

Posted on Saturday, Nov 18, 2006 - 8:10 am:

Hally you will find a description of rabies in horses at Diseases of Horses » Nervous System » Dementia: Depression, Excitement, Coma » Rabies.
DrO
Member:
Gailkin

Posted on Tuesday, Nov 21, 2006 - 3:43 pm:

Dr O,
The 15 page article I have came from the veterinary seminar at UC Davis put on last spring. Four vets speak for an hour each on new developments in vet medicine. This article was written by Dr. W. David Wilson for his presentation and was dated 5/9/06, but I don't think it has been published yet; it was a summary of his talk. I would be happy to either mail it or fax it to you if you send me your address. I have sent copies to my local horse vets (several went to Davis and know Dr. Wilson's work and were curious about his latest findings).
Gail
Moderator:
DrO

Posted on Tuesday, Nov 21, 2006 - 6:28 pm:

Gail you could fax it to us at:
Three Three Six 643-0833
DrO
Moderator:
DrO

Posted on Monday, Nov 27, 2006 - 9:22 am:

Gail I think you misread these notes or I misunderstand you. When most people say vaccinate they are talking about their booster shots. The article by Dr Wilson specifically states that pregnant mares respond to such vaccines (pg 6 paragraph 2 sentence 2) and specifically recommends the practice (page 6 para 3 last sentence).

His concern is that there MAY be a DAMPENED response to the initial vaccination and therefore this should be given prior to pregnancy. However if you have an unvaccinated mare that is pregnant I do not think the good Dr would suggest you should not attempt vaccination on the contrary I suspect he would argue she may need several boosters though the information appears in doubt by his use of the word "may" at this time.
DrO
Member:
Gailkin

Posted on Wednesday, Nov 29, 2006 - 3:18 pm:

Dr O,
The article was presented before the talk which was an hour and included slides, etc. Dr. Wilson spent some time on the issue of a previously unvaccinated mare being given vaccines during pregnancy not having any response to the WNV or rabies. He showed a graph where unvac. mares were given 4 or 5 shots of the same vaccines during pregnancy and their titers remained at the baseline level and never showed any response and they DID NOT pass along any antibodies to their offspring. So he did not recommend vaccinating previously unvaccinated pregnant mares during pregnancy with WNV or rabies. Just the opposite. He said to do it before breeding. If mare is unvac. and pregnant, then he would wait until the foal was born and start its vaccinations early since it would not receive any immunity from the mare. There is no point in giving the unvac. pregnant mare several boosters for either WNV or rabies. His other emphasis was that vaccinated mares give a rather longer lasting immunity to their foals than previously suspected. Instead of starting at 3 months as some do, he would start vaccinating the foals at a later schedule as I posted earlier and that some of the vaccines would probably not be effective until 10 or 11 months for tetanus, EEE, flu, EHV-1, rabies and strangles. The exception is WNV by Merial which is effective in foals because it does not succumb to the blocking effect of the mare's being vaccinated. He would start WNV at 3 months and give 3 doses with the last dose being about 10 weeks after the 2nd dose. I'm sure he will publish his info at some point. I just thought it was very interesting that the unvaccinated pregnant mare's immune system will not respond to certain vaccines or boosters. I just wonder what there is about pregnancy that would cause that to happen.
Gail
Moderator:
DrO

Posted on Thursday, Nov 30, 2006 - 7:06 am:

On the delayed onset of vaccines to foals with properly vaccinated mares, you are preaching to the choir. We have been making the recommendation of a delayed onset but fairly aggressive schedule for the first 2 years of life, for more on this see Horse Care » Vaccines, Vaccination, & Coggins Test » Vaccine Schedules.

Fortunately running into a pregnant mare with no history of vaccinations is quite a rare phenomena for me. However without more information if I were presented with a mare who is pregnant and at significant risk for rabies or WNV and unvaccinated, I would recommend a primary series be given. This is not so much out of concern for the foals protection but the mares health. It should be noted that measured titers are not always a good measure of immunity, though I agree it is not encouraging to see no response. I look forward to more information on this and often Dr Wilson is at the AAEP meeting I will be attending soon. If I run into him I will discuss this further.
DrO
Member:
remmi

Posted on Wednesday, Nov 24, 2010 - 9:51 am:

Dr O,

Do you vaccinate for Flu/Rhino on your own horses? I am trying to decide if I should this fall - my horses do have some exposure to outside horses but not that much. Both have allergy issues and I wonder if I am better off not vaccinating for Flu/Rhino knowing that if they get sick they likely won't die!

Thanks - Heidi
Moderator:
DrO

Posted on Wednesday, Nov 24, 2010 - 6:20 pm:

Yes we vaccinate all our horses yearly because they all go on rides with other horses or they are young and in contact with the traveling horses. When our stallion is showing he is vaccinated 4 times a year.
DrO
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