Canine McCarthyism – Dog owners on an anti-vaccination witch hunt

Anti-antivax opinion piece about dog vaccinations in The Netherlands
By Laure-Anne Visele, Jan 2015
Full illustration credits at the end of the post.

About the author: certified dog trainer in The Hague

Canis bonus: Laure-Anne Visele

I am a behaviour therapist for dogs (Canis bonus, The Hague, Westland, Delft and region) and the co-founder and head trainer at OhMyDog! (dog training school in The Hague).

I studied Zoology (University of Newcastle), got a postgrad specialization in applied animal behaviour (dip) and am a licensed/certified dog trainer (O&O).

After mocking around with dogs all day, I spend my nights and week-ends reviewing dog books and writing about dog behaviour for my blog and other websites.

If you are near The Hague and have dog behaviour issues, get in touch to make an appointment. I work in English, French, or Dutch and only use animal-friendly methods. Want to find out more about the behaviour therapy practice? Check my training page.

Dog training clients don’t want to vaccinate?

Two clients at OhMyDog! (our dog training school in The Hague) refused to show proof of their (adult) dogs’ vaccinations the other day. “Oh?” I thought. Canine anti-vaxxers?

We are funny about vaccinations at OhMyDog! because we also teach VERY young pups. So young they haven’t had their third vaccination round. We looked at epidemiology research – i.e. huuuuuge numbers of dogs – to compare behavioural and medical risks.

1. Behavioural risks: How many dogs get put down due to behaviour issues, and how much of this can be traced back to delayed socialization?
2. Medical risks: How many pups catch the diseases between rounds 2 and 3 of their vaccinations (see notes on puppy vaccination for details)?

The conclusion is: bring your pups to school early.

But here’s the rub: for that calculation to hold water, we need the dogs who are old enough to be vaccinated to be on-schedule with their shots.

Because somehow people listen more when I show a pup picture

I was intrigued by my clients’ reservations so I asked them and other anti-vaxxers what worried them. It boiled down to three beliefs:

1. Vets push for unnecessary vaccinations for profit.

2. Dogs don’t need so many boosters. 

3. Vaccinations have dangerous side effects, sometimes giving the disease itself.

I wanted to dig into this before I dismissed the objections, so I read a couple of review papers and a few pop science articles. I then took it to our local veterinary clinic (Huisdierenziekenhuis in Honselersdijk – great staff, check them out if you’re in the Westland). Below is what I’ve found on my journey through the world of canine anti-vaxxers.

A big thank you to Dieneke Jongepier (my vet), who took time out of her gruelling schedule to help with the medical aspects. I have simplified the information Dieneke gave me, but I hope I respected the original message. I have marked Dieneke’s contributions with ~.

Human anti-vaxxer theories gone to the dogs

My clients’ worries reminded me of Jenny McCarthy’s campaign against human vaccines. McCarthy is a TV presenter trying to convince the world that childhood vaccines cause autism. She bases her claims on thoroughly discredited research about the MMR vaccine by Dr. Wakefield. Jenny McCarthy’s son being autistic, she followed sloppy ‘post hoc ergo propter hoc‘ reasoning. She blamed the vaccine because her kid first got the shot, then was diagnosed. By this logic, anything that had happened in her son’s life, no matter how unrelated, could be have been blamed.

Yet more irrefutable evidence that MMR vaccines cause autism

Ms. McCarthy isn’t the only celebrity playing doctors. Charlie Sheen and countless other scandalously untrained A-listers see fit to spread disinformation about the dangers of vaccines. Results? More and more kids go to school unprotected, and measles is on the up in the US (and in religious fringes the world over, including the Netherlands).

Jenny McCarthy: Graduate from the Immunology Faculty of Good Looks and Hasty Conclusions

In case you can’t tell, I am a staunch anti-anti-vaxxer on the human scene. And I am not about to budge on the canine side without some evidence.

So let’s examine that evidence, shall we?

Dog vaccinations: All for profit?

Claim 1: Vets push for unnecessary vaccinations for profit

Your unvaccinated dog will only set foot in our school (or any reputable pet establishment) if you show an up-to-date antibody titer (‘titerbepaling’ in Dutch). ~The titer proves the dog took a blood test that confirms he has adequate levels of immune protection (i.e. antibody concentrations) against specific diseases.

Many see it as a get-out-of-vax-free card but, to use Ben Goldacre‘s words: “I think you’ll find it’s a bit more complicated than that”

• The vet gets the blood by… taking a blood sample from the dog. I would argue that is at least as invasive as an injection, no? A needle is a needle is a needle.
• Expired titer certificates are worthless. The point is to demonstrate your dog is CURRENTLY protected. That’s potentially MORE vet visits if you don’t coordinate your paperwork between your dog walker, training school and, say, dog pension. This is particularly problematic when you consider this: the duration of immunity based on similar titer values varies enormously between individual dogs.
• Also (I am splitting hairs here) low values on a titer do not necessarily mean you need to re-vaccinate as titer tests don’t look at the dog’s entire immune protection. So a dog may very well still be protected against a specific disease even though the titer shows the dog as having low immunity against it.
• ~The titers don’t test for every vaccinated-against disease. Kennel cough, for example, isn’t on the pannel. So you need to 1/ Do the blood test; 2/ Have the dog vaccinated against kennel cough. More cost, more discomfort.
• ~Like for like, titers cost more than vaccinations. Three reasons: (1) They are more labour-intensive for the vet (drawing blood then interacting with a computer screen for thirty minutes); (2) Each kit costs the vet more (economies of scale: they get ordered in smaller bulks as they are less in demand); (3) Vets make a larger margin on titers.

If you want to find out more about titers, check this article by the SkeptVet.

But base cost considerations aside, I get VERY tetchy when people accuse vets of greed. They work grueling hours for peanuts (relative to equally educated professionals). In my own circle of worn out moneyless nerds, my vets friends come out the worst by a mile: always broke and never home.

Let’s say that being broke doesn’t make vets honest, that it could even make them keen to scam (for the sake of pushing the argument). If that were true, wouldn’t they push for titers over vaccinations?

If vets were in it for the money, they wouldn’t be vets.

I would like to close this sorry vets-are-greedy-scrooges chapter by planting a seed in your mind. Isn’t it a downside more reasonable – and less twisted – to assume that vets maybe, just maybe, have our pet’s best interests at heart?

Dog vaccinations: Life-long?

Claim 2: Dogs don’t need so many boosters. 

This one gets a little trickier because – typical conspiracy theory – there’s an element of truth. The misconceptions stem partly from the erroneous ideas that 1/ human vaccinations are lifelong and 2/ therefore so should dogs’. Let’s shed some light on this.

Human vaccines can be lifelong. Aherm, nope. Not all of them are. Remember hauling your butt to the clinic every ten years for that mortifying tetanus shot? And the flu vaccine – which, by the way, is as humiliating as the tetanus one as they send me to the “fainters’ queue” every year…

Dieneke and her long-suffering colleagues will testify that I am as undignified when it comes to my dog getting his shots. Needles + me = baaaaad bed fellows. So believe me, if there was any reasonable way I could squirm out of vaccinations I’d be there in a shot – ‘scuse pun.

If long-acting vaccines work for humans, why not for dogs? Because… Dogs aren’t humans? The duration of immunity [DOI] depends on a lot of factors including the respective species of the host and of the pathogen. Expecting exact parallels between dogs’ and humans’ immunology is like measuring dogs in catnip.

But it IS possible to make long-lasting dog vaccines. ~Vet pharma makes a fraction of the profit its human counterpart does. So they run shorter trials on the vet side. Human pharma trials are the fat cats of the pharma industry. They can run ten years or more and cost millions, but there’s a fat return on investment. In constrast, the average vet trial takes roughly thirteen months. All  you can say about DOI one year in is how many dogs are still adequately covered after… one year. If the trial is one year long, you don’t have data going beyond that.

“What Old Yeller here? He’ll don’t need no booster. He got his puppy shots 12 years ago, he’s covered” – Please note the caption is dripping with sarcasm

But ‘they’ know ‘the’ vaccines are protective for six years on average: True. The average DOI distemper, parvovirus and rabies vaccines hovers around five-seven years (Vet. Am. An. Hosp. Ass., Veterinary Practice Guidelines, 2011) yet they are on a three-year schedule. What’s up with that?

~When you test a large population of vaccinated dogs, quite a few of the dogs are still protected even after a few years. But even if that number is, say, 50%, would you gamble that your dog falls in the right group? At what number would you gamble? 60%? 80%? Vets aren’t big risk takers when pets’ lives are in the balance either, so they set the bar at 95%. If 95% (or more) of the dogs are still protected after n years (and if the research was registered and run according to regulations), then you can say that n years is the DOI. You don’t determine the DOI on a measly (excuse the pun) average, but on the overwhelming majority.

They managed long protection for rabies, so why not for the others? ~The DOI from the rabies vaccine lasts three years, fair enough. It’s partly because rabies can be transmissible to humans so it got more research funding. Who says funding says longer trials. The rabies vaccine is also ‘modulated’: immunologic adjuvants are added so antibodies circulate and are produced for longer.

The ‘cocktail’ vaccination (i.e. distemper, parvovirus, hepatitis) also benefited from longer trials, and boasts a three-year DOI.

But vets still vaccinate yearly: They do, but not against every disease. Like the human flu, some canine diseases are vaccinated against yearly (leptospirosis), whilst others are on a three-year cycle (rabies, cocktail). You are taking Rover to the vet’s every year for his shots, but they rotate the kind of vaccination he gets. ~A typical scheme in The Netherlands is:

1. Cocktail (distemper, parvovirus, hepatitis)
2. Leptospirosis
3. Leptospirosis
4. Cocktail,
5. etc.

~If you want information about pet vaccination schedules in the Netherlands, check my overview or the Landelijk Informatie Centrum Gezelschapsdieren (in Dutch). The LIC article also has a section for people who want to vaccinate less often too “als u toch minder vaak wilt inenten”.

This infographic gives you a visual idea of a typical vaccination schedule. It is a US schedule so it differs slightly from the Dutch one, but you get the gist.

Dog vaccinations: Dangerous?

Anti-vax claim 3: Vaccinations have dangerous side effects, sometimes give the disease itself.

Let’s open up by reminding you that vets swear an oath of non maleficence (Do – no – harm). Even the most cynical of conspiracy theorists cannot seriously believe that every single vet in the country is willing to put all their patients at risk?

Meet Dr Death. He’d signed the wrong oath

But enough about double-guessing intentions. Let’s look at hard facts.

Severe adverse effects are not the norm: Severe post-vaccination reactions do happen, but it’s rare (exact numbers in Veterinary practice guidelines, 2011). If your dog is worrying you after his shots, call your vet’s pronto because something is not right.

I heard some dogs developed the very disease they were vaccinated against ~I am going to barely paraphrase Dieneke’s words here: There is ABSOLUTELY no correlation between receiving a vaccination and the onset of that disease. None, zero, nada, zilch.

Mild adverse effects do happen: Pups may feel a little poorly two-three days after the shot. They might be sleepier, sensitive around the injection area, or a they might get a mild fever. But they should perk up quickly, or, again, something is awry and you should pick up the phone, like, now.

It takes two to fear-monger: I can play the fear mongering game too, and something tells me I’m going to win. So you play the “mild or impossibly improbable adverse effects” card, right? Here’s my card: the ugly, stinky, painful reality of your dog’s discomfort, suffering, or even death from an avoidable disease.

For most of these diseases, the dogs who make it “get away” with invasive, painful, long-lasting (and expensive) treatment. If they make it at all. ~The not-so-lucky one who died in my neighbourhood (just back in August 2014) was four years old. He died a painful death – organ failure – after contracting the scandalously preventable leptospirosis. He was just… three months late on his vaccine.

Fear mongering: I can play that game too

Let me tear you away from the comfort of abstraction and ask you to really imagine your dog suffering the following list of symptoms. Please don’t cheat, the whole point is to shock some sense into you if you’re still contemplating leaving your dog unprotected.

~Distemper:

• Coughing
• Diarrhea
• Fever
• Infected eye and nose lining
• Nervous system can be affected (lack of coordination and all that charming stuff, seizures, etc.)
• ~Painful swelling of the nose and soles of the feet can happen
• ~Sometimes, despite intervention, death

Parvovirus:

• Bloody diarrhea
• Vomiting blood
• Dehydration
• ~Invariably long, expensive and invasive treatment.
• ~Vulnerable to a host of other infections
• ~Often life-long sequels, despite intervention
• ~80-90% die

Hepatitis:

• Compromised liver function
• ~Can’t be detected early so can be lethal
• ~Can become chronic so your dog will be on meds… lifelong… because you didn’t vaccinate

Kennel cough:

• Weeks-long dry intense cough
• Vomiting
• ~Can develop into pneumonia, which requires costly treatment and can be lethal.

Leptospirosis:

• Vomiting
• Fever
• Exhaustion
• Coughing
• Diarrhea
• Bleeding disorders
• ~Kidney failure
• ~Intensive, invasive, expensive intervention
• ~Lethal in unvaccinated animals
• Can be passed on to humans – maybe that’ll convince you

Rabies:

• Extremely rare (~because we don’t allow unvaccinated dogs in The Netherlands)
• Uncontrolled violent bouts of aggression
• Incredible suffering (horrendous thirst whilst, oh mother nature must you be so cruel, having become extremely phobic of water)
• Lethal
• And of course transmissible to humans.

I’ve spared you the more graphic details but if you think you can stomach it, hop along to the vaccination guidelines for owners and breeders by the Veterinary Association (2010). Warning: It’s not for the faint-hearted.

Dog vaccination: last misunderstandings

I have also heard these vague objections, so I thought I’d address them too:

My neighbour’s dog was vaccinated, and he still got sick: He would have been A LOT sicker a lot sooner if he hadn’t been vaccinated. ~The vaccine doesn’t protect the dog from catching the disease, it protects him against developing it full-blown.

My neighbour’s dog was not vaccinated, and he never got sick: Well done him, he dodged a bullet. Want to know what saved his gambling butt? The dog owners who did their civic duty and had their own dog vaccinated. There weren’t so many infected dogs around for your neighbour’s dog to get infected. It’s called ‘herd immunity’. And the less people vaccinate their dog, the more we compromise herd immunity.

My dog is sick, surely I don’t need to vaccinate him? Talk to your vet about your concerns so you can decide from an informed position. Seek a second opinion if you’re not comfortable, but do not make the call based on gut feeling. If the veterinarian’s verdict is to not vaccinate, by the way, thank herd immunity.

Canis bonus comes down on anti vaxxing

I care too much about dogs to take a wishy washy stance on vaccinations. I heard the objections, weighed them up, and came out even more convinced of their necessity. I get that calls to ‘go back to nature’ and ‘beware of big bad modern medicine’ are tempting, but please check the facts before you get sucked in and harm your dog – and our pups – in the process.

In medical matters as in behavioural ones, opinion is best swayed by valid arguments and solid research, not fear-mongering.

Further reading

I am a stickler for evidence and an incurable skeptic, so don’t take my word for this. If you want to take your dog’s vaccination decisions based on solid stuff, check these out:

• American Veterinary Association – Position Statement on puppy vaccinations (2008)
• Landelijk Informatie Centrum voor Gezelschapsdieren (Dutch National Information Centre for Companion Animals – LICG over vaccinatie (In Dutch)
• Refutations to anti vaccine memes: Start with their landing page and explore their anti-vax counter-apologetics.
• SkeptVet – Routine Vaccinations for Dogs & Cats: Trying to Make Evidence-based Decisions (5 Aug 2014)
• SkeptVet – Antibody Titer Testing as a Guide to Vaccination in Dogs and Cats (11 Dec 2014)
• Veterinary American Animal Hospital Association – Veterinary Practice Guidelines on vaccination (2011)
• World Small Animal Veterinary Association – Vaccination guidelines for owners and breeders (2010)

Photos and art attribution

1. Sleeping puppy: By daily sunny on Flickr CC. http://bit.ly/1yCs7YB (CC BY 2.0)
2. A.U.T.I.S.M. poster: by Refutations to anti-vaccine memes on Facebook. http://on.fb.me/1EdlHQ3 (authorisation granted 18 Jan 2015, FB)
3. Jenny McCarthy: By Steven Depolo on Flickr CC. http://bit.ly/15kjpmJ (CC BY 2.0)
4. Veterinarian sign: By Celeste Lindell on Flickr CC. http://bit.ly/1udaSwQ (CC BY 2.0)
5. Old starter dog: By Roveritis on Photobucket. http://bit.ly/1B31prk (under Allow others to copy my media section)
6. Do my pets really need vaccines: By Hudson Veterinary Hospital. http://bit.ly/1Ge97Vf (Sought authorisation 17 Jan 2015)
7. Mad doctor: By OakleyOriginals on Flickr CC. http://bit.ly/1xgsAvf (CC BY 2.0)
8. Fear – Graffiti: By Jimee, Jackie, Tom & Asha on Flickr CC. http://bit.ly/15qmZen (CC BY S.A 2.0)
9. Herd immunity poster: From Refutations to anti-vaccine memes on Facebook. http://on.fb.me/1wjCE5a (authorisation granted 18 Jan 2015, FB)
10. Would you cross this bridge poster: From Refutations to anti-vaccine memes on Facebook. http://on.fb.me/14RGwnm (authorisation granted 18 Jan 2015, FB)