Robert E. Holland Jr., DVM, Ph.D., can’t help but wonder, “Why would you risk the death of your horse to save $20?” But horse owners indeed are doing just that by forgoing core vaccines in a struggling economy. “Times are tough in many places in the U.S.,” says Rob Keene, DVM, an equine professional services veterinarian for Boehringer Ingelheim Vetmedica Inc. of St. Joseph, Mo. “I would hope that the administration of core vaccines would not suffer due to the economy.” Tom R. Lenz, DVM, MS, Dipl. ACT, estimates that the cash crunch has led to a 15 to 20 percent decline in equine vaccinations over the last couple of years. “For instance, many people feel that West Nile Virus is no longer a threat, but they are wrong,” says Dr. Lenz, senior director of Equine Veterinary Services at Pfizer Animal Health of New York. “It still exists.” Dr. Holland, Pfizer’s associate director of outcomes research, says not vaccinating a horse is shortsighted, pointing to a surge in Eastern Equine Encephalitis cases in Florida, including seven reported in one day. “The majority of mosquito-borne infections can be prevented by proper vaccination,” Holland says. Dr. Keene says clients may be trying to save money, “but we need to continue to push the practice of best preventive medicine and the inclusion of all the important agents in the core vaccines for our patients.” April L. Knudson, DVM, manager of Large Animal Veterinary Services at Merial Ltd. of Duluth, Ga., says the annual exam gives veterinarians an excellent opportunity to talk to their clients about horse owner responsibilities and about why core vaccines are absolutely necessary. The American Association of Equine Practitioners and the American Veterinary Medical Association say core vaccines for equines cover tetanus, Eastern and Western encephalomyelitis, West Nile virus and rabies. Every horse in the U.S. should receive these vaccinations at least annually, experts say. “These diseases can be fatal,” Dr. Knudson says. “Why wouldn’t you vaccinate against them? Even if you don’t see many cases of these diseases in your immediate area, it is important to remember that many horses travel throughout the U.S. and could be exposed to these diseases while on the road.” She pointed to the recent death of a 3-year-old mare in St. James Parish, La., who tested positive for both WNV and EEE. “Vaccination would have prevented this death,” she says. Best in Vet’s Hand Veterinarians also must explain why equine practitioners should administer the vaccines, rather than having the owners do it themselves using drugs bought at a feed store.“When the veterinarian vaccinates a horse, most pharmaceutical companies will stand behind the vaccine and in some cases, guarantee it,” Lenz says. “That is not the case when owners give the vaccination. The reason is that the company cannot guarantee the product was administered properly or stored properly.” Lenz says rabies was added to the AAEP’s list of core vaccines for good reason: Outbreaks have been documented in horses in Colorado, Arizona, Texas and Florida. Rabies can be transmitted through the bite of an infected animal. As for the other diseases covered by core vaccines, “Tetanus is found in the soil and [can enter] the horse’s body through wounds,” Lenz says. “EEE, WEE and WNV are spread via mosquitoes [and birds] and therefore, the horse does not have to come in contact with sick horses.” Knudson says Merial has a new 4-in-1 vaccine that protects against West Nile, Eastern and Western encephalomyelitis and tetanus. The West Nile portion features recombinant technology, which stimulates both humoral and cell-mediated immune responses. “Every horse is susceptible to mosquito bites,” Knudson says. “Whether you own one horse or 300, there is no reason not to vaccinate.” Defining Core Vaccine By the AVMA’s definition, core vaccinations “protect from diseases that are endemic to a region, those with potential public health significance, required by law, virulent/highly infectious and/or those posing a risk of severe disease.” “Core vaccines have clearly demonstrated efficacy and safety, and thus exhibit a high enough level of patient benefit and low enough level of risk to justify their use in the majority of patients,” the AVMA says. Julia H. Wilson, DVM, Dipl. ACVIM, encourages equine practitioners to stay abreast of developments and emphasize the importance of reporting both infectious disease cases and vaccine reactions. She is an associate professor at the University of Minnesota College of Veterinary Medicine and serves on the AAEP’s Infectious Disease Committee. She says researchers need to be involved in “both making more effective vaccines for diseases for which we are already vaccinating (e.g., EHV1), and for diseases against which we do not currently have a vaccine (e.g., equine infectious anemia).” While some diseases lack a vaccine, scientists are hard at work looking for one. “Many universities and all vaccine companies have ongoing research programs regarding improvement in vaccine and disease prevention programs,” says Boehringer’s Keene. “Diseases such as R equi and Lawsonia continue to be frustrating to prevent without good vaccination strategies available.” Pfizer’s Lenz remains hopeful. “Some research is being done on vectored vaccines as well as oral vaccines that may eventually replace some of the current injectable vaccines,” he says. Keene applauds the efforts of the AAEP. “AAEP has done a great job in keeping with the dynamic changes in equine infectious diseases,” he says, “making improvements and modifications of the vaccine guidelines for foals and adult horses.” Educate Horse Owners AAEP member veterinarians are encouraged to download PowerPoint presentations at AAEP.org and hold horse-owner meetings to educate them about the importance of vaccinations. “This is a good way to reach new clients, as well as those you aren’t in contact with regularly,” Knudson says. She encourages equine veterinarians to use client mail and e-mail lists to spread the word about the need for core vaccines. Just as important, she says, is to reach new clients and those who don’t vaccinate their horses regularly. Advertising an educational seminar in a local newspaper or equine magazine is a good idea, she says. The pharmaceutical industry may be able to help. “Ask your pharmaceutical sales representative to help sponsor a meeting, and maybe host a barbecue or bring in some pizzas,” Knudson says. “A free meal can entice potential clients to come and find out about the importance of vaccination. “You’re probably already seeing your good clients on a regular basis and they have their horses on a regular vaccination schedule,” Knudson says. “To grow your business, you should invite potential new clients to learn about the importance of vaccinating.” Dr. Wilson, of the University of Minnesota, says the AAEP is a great source of information. “The AAEP has made the vaccination guidelines available to the public and with its educational partner, Bayer Animal Health, provides excellent client handouts,” she says. AAEP member veterinarians have access presentations that cover what horses owners need to know about vaccinations, core vaccines and other topics. The AAEP also can provide news releases and articles about the importance of equine vaccination. The downloadable articles are easily personalized and can be e-mailed to local equine publications, giving veterinarians more, and usually free, publicity. “For veterinarians without their own marketing representatives, the AAEP offers some great tools,” Knudson says. Vaccine Storage and Handling The proper storage and handling of vaccines is critical to their efficacy and safety, according to guidelines of the American Association of Equine Practitioners. Among AAEP’s recommendations: • Follow an aseptic technique when handling and administering vaccines. Always adminster vaccine to a clean site. Avoid cross contamination of products and possible adverse reactions by vaccinating each animal using separate new needles for each vaccine product. • Always adminster vaccines via the intended route. Intranasal vaccines should never be given intramuscularly. • Read and follow the manufacturer’s recommendations for each product regarding storage temperature, exposure to light during storage and shaking of the product to assure uniform vaccine suspension. • Maintain vaccines at the appropriate temperature from arrival from manufacturer to patient administration. A lack of adherence to proper temperature maintenance can result in lack of efficacy, undue vaccine failures and an increased rate of adverse reactions post vaccination. <HOME>
