Vaccinations are no longer considered to be the cornerstone for the yearly examination. Patient recalls should be based on the need for a comprehensive physical examination and consultation rather than for vaccination alone. The wording of recall messages is important; here is a suggested format:
It’s time for Fluffy’s comprehensive physical examination and consultation regarding nutrition and behaviour. Cats are good at hiding health problems. This appointment is an opportunity to find things that might otherwise go undetected—and become more difficult and costly to treat later on. During the appointment, we’ll review Fluffy’s vaccination needs and we’ll recommend flea and internal parasite control based on her individual needs. In addition, blood and urine tests might be recommended for health monitoring and early disease detection.
Vaccination decisions should be based on risk assessment and tailored to the individual patient. As is always the case in using disease management guidelines, practitioners should adapt the recommendations to best suit the needs of their own patients. In assessing the risk, information about the cat, the environment, and infectious agents to which the cat will be realistically exposed and the potential for zoonosis must be considered:
- Patient factors: Most infectious diseases are more prevalent in kittens, particularly those under 6 months of age. Kittens therefore, represent a principal target population for vaccination
- Maternally derived antibodies (MDA): MDA provide important early protection against disease for kittens. However, MDA may also interfere with the response to vaccination. The level of MDA varies among individuals, so that the age at which a kitten may be able to fully respond to vaccination will also vary. In some cases, this may be 16 weeks of age or older
- Aging cats: Immunosenescence occurs as cats age, blunting previously established immunity. As a result, even though a cat may have been properly vaccinated at an earlier age, vaccination should not be allowed to lapse in this age group
- The environment: Risk of exposure to infectious diseases is affected by population density and the opportunity for exposure to infectious agents from other cats. Cats in multiple-cat households, cats admitted to boarding facilities, and cats with access to the outdoors are likely to have a higher risk of infection than are cats in households with 1 or 2 indoor cats. However, ‘indoor cats’ are not without risk of exposure to infectious disease during their lifetime and also require protection
- Location: Infectious diseases vary in geographic distribution, resulting in substantially different risks of exposure for cats living in different areas. Determining a cat’s risk for infectious disease also includes plans for future travel away from home
- The infectious agent: Variables associated with the infectious agent itself, such as virulence, strain variation, challenge dose, and environmental stability, will influence the outcome of infection; these may be difficult to assess. See the AAFP disease information fact sheets for helpful information (see Resources)
- Government regulations: Rabies is considered to be endemic in most of Canada and legislation mandating rabies immunizations for all cats (indoor and outdoor) is present in many municipalities. Veterinarians should be aware of, and abide by, local and provincial regulations and by-laws
Several organizations have reviewed and updated vaccination guidelines for cats with all recommending to vaccinate more cats but to vaccinate individual cats less often than in the past (see Resources). Based on these published guidelines for the indoor/outdoor cat, this panel recommends the following vaccinations for the owned cat:
|VACCINE||FIRST INOCULATIONS: KITTENS||FIRST INOCULATIONS: ADULT CATS AND KITTENS OVER 16 WEEKS OF AGE||SUBSEQUENT INOCULATIONS||COMMENTS|
|Panleukopenia, herpes virus-1, calicivirus||Administer the first dose as early as 4-6 weeks followed by revaccination every 3-4 weeks until at least 16 weeks of age (when risk of maternally derived antibody interference is minimal)||Administer the first dose followed by revaccination 3-4 weeks later||Administer a booster 1 year after completing the initial series followed by revaccination every 3 years unless a high disease risk requires more frequent vaccination intervals||Killed virus and modified live virus vaccine products are available in Canada. All vaccines must be administered according to the manufacturer directions.|
|Rabies||Administer a single dose at not less than 12 weeks of age||Administer a single dose||Administer a booster 1 year after the initial vaccination and then once yearly or every 3 years according to the manufacturer’s guidelines||Recommended for:
|Feline leukemia virus (FeLV)||Administer the first dose as early as 8 weeks of age followed by revaccination 3-4 weeks later||Administer the first dose followed by revaccination 3-4 weeks later||Administer a booster 1 year after completing the initial series followed by revaccination:
Revaccination is not needed in cats that are at no risk (indoor‑only single cat or indoor multiple-cat household with known negative FeLV status of all cats)
|Cats should be tested for FeLV and feline immunodeficiency virus prior to vaccination.
All kittens should be vaccinated (even if they are intended to be housed indoors) as this is the most susceptible age group for FeLV infection and, despite a client’s best intentions, housing status and exposure to other cats can change.
Low-risk cats would include those that go into boarding facilities where cats are housed individually, cats with limited outdoor access (i.e., outside enclosures) where risk of contact with another cat is minimal or in cases where the aforementioned cat is housed indoors but housemates go outside.
High-risk cats would include those that are free roaming and/or are seen at the clinic for abscesses (as evidence of cat fights).
The following vaccines are not considered necessary for use in most cats:
Feline Infectious Peritonitis: At this time, there is insufficient evidence that the vaccine induces clinically relevant protection and use of the vaccine is not recommended.
Feline Immunodeficiency Virus (FIV): The FIV vaccine is no longer available in North America as of 2015, but there are 2 important points for those cats previously vaccinated with this product. First, it may not provide complete protection against all field strains due to the highly mutable nature of the virus, leading to a false sense of security. In addition, some cats may test FIV antibody-positive for 4 years or longer after the last vaccination. The conventional testing methods for FIV are based on antibody detection. Commercially available test kits use a variety of antibody targets. Some tests may be able to distinguish antibodies induced by vaccination from those induced by natural infection, but other tests are unable to make this distinction. Additional PCR testing in antibody-positive animals may be required to distinguish between these two populations, involving additional costs, time, and anxiety.
Feline Injection Site Sarcomas
Feline injection site sarcoma (FISS) is a rare but devastating neoplasm that has been associated with vaccinations as well as, in rare cases, other injected products (e.g., lufenuron, long-acting medications, microchip). Current theories suggest that the etiology is complex and multi-factorial, involving the nature of the inflammatory response in certain individuals that may be genetically predisposed to tumour development. These tumours can occur months to years after vaccination, making determination of cause and effect very difficult. One study suggested that cats with sarcomas in the rear leg were significantly less likely to have received recombinant rabies vaccines than inactivated vaccines. We therefore recommend avoiding inactivated vaccines when possible and when appropriate. However, it’s important to note that no vaccines are free from risk.
Although we may never be able to fully prevent FISS, based on the available evidence, we recommend the following to reduce risk:
- Use extended revaccination intervals for adult cats where appropriate
- Vaccine selection should be based on disease risk assessment
- Practitioners must be mindful of choosing a site where surgical intervention might be more effective in the event FISS does occur. Vaccinations should not be administered in the interscapular area. Using a consistent location for each vaccine type and recording it in the medical record is essential both for surgical planning and for identification of causality. The following sites are recommended for vaccine administration:
- FVRCP vaccines at or below the right elbow
- FeLV vaccines at or below the left stifle
- Rabies vaccines at or below the right stifle
Administration of vaccines should be as close to (at or below) the joint. When given higher on the limb, surgical removal of a sarcoma becomes more complex and invasive.
REFERENCES available on request
Photo courtesy of Dr. Liz O’Brien
Photo courtesy of Dr. Liz O’Brien
World Small Animal Veterinary Association Vaccination Guidelines:
European Advisory Board on Cat Diseases: Recommendations on the Prevention and Management of Feline Infectious Diseases:
AAFP Feline Vaccination Advisory Panel Report:
- Feline Vaccination Guidelines
- Disease Information Fact Sheets