Vaccination principles pass final checkpoint

One of the key items the AVMA House of Delegates approved in July, as part of the annual report of the Council on Biologic and Therapeutic Agents, was the council's "Principles of Vaccination."

Even though the principles became official AVMA policy in April when the Executive Board approved them, passing muster with the HOD is an indicator that the profession's leadership is satisfied with the resource.

The implied endorsement is especially welcome, given the fact that three years ago, the HOD disapproved an earlier version and referred it back, asking that the council gather more information and reassess the AVMA's position.

Among the 1998 critics was the American Association of Feline Practitioners, whose alternate delegate had told the HOD that the AVMA position was ambiguous and didn't accurately reflect veterinary practice.

Moreover, the AVMA and AAFP had competing statements. The AAFP's Dr. David Rosen had urged referral back so the council could develop a unified position the profession would embrace.

In a reference committee at the 2001 HOD session, Dr. Jane E. Brunt, current AAFP delegate, voiced her organization's appreciation for the newly developed principles.

Arriving at the new document entailed the AVMA undertaking a comprehensive review of dog and cat vaccination information. The process included reviewing contemporary vaccination practices. The AVMA convened four panels of experts to form a consensus on guidelines for canine and feline vaccine use. The four panels included expert opinion from academic, industry, regulatory, and practice backgrounds. The practitioner panel included presentation of all the information gathered at an interactive workshop during the 2000 AVMA Annual Convention in Salt Lake City. Practitioner testimony and ideas from the forum were added to the pool of information.

The resultant document does not make specific recommendations. The council concluded that inadequate data exist to determine scientifically a single best protocol for vaccination or revaccination of all dogs and cats. Instead, the principles call for "a customized approach to vaccination recommendations to best match the variation in the patients presented for immunization."

Veterinarians should consider creating a core vaccine program for use in the majority of animals in their practice area, the guidelines state, as well as a non-core vaccine program for the minority of animals.

The principles also acknowledge a critical need for more fully developed, scientifically based, and statistically valid evaluation of vaccine products.

"The principles document represents the first product of our study," said Dr. Donald J. Klingborg, council chair during this activity, "and will be joined with additional materials over the next year."

Other ongoing activity includes two work groups with appropriate representation from the AVMA, the Canadian VMA, the government, industry, and other appropriate organizations, to tackle needed improvements in labeling and adverse event reporting.

Dr. Klingborg added, "Our goal is to provide only science-based data on labels, to change labels to make them more useful to veterinarians, and to create a working surveillance system to improve the health of our patients."

The "Principles of Vaccination" are printed in their entirety on pages 575-576. AVMA members can also access them online.