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Another approach recommended by Weimaraner breeders and this author is to modify the vaccination protocol, especially for puppies from families known to have experienced adverse vaccine reactions. Examples would be to limit the number of antigens used in the vaccine series to those infectious agents of most clinical concern (i.e., CDV, CPV, and rabies virus), separating these and other antigens to 2- to 3-week intervals, and giving rabies vaccine by itself at 6 months of age. A booster series is administered at 1 year by separating the CDV, CPV, rabies virus, and other vaccine components, where possible, and giving them on separate visits at least 2 weeks apart. Thereafter, serological antibody titers can be measured (except for those vaccines required by law, unless a specific exemption is made on

an individual case basis).



Practitioners should be encouraged during the initial visit with a new puppy owner or breeder to review current information about the breed's known congenital and heritable traits. Several databases, veterinary textbooks, and review articles contain the relevant information to assist here (2). For those breeds at increased risk, the potential for adverse reactions to routine vaccinations should be discussed as part of this wellness program. Because breeders of at-risk breeds have likely alerted the new puppy buyer to this possibility, we should be mindful and respectful of their viewpoint, which may be more informed than ours about a specific breed or family issue. To ignore or dismiss these issues can jeopardise the client-patient relationship and result in the client going elsewhere for veterinary services or even turning away from seeking professional care for these preventive health measures. As a minimum, if we are unaware of the particular concern expressed, we can research the matter or ask the client for any relevant scientific or medical documentation. The accumulated evidence indicates that vaccination protocols should no longer be considered as a "one size fits all' program.

For these special cases, appropriate alternatives to current vaccine practices include: measuring serum antibody titers; avoidance of unnecessary vaccines or overvaccinating; using caution in vaccinating sick, very old, debilitated, or febrile individuals; and tailoring a specific minimal vaccination protocol for dogs of breeds or families known to be at increased risk for adverse reactions (3,5-8). Considerations include starting the vaccination series later, such as at 9 or 10 weeks of age, when the immune system is more able to handle antigenic challenge; alerting the caregiver to pay particular attention to the puppy's behaviour and overall health after the second or subsequent boosters; and avoiding revaccination of individuals already experiencing a significant adverse event. Litter mates of affected puppies should be closely monitored after receiving additional vaccines in a puppy series, as they, too, are at higher risk. Altering the puppy vaccination protocol, as suggested above for the Weimaraner, is also advisable.

Following these recommendations may be a prudent way for our profession to balance the need for individual patient disease prevention with the age-old physician's adage, forwarded by Hippocrates, of 'to help, or at least do no harm'.



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