Abstract
In response to recent concerns, and to help veterinarians make wise decisions about small animal vaccination, the American Animal Hospital Association's Board of Directors approved AAHA's ‘Opinion Paper on Vaccine Issues’ in June.
‘The intent of the opinion paper is to encourage veterinarians to consider vaccination procedures as medical decisions and not automatic actions prompted by a calendar,’ said AAHA President Michael Paul, DVM. ‘With this paper, AAHA is providing its members with the tools necessary to address the issues they face in their practices.’
The opinion paper considers arguments for reduced frequency of administration, evidence of extended duration of immunity and the understanding that vaccines provide risks as well as benefits. The paper encourages the formation of a task force to consider the issues and support studies in this area. It also acknowledges that deviance from the traditional annual vaccination protocol is becoming more common and should be determined an acceptable standard of care in most cases.
Thus the opinion paper is offered as a means of support in veterinarians who choose to follow manufacturers’ recommendations as well as to those who choose a less aggressive vaccination protocol in the best interests of their clients. Throughout the paper, AAHA emphasises that each veterinarian should take all factors into consideration, include client input and make vaccination judgments that are in the best interest of the patient.
AAHA's opinion paper on vaccine issues
AAHA recognises that veterinarians are looking to organised veterinary medicine for directions on the issues of duration of immunity and discretionary uses of companion animal biologics. There is growing professional and public awareness that vaccine products are not as benign as generally believed and controversy as to duration of immunity and frequency of administration.
The argument for continuing current historically practised regimens is based largely on tradition and the perceived paucity of proof supporting extended duration of immunity. While arguments for reduced frequency of administration are based in part on extrapolation from human medicine, intuition and ‘it makes sense,’ there is a growing body of evidence to support this point of view. Many veterinarians are under the misconception that current recommendations were and are scientifically based when, in fact they may have less of a basis than the arguments for change. Industry is unlikely to try to document real maximum duration of immunity due to issues including expense and time limitations.
The American Animal Hospital Association encourages the formation of a high-level task force to consider the issue and purpose and support needed studies. We encourage appropriate government agencies to include duration of immunity studies as a condition of product licensing. In addition, we recommend that companion animal vaccine administration recommendations ultimately be based on the most current and reliable information rather than tradition.
AAHA has found that, while there is evidence to support extended duration of immunity, it has not been globally embraced. There is definite evidence that biologics carry with them risk and benefit. Vaccine administration is a medical procedure in which, as with any medical decision, there are benefits as well as attendant risks that must be weighed and a medical decision regarding administration made. We feel strongly that, as with any medical decision, the veterinarian involved should use his or her best judgment to act in the best interest of the patient.
A growing number of academic institutions, experts respected in the field and private practitioners are recommending reduced administration of biologics to companion animals. This has the very real benefit of reducing adverse reactions and reducing unwarranted expense to clients. On the other hand, there is some degree of risk that in a given patient or group of animals, a disease might occur that could have been prevented. Nonetheless, such deviations from recommended administration are becoming more common and more widely endorsed and, as such, should be considered an acceptable standard of care.
We encourage veterinarians, in each case, to use clinical skill and knowledge, along with client involvement in the decision to act in what he or she believes to be the best interest of the patient. This would provide flexibility and allow for deviations from labeled recommendations without risk of liability or censure. The AVMA Professional Liability Insurance Trust is on record that they will support and defend veterinarians who use their clinical judgment and who are supported by a widely accepted standard of care, as long as they are not doing anything considered illegal or unethical. This assures that those administering biologics according to manufacturers’ recommendations would be on medically sound ground should a given patient experience a serious adverse reaction to a vaccine. It would also allow the benefit of a “standard of care” protection for those who choose to deviate from recommended administration and follow a protocol in line with less aggressive recommendations but in line with the opinion of recognised experts.
‘This is a controversy that is not decided by any means,’ Dr Paul said. ‘However, the issue is one of patient care and medical indication, not of practice management. It is the obligation of each veterinarian to act in conjunction with their client, to stay informed, and to evaluate the risk of each patient for each disease before administering a vaccine.’
The American Animal Hospital Association is an international organization of more than 16,000 veterinary care providers who treat companion animals. Established in 1933, the association is well-known among veterinarians for its high standards for hospitals and pet health care.
ESFM Bye-Laws
The European Society of Feline Medicine is a specialist division of FAB (the term medicine is used to encompass all aspects of feline clinical practice). ESFM falls within the FAB constitution, a copy of which is available on request. The guidelines or bye-laws below lay out rules for the day-to-day running and management of ESFM.
ESFM objectives
To serve veterinary practitioners and scientists with an interest in feline medicine and to establish links between different groups across Europe. To promote continuing education in the field of feline medicine To raise awareness of feline medicine to the practitioner To develop a specialist Journal to include clinical and basic studies To develop specialist qualifications in feline medicine To forge links with humane societies and exchange information To maintain non-exclusive contacts with industry To develop the subject of feline medicine
Structure
The makeup of the governing bodies of ESFM will reflect the range of countries and feline interests within the Society. However, while ESFM is a veterinary based organisation, membership is not exclusive and is also open to non-veterinarians.
Executive committee
An executive committee will be made up of the President, Treasurer/financial advisor, Secretary, FAB Chairman (fixed post), BoR coordinator and FAB Chief Executive (fixed post). Other than the fixed posts, posts will normally be held for a period of 3 years and officers can be re-elected. No more than two officers will be elected each year unless necessitated through resignation from the Executive Committee. Election will take place at the Annual General Meeting (AGM) which will usually be held at BSAVA congress in April each year.
Meetings and proceedings of the executive committee
The Executive Committee shall hold at least two ordinary meetings each year of which one may (of necessity) be a teleconference. A special meeting may be called at any time by the President or by any two members of the Executive Committee upon not less than 21 days’ notice being given to the other members of the Executive Committee of the matters to be discussed.
The President shall act as Chairman at meetings of the Executive Committee. If the President is absent from any meetings, the members of the Executive Committee present shall choose one of their number to be Chairman of the meeting before any other business is transacted.
There shall be a quorum when at least four members of the Executive Committee for the time being are present at a meeting.
Every matter shall be determined by a majority of votes of the members of the Executive Committee present and voting on the question but in the case of equality of votes the President of the meeting shall have a second and casting vote.
The Executive Committee shall keep minutes of the proceedings at meetings of the Executive Committee and any sub-committee.
The Executive Committee may from time to time make and alter rules for the conduct of their business, the summoning and conduct of their meetings and the custody of documents. No rule may be made which is inconsistent with the objectives of ESFM.
The Executive Committee may appoint one or more sub-committees consisting of one or more members of the Executive Committee together with two or more other persons being full members of ESFM for the purpose of making any enquiry or supervising or performing any function of duty which in the opinion of the Executive Committee would more conveniently be undertaken or carried out by a sub-committee, provided that all acts and proceedings of any such sub-committee shall be fully and promptly reported to the Executive Committee.
Each annual general meeting shall be called by the Executive Committee. The secretary shall give at least 28 days’ notice of the AGM to all members of ESFM. All members of ESFM shall be entitled to attend and vote at the meeting.
The President of the Executive Committee shall be the Chairman of each annual general meeting, but if he or she is not present, before any business is transacted, the persons present shall appoint a chairman of the meeting.
The Executive Committee shall present to each AGM the report and accounts of the ESFM for the preceding year.
Nominations for the Executive Committee must be made by members of the ESFM in writing and must be in the hands of the secretary of the Executive Committee at least 150 days before the annual general meeting to allow notification of ESFM members for postal votes to be received. Should nominations exceed vacancies, election shall be by ballot at the AGM and postal votes included.
Board of Representatives
The Board of Representatives will be made up of one or more members of individual European countries. Some representatives may represent more than one country. Suggestions for representatives will be considered by the Executive Committee. Members of the Board of Representatives can be recruited from practice or academia, but not from industry.
Membership/subscriptions
The subscription rate will be set by the Executive Committee in agreement with the FAB Committee. Part of the subscription will be used by FAB to cover administration costs and this rate will be set by the Executive Committee and the FAB Committee. Separate accounts will be kept for ESFM.
Newsletter/Journal
The Journal of Feline Medicine and Surgery is the official Journal of ESFM and will be received by all members. Its Feline Focus pages provide information on ESFM.
Scientific meetings
ESFM will aim to provide at least 2 scientific meetings per year, one at BSAVA congress and one at another European conference, the venue of which may change from year to year.
ESFM Elections
Nominations for ESFM Executive Committee: Myra van Hijfte has been nominated as Treasurer
Stefano Romagnoli has been nominated for position of ESFM President Marian Horzinek has been nominated as BoR representative
Diary
If you are holding a feline meeting and would like to publicise it further, please send details to: Claire Bessant, JFMS, Taeselbury, High Street, Tisbury Wiltshire SP3 6LD, UK. Fax: +44 (0)1747 871873. E-mail:
February 6–8 2000
Title: Ski 2000—feline meeting
Location: Olympoa Park Hotel and Conference Centre, Park City, Utah, USA
Contact: AAFP, 2701 San Pedro NE, Suite 7, Albuquerque, NM 87110, USA
Tel: +1 505 888 2424
Fax: +1 505 888 2688
e-mail:
February 20–24 2000
Title: Western Veterinary Conference
Location: Las Vegas, NV, USA
Contact: Western Veterinary Conference, 2425 East Oquendo Road, Las Vegas, NV 89120, USA
Tel: +1 702 739 6698
e-mail:
Home page: http://www.wvc.org/
March 8 2000
Title: Feline Neurology
Location: Corby, South East, UK
Contact: BSAVA Administration Office, Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL2 4AB, UK
Tel: +44 (0) 1242 862994
e-mail:
March 11 2000
Title: Feline Medicine
Location: University of Liverpool, Leahurst, UK
Contact: The Continuing Professional Development Unit, Faculty of Veterinary Science, Leahurst, Neston CH64 7TE, UK
Tel: +44 (0) 151 794 6010
Fax: +44 (0) 151 794 6005
e-mail:
March 11–12 2000
Title: Ophthalmology for Feline Medicine Symposium
Location: Adelaide, Australia
Contact: Post Graduate Foundation, Level 2, Conference Centre, Building B22, University of Sydney, NSW 2006, Australia
Tel: +61 029 3517979
Fax: +61 029 3517968
e-mail:
March 24–26 2000
Title: Feline Cardiology
Location: Cheshire, Midlands, UK
Contact: BSAVA Administration Office, Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL2 4AB, UK
Tel: +44 (0) 1242 862994
e-mail:
March 30–April 2 2000
Title: SCIVAC 40th Annual Congress
Location: Montecatini, Italy
Contact: Palazzo Trecchi, Via Trecchi 20, I–26100 Cremona, Italy
Tel: +39 0372 460440
Fax: +39 0372 457091
April 6–9 2000
Title: BSAVA Congress
Location: Birmingham, UK
Contact: BSAVA, Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL51 5TQ
Tel: +44 (0) 1242 862994
Fax: +44 (0) 1242 863009
e-mail:
Home page: http://www.bsava.ac.uk
April 25–29 2000
Title: WSAVA–FECAVA World Congress, organised in conjunction with the Voorjaarsdagen of The Netherlands Association of Companion Animal Medicine
Location: Amsterdam, The Netherlands
Contact: Voorjaarsdagen Congress Secretariat, PO Box 14031 SB, Utrecht, The Netherlands
Tel: +31 30 2510111
Fax: +31 30 2511787
e-mail: