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This web site is dedicated to grassroots efforts to clarify and change existing misconceptions and practices concerning rabies vaccination protocols. The issue discussed on this web site pertains to adult rabies dog booster shots, not the initial (puppy) shot and the first booster.

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Related: March 1, 2012 - The MN Board of Veterinary Medicine has announced guidelines and recommendations, Rabies Vaccination Guidance Document(link) concerning rabies vaccines protocols and the practice of veterinary medicine for the State of MN., see the MN Board of Veterinary Medicine's Rabies Vaccination Committee Report(link).


THE SIMPLE TRUTH - THREE YEAR CERTIFICATION
- There are no two-year Rabies vaccines

If you have received a two year certificate for your adult dog, you can request that the duration stated on the certificate be changed by your veterinarian to a three year certificate. MN Admin. Rules, “Rabies definitions” Subp.3. c. which says that a rabies certificate must list the duration of immunity.¹ (link)

THE SITUATION/PROBLEM
Dog owners may be paying too often for their adult dog's rabies vaccination and possibly exposing your dog to adverse reactions, some of which may be life threatening.

Some veterinarians are providing their clients with INCORRECT/inaccurate information regarding the licensed rabies vaccination duration of immunity.
For anyone receiving a two year certificate, the state has issued provisions
so the certificate can be amended to a three year certificate. Veterinarians can correct the certificate two different ways (excepted from Animal Bites 8/8/2013):

  1. The veterinarian that administered or oversaw the administration of the vaccine and issued the certificate can correct the information on the certificate, and initial and date the change.
  2. The veterinarian can issue the animal owner a letter indicating the error and what the actual vaccine duration of immunity is.
There is NO ADULT RABIES VACCINE LICENSED in the USA THAT HAS A DURATION OF IMMUNITY FOR 2-YEARS. (see the CDC's Rabies Compendium Table I or Table II Nov. 2011) Veterinarians used multiple excuses for administering this vaccine more often than the recommended 3-years. None a

a KMSP Fox9 news investigative report that aired 7-27-2011 (click to view the report)


A survey conducted by the MN Board of Veterinary Medicine concluded: "Eighty-nine percent of veterinarians in the state administer a three-year vaccine to dogs and cats, but 39 percent of those re-vaccinate more frequently. link

March 1, 2012 Minnesota Board of Veterinary announced Rabies Vaccination Guidance document (PDF, click to download) If veterinarian suggests a different vaccination schedule, it should be based on "credible, scientifically based information" t

re based on medical scientific evidence.

There is NO scientific data/research proving administering this vaccine more often than every 3-years is beneficial to the animal. Requesting the owner pay for a vaccination that may not be necessary could constitute fraud and/or deception as defined by Minnesota Administrative rule, link.

This situation/problem is described inhat should be made available for customer review, according to guidelines adopted by the board in February."
Minneapolis Star/Tribune article (4/18/12) or download the MBVM Survey (PDF, click to download).

 


Vaccines are important for preventing serious diseases. Please vaccinate your pets. (See the article, "Thirteen ways to vaccinate more safely")

There is rabies present in Minnesota and there is no cure. According to the MN Board of Animal Health (BAH) there has been a substantial decrease in rabies in Minnesota and we all want to maintain that decline. (Board of Animal Health) However, vaccine overuse can harm animals without enhancing their immunity. There is no scientific data/research proving more vaccine translates to more protection. Pet owners need to be well informed and be an active participant in their pets veterinary care. Maintain a collaborative relationship with your veterinarian with an honest and open dialogue. Vaccines are potent treatments with benefits and risks to the patient. Rabies vaccines are the most potent of all veterinary vaccines. (JAVMA 10/1/05 Article: Adverse events diagnosed within three days of Vaccine Administration in Dogs)

KNOW VACCINE GUIDELINES BY VETERINARY MEDICAL ASSOCIATIONS

American Veterinary Medical Association's
Principles of Vaccination (link) States, on page 5, ""Unnecessary stimulation of the immune system does not necessarily result in enhanced disease resistance, and may increase the potential risk of post-vaccination adverse events" . "
AVMA
website AVMA Principles of Veterinary Ethics(link)

American Animal Hospital Association
"It is the view of the Task Force that veterinarians have considerable latitude in selection and use of veterinary biologic products licensed for dogs, with rabies vaccine being a noted exception..." American Animal Hospital Association's 2011 Vaccine Guidelines

2011 Vaccine Guidelines (pdf) on Page 6 Table 1 "...revaccination with '3-year rabies' vaccine' should be administered every 3 year... On Page 34, "Current studies have shown that, among dogs, the risk of an acute onset (within 3 days) adverse reaction is greatest among small breeds receiving multiple vaccines at same appointment." For more information read, Page 22, paragraph on Small dogs (AAHA) website


CONSUMER PROTECTION


YOU ARE ENTITLED TO INFORMED CONSENT

The pet owner has the right to be given informed consent and the photo of a Sammy running, Copyright by Lois Stanfieldveterinarian has the legal obligation to provide it. Informed consent means the medical profession must disclose the benefits and risks of all recommended treatments to the owner before treatment is initiated.The veterinarian MUST DISCLOSE to the owner what the proven duration of immunity of the vaccine is and scientific proof must be provided to the owner if the veterinarian deviates from the accepted standards of practice/standards of care.
AVMA adopts policy on informed consent


Minnesota Administrative Rules: 9100.0800 Minimum Standards of Practice - click includes,

Subp 9: "Informed consent. A client shall be informed by the veterinarian, prior to treatment, of the treatment choices and reasonable medical or surgical alternatives including an estimated cost of the alternatives for consideration by the client."




STANDARDS OF PRACTICE - STANDARDS OF CARE
All veterinarians are governed by what is called a standard of care, or standard of practice. This is a way of caring for patients that has been set by professional associations/organizations that govern the practice of veterinary medicine, along with pharmaceutical manufactures and government agencies. In tort law, the "standard of care is the degree of prudence and caution required of an individual who is under a duty of care." It directs veterinary professionals to "what would be exercised by the reasonably prudent manufacturer of a product or the reasonably prudent professional in that line of work" and "determines whether ahappy Labradoodledoctor is liable for medical malpractice."

Veterinarians, like physicians, are to adhere to the generally accepted "standard" of professional medical care... Failure to provide informed consent or adhere to the accepted standards of care/practice not only carries potential legal liabilities, they may also violate MN consumer protection laws.

Minnesota Administrative Rules: 9100.0700 UNPROFESSIONAL CONDUCT-click to view
Subpart 1. Describes "Prohibited Acts" including:

B. engaging in conduct likely to deceive, defraud, or harm the public or demonstrating a willful or careless disregard for the health, welfare, or safety of a patient, in which case, proof of actual injury need not be established;

Q. performing or prescribing unnecessary or unauthorized treatment.

9100.0800 MINIMUM STANDARDS OF PRACTICE.
   Subpart 1. General standard. The delivery of veterinary care must be provided in a competent and humane manner consistent with prevailing standards of practice for the species of animal and the professed area of expertise of the verterinarian. For a veterinarian to excercise properly the rights granted by the veterinary license, a veterinarian-client-patient relationship must exist.

Minnesota does have state law concerning rabies vaccination and rabies certification (many veterinarians are unaware of this law)
MN Administrative Rules 1721.0540 Subp.3. Rabies vaccination certificate.
MN Administrative Rules 1721.0550 ANIMAL RABIES VACCINES Subp 2 Administration of Rabies Vaccine

1721.055 Animal Rabies Vaccines.
B. "...that has been vaccinated for rabies in accordance with parts 1721.0540 to 1721.0580 and the compendium."
C."No person shall issue a rabies vaccination certificate for an animal in a manner not in accordance with parts 1721.0540 to 1721.0580 and the compendium."



COMPENDIUM
The U.S. Center for Disease Control (CDC) National Public Health Veterinarians publishes The Compendium of Animal Rabies Prevention and Control, 2011. This is the guide and reference of UPDATED RESEARCH THAT SETS THE STANDARD OF CARE OF RABIES CONTROL AND PREVENTION PROGRAMS IN THE USA. The Compendium IS ENDORSED BY The National State Public Health Curly-Coated Retriever Veterinarians Association, The American Veterinary Medical Association, The American Animal Hospital Association, The Association of Public Health Laboratories, Council of State and Territorial Epidemiologists, The National Animal Control Association.
Rabies COMPENDIUM:
the complement of updated rabies research/protocols and standard of care/practice (link to Rabies Compendium as an html web page, or download as pdf). All rabies licensed vaccines and manufacturers are listed on either of the following links: Table I or Table II

The Compendium states, "Vaccines used in state and local rabies control programs should have at least a 3-year duration of immunity. This constitutes the most effective method of increasing the proportion of immunized dogs and cats in any population."

The Compendium states "No laboratory or epidemiologic data exist to support the annual or biennial administration of 3-4-vaccines after the initial series."


FACTS AND RESOURCES

Minnesota has no state wide law that requires rabies vaccinations. There is state law pertaining to rabies vaccination and certification. Requirement of rabies vaccination, regulation and enforcement is left to counties, cities and municipalities. But remember cities can regulate and/or require licenses, they cannot dictate veterinary medical protocol. Do not confuse obtaining a license with the administration of a rabies vaccine protocol. This is an excuse many veterinarians use to administer the vaccine every 2-years. Check your city codes as most all say "current rabies vaccination required to obtain a license."

All 50 states recognize the 3-year vaccine.(Rabies Laws by State)

Protocols of the past have changed and will probably continue to do so in the future. For information on Rabies vaccination duration study, go to Rabies Challenge Fund. (link)

Three year adult rabies boosters are endorsed internationally (WSAVA, link). All USA veterinary medical colleges including the University of Minnesota endorse the 3-year rabies vaccination protocol.


SOME STATEMENTS (Excuses & Responses) MADE BY VETERINARIANS PRACTICING 2-YEAR BOOSTERING
(click on an excuse to get the reply):

Because it's a state law
False. MN does not have a state law requiring rabies vaccination. There is no 2 yr rabies vaccine law. Regulation of rabies vaccination is left up to municipalities, cities and counties. Often regulation is in the form of a rabies city license. Board of Animal Health might introduce rabies legislation, for uniformity. (link NPR story, "Minnesota statewide rabies rule")

MN does have law defining what a rabies vaccinated animal is and what should be listed on a rabies certificate ie duration of vaccination.
Link Administrative Rule 1721.0540 Definitions, Subp. 3. Rabies Vaccinations

Because I want to.
This is not an acceptable or valid reason. Veterianians MUST provide a reason with a scientific base. Veterinarians, like physicians, are supposed to adhere to the generally accepted "standard" of professional medical care.

Giving 2-year boosters instead of 3-year boosters practice goes against the recommendation of ALL the national veterinary medical associations, CDC'c National Association of State Public Health Veterinarians' Rabies Compendium, the American Animal Hospital Association, and The American Veterinary Medical Association as well as the national 3-year standard set in all 50 states.

MN Board of Verterinary Medicine Recommendations and Protocols should be scientifically-based from unbiased sources. The committee has identified the NASPHV Compendium of Rabies Prevention and Control as appropiate reference document.

The compenduim states, "No laboratory or epidemilogic data exist to support the annual or biennial administration of 3 or 4 year vacciines after the initial series."

Modern elements of informed consent for general veterinary practitioners
by D. Duane Flemming, DVM, JD, DACVO,
and John F. Scott, DVM, JD


Current MN Law states 1721.055 Animal Rabies Vaccines. Subp.2 Administration of rabies vaccine B..."that has been vaccinated for rabies in accordance with parts 1721.0540 to 1721.0580 and the compendium."

Because there are no 3-year Rabies Vaccine.
False. Rabies vaccines for dogs are either 1 year or 3 year. The Compendium states "Vaccines used in state and local rabies control programs should have at least a 3-year duration of immunity. This constitutes the most effective method of increasing the proportion of immunized dogs and cats in any population." See:

List of approved vaccines ~ Table I (page loads slowly on first visit)

Part II. Recommendations for Parenteral Rabies Vaccination Procedures

Because rabies is in the area
False. Compendium Part 1. Rabies and Prevention and control. 6. Rabies in vaccinated animals: Rabies is rare in vaccinated animals (11-13) and B Prevention and Control Methods in Domestic and Confided Animals 1. Preexposure Vaccination and Management: "No laboratory or epidemiologic data exist to support the annual or biennial administration of 3-or 4-year vaccines after the initial series."

Postmarketing surveillance of rabies vaccines for dogs to evaluate safety and efficacy states: "The information presented here provides additional support for the premise that rabies vaccines for dogs are highly efficacious and a vital component of a successful rabies control program."
Dog has a Two Year certificate and is overdue

A veterinarian not acknowledging the vaccine has a three year duration may be in conflict MN law, MN MN Board of Veterinary Medicine Guidelines, the compendium, and medical standards of practice.

2011 AAHA Canine Vaccine Guidelines state, "Administer a single dose of a "3-yr" rabies vaccine within 1yr after administration of the initial dose, regardless of the animal's age at the time the initial dose was administered. Subsequently, revaccination with a "3'-yr rabies" vaccine should be administered every 3 yr. thereafter, unless state, provincial, and/or local requirements stipulate otherwise."

The MN Board of Animal Health acknowledges the rabies vaccines's manufactures three year duration of immunity.

HELP other Minnesotans with 2 year rabies certificates get amended certificates to read 3 year, contact MN Board of Veterinary Medicine Ph 651-201-2844 email vet.med@state.mn.us and ask for support in amending all 2yr rabies certificates.

"If you are in possession of a rabies certificate that says two years you were given a three year duration of immunity vaccine contact
MN Board of Veterinary Medicine phone 651- 201-2844 04 email vet.med@state.mn.us

Tell them you want your vaccine certificate to be amended to reflect its the 3 year duration of immunity as stated on the manufactures' label.

The more vaccine, the more protection

False. Compendium: On Page 6: "No Laboratory or epidemiologic data exist to support the annual or biennial administration of 3- or 4-year vaccines following the initial series."

2011 American Animal Hospital Association's Canine Vaccine Guidelines. (link)
"...revaccination with '3-yr rabies' should be administered every 3 yr..."

AVMA's Principles of Vaccination states on page 2:
"Unnecessary stimulation of immune system does not result in enhanced disease resistance, and may increase the risk of adverse post-vaccination events."

Because some owners are late coming in for shots
How do you feel about paying money, spending time, exposing your pet to possible adverse events and the stress of a vet visit because someone ELSE is delinquent? This is unfair to responsible "on time" pet owners. Pet owners and their animals shouldn't be penalized for non-compliant, irresponsible people.

MN Board of Veterinary Medicine guideline recommendations state, "5. Veterinarians should not adopt rabies vaccination recommendations and protocols based on actual or perceived client compliance with the rabies vaccination schedule. It is the animal owner's responsibility to ensure that the animal's rabies vaccination status is current."
The City/County requires it.
Check your city codes!! Most cities and municipalities require a "Current" Rabies vaccination certificate. DO NOT confuse requirements for a license with requirements for a vaccination. Many veterinarians mistakenly confuse the duration of immunity of the vaccine with the duration of the city license. City officials do not practice veterinary medicine, veterinarians do. Cities enforce.

If you live in a city with outdated 2-year requirements, alert city officials of the updated Compendium and letter from the MN Board of Veterinary Medicine and MN Board of Animal Health requesting cities to use word 'Current"as to not dictate frequency of vaccination.

Why is the City of Oak Park Heights code well written? 601.09 Rabies Inoculation of Dogs and Cats..."re-inoculated according to the standard veterinary practices there after." 601.06 Dog or Cat license. B ."The terms of a license shall run concurrently with a dog's or cat's rabies vaccination schedule" (rabies protocols have changed in the past and probably will do so in the future, this keeps the code current). Also there is late license fee (to encourage keeping vaccinations current), and microchips are allowed.

MN Board fo Veterinary Medicine vaccination recommendations:
6. Veterinarians should not adopt rabies vaccination recommendations and protocols base soley upon local/regional animal licensing ordinances which prescribes rabies vaccination frequency. It is hte animal owner's responsibility to meet the requirements of local/regional annual licensing requirements.


Get clients to come in for an annual wellness exam.
Wellness exams are an important part of good veterinary care, but using a vaccine hook to get clients in the door is unacceptable, especially when rabies vaccines are administered more often than set by the standard of practise, vaccine manufacturers' labels, all medical associations, and the CDC's Rabies Compendium. Redundant vaccination increases the risk of adverse reactions without enhancing immunity.

Article: What Everyone Needs To Know About Canine Vaccines and Vaccination Programs, by Ron Shultz, PhD.

The two most common excuses used by veterinarians to justify their administering rabies vaccines every 2-years are the city codes and that clients don't come in on time. Many of the vets have not bothered to even check the city codes to see that they require a CURRENT vaccination, they assume the license correlates with the vaccination. Most have done nothing with the city officials to clarify this issue. Some vets have actually been knowingly allowing cities to practice veterinary medicine. As for clients being overdue for vaccinations, how to you feel about having to pay more money and exposing your dog to more vaccine because SOMEONE ELSE is over due?

OVERDUE FOR YOUR DOG'S RABIES SHOT?
2011 AAHA Canine Vaccine Guidelines state "Administer a single dose of a "3-yr" rabies vaccine within 1 yr after administration of the initial dose, regardless of the animal's age at the time the initial dose was administered. Subsequently, revaccination with a "3-yr rabies" vaccine should be administered every 3yr thereafter, unless state, provincial, and/or local requirements stipulate otherwise."

Thank you
A very special thank to the Rabies Challenge Fund Co-Trustee founders Kris Christine, Dr. Dodds and Dr. Schultz researchers for all the time, effort and expertise given to educate the public and veterinarians about rabies vaccine duration and protocols.

 

 


Footnotes:
¹ 1721.0540 Minnesota Administrative Rule (MN Admin. website, or download pdf) states that each Rabies certificate must list "vaccine name, manufacturer, serial number, expiration date, and duration of immunity;..."