Core vs. noncore vaccines
Some years ago, amid a flurry of understandable concern over adverse events associated with vaccinations as well as a growing
body of evidence that vaccines had a much longer duration of immunity than generally thought, the American Association of
Feline Practitioners (AAFP) and American Animal Hospital Association (AAHA) developed vaccination guidelines for dogs and
cats. One of the outcomes of these recommendations was the introduction of the concepts of core and noncore vaccines.
Core vaccines are those that should be administered to every dog or cat regardless of lifestyle and risk exposure. Noncore
vaccines were intended to be those that were situational and risk-based in their application. Unfortunately, the concept of
noncore has come to be interpreted as optional or elective, when, in reality, in some communities and with some risk factors,
these noncore vaccines might actually be considered as core in a given individual.
Determining whether a noncore vaccine should be strongly advocated for or not is not an arbitrary decision. Rather, it requires
a thorough assessment of the likelihood of exposure and an informed discussion with the pet owner while advocating for vaccines
that prevent diseases that may not have the level of morbidity or mortality of a core vaccine—showing owner pet owners that
these diseases result in avoidable suffering on the part of the pet and avoidable expense on the part of the pet owner.
If there is a risk and if the available vaccine is effective and safe, then we should become strong proponents of individual
noncore vaccines, and, perhaps in some situations, we should elevate them to core status.
For example, if a dog that lives in Florida is kenneled whenever its owner goes on vacation, should it not be routine that
the dog be vaccinated against Bordetella species infection and parainfluenza as well as canine influenza? If this pet is thus known to be at significant risk for
these respiratory diseases, should they not be considered as core vaccines for that dog?
Or take the instance of a field dog in New England where Lyme disease is endemic. Shouldn't vaccination against Borrelia species infections be considered a core vaccine for that dog?
What about a 4-year-old indoor cat that is prone to fighting and abscesses. Shouldn't that cat's owner be informed and given
the option of annual vaccination against feline leukemia virus?
Are you seeing a pattern? Based on the AAFP and AAHA guidelines, every dog and cat is to be vaccinated every three years against
the core diseases. By asking a few questions, it is likely that virtually all dogs and cats should receive at least one so-called
noncore vaccine every year.
The net results are obvious as well as not so obvious. Animals will be better protected against preventable diseases. More
frequent patient visits allow for improved early diagnostic opportunities, more frequent opportunities to inform and educate
owners and stress adherence to recommendations and an increased revenue stream for practices. Doctor-patient-client interactions
will be more frequent and allow for a better opportunity to build relationships.
Dr. Paul is a veterinary consultant as well as a founding member and former executive director/CEO of the Companion Animal
Parasite Council. He has served as president of the American Animal Hospital Association. He now lives in Anguilla in the
British West Indies.