Vaccinations

• DHPP Vaccine - DHPP stands for Distemper, Hepatitis, Parainfluenza, and Parvovirus. Adult dogs usually also have a leptospirosis vaccine included.

  The vaccine comes in a vial as a dry mix. Right before injection, it is mixed with sterile diluent to become a liquid. It is pink in color. In small dogs, our clinic usually recommends giving some type of glucose, because this injection tends to lower blood sugar and small dogs tend to have more reaction because of their size. The same dose is given no matter the dogs body weight.

Otherwise known as the puppy vaccine, its components are:

• Distemper virus - Attacks the lungs and affects the function of the brain and spinal cord. Disease can be fatal.
• Hepatitis - Affects the liver and can cause loss of vision.
• Parainfluenza - Respiratory virus that causes coughing.
• Parvovirus - Attacks the lining of the intestinal tract and damages the heart of very young puppies. Can be fatal.

The DHPP vaccine is administered every three to four weeks to your new puppy. The vaccine is generally given at eight, twelve, and sixteen weeks, unless your breeder already started the process at six weeks.

Vaccine Reactions: For the first half-hour after vaccination, owners should carefully observe their animal for signs of acute allergic reactions. In our clinic, this is about the time it takes to write up the discharges and have the Business Office prepare the bill. In case of allergic reactions, contact the clinician or the Emergency Service immediately, treat with Benadryl® (diphenhydramine at 2-4 mg/kg TID-QID PO IM or IV) and/or short-term steroids (dexamethasone sodium phosphate for anaphylaxis at 0.25 mg/kg IV or prednisolone tablets for milder reactions at 0.5-1 mg/kg BID PO or IM). Also give the owner medication to take home for the affected animal. In very severe cases, it may be necessary to give epinephrine (0.5-1.5 ml IV of a 1:10,000 solution; repeat in 30 minutes) and life support. If an animal has had a reaction before, depending on the severity, it may be given Benadryl® one half hour before vaccination, may be kept in the clinic for 24 hours for observation, or not vaccinated at all. In cases where the veterinarian and the owner have opted not to vaccinate the animal, titers to the corresponding diseases may be measured, but keep in mind that serum titers do not reflect the actual state of local immunity.

Does TRICARE pay for the shingles vaccine? Yes. As of October 19, 2007, Zostavax™, the vaccine that helps reduce the risk of getting shingles (herpes zoster) is reimbursable under TRICARE.

The Centers for Disease Control and Prevention (CDC) recommends a single dose of the vaccine for adults age 60 or olderregardless of whether they report a prior episode of shingles (herpes zoster). For more information on the vaccine, please visit FDA's Questions & Answers on Zostavax™.

TRICARE Prime Beneficiary:

As long as you get your shingles vaccine from your primary care manager you won't be responsible for a deductible or copay.

TRICARE Standard/Extra Beneficiary:

You may get your shingles vaccine from any TRICARE-authorized provider (network or non-network) who is licensed to give the vaccine. Standard/Extra deductibles and cost shares apply.

TRICARE For Life Beneficiary:

Medicare covers the shingles vaccine under Medicare Part D. If you don't have Medicare Part D, TRICARE will be the primary payer for the vaccine. You may get the shingles vaccine from any TRICARE-authorized provider (network or non-network) who is licensed to give the vaccine. Standard/Extra deductibles and cost shares apply.

NOTE: TRICARE won't pay for the shingles vaccine if it is given at a pharmacy or if your doctor writes you a prescription to buy the shingles vaccine and have it administered at his or her office. If you want TRICARE to cover the shingles vaccine, you must have the vaccine administered in your doctor's office.

Please refer to http://www.tricare.mil/ for additional info.

Here are the 5 things you must know before you vaccinate your child:

1. Most vaccines contain mercury, which has some very bad side effects (such as causing Alzenheimer's disease). It's in the vaccines to prolong shelf life. You can ask for a non-mercury version, but it costs extra.
2. While it is true that child mortality has decreased dramatically over the course of the last few decades, the number of children suffering from diagnosed learning disabilities, diabetes, asthma, and autism has gone up.
3. Many kids have extremely bad reactions to vaccines. It's happened enough times that the government has limited payouts to $250,000 per child for a "catastrophic reaction."
4. As of 1997, the US government has paid out nearly a billion dollars to 1,000 families whose kids suffered catastrophic reactions
5. Almost 20% of all American children are now chronically ill or disabled, according to the National Vaccine Information Center.

They are currently made exactly the same in the US with all the same ingredients, except the strain of the flu is the A-H1N1/09 strain in the H1N1 shot and the seasonal flu shot has three different types of seasonal flu. The strains of virus that are in the 2009 - 2010 seasonal flu shot in the US are:

• A/Brisbane/59/2007(H1N1)-like virus;
• A/Brisbane/10/2007 (H3N2)-like virus;
• B/Brisbane 60/2008-like antigens.

The 2009-10 seasonal influenza vaccine can protect you from getting sick from these three viruses, or it can make your illness milder if you get a related but different influenza virus strain. The H1N1/09 Swine Flu shot protects you from the Pandemic Swine Flu.

Update June 20, 2013:

The CDC has issued the following media advisory:

The Advisory Committee on Immunization Practices (ACIP) voted today, 13 to 0, in favor of recommending FluBlok during the 2013-2014 influenza seasons for vaccination of persons 18 through 49 years of age with egg allergy of any severity. FluBlok was licensed by the Food and Drug Administration (FDA) in January 2013. Unlike current production methods for other available seasonal influenza vaccines, FluBlok does not use the influenza virus or chicken eggs in its manufacturing process.

Most of the vaccines in the flu vaccinations contain tiny/trace amounts of egg or chicken protein. An egg allergy is a contraindication (i.e., don't use) for these vaccines according to the manufacturers' original package information.

However, at least 17 recent studies determined that in some cases this does not need to prevent a flu vaccination with an inactivated vaccine (i.e., you can not use the nasal "live" vaccines) unless you have a severe egg allergy, and those are rare. You should check with your allergy specialist to find out if you are one who could get the flu shot even though you have the egg allergy. The allergist may want to administer the vaccine in the office so observation for signs of allergic response can be provided.

According to the US Centers for Disease Control and Prevention (CDC) new guidelines for administering flu vaccines to patients with allergies to eggs have been published. The CDC has quite a bit of information about this topic on their web pages. The link to this information is provided below in the Related Links section. Here is an excerpt from that publication:

Recommendations Regarding Persons with Egg Allergy

Each of the following recommendations applies when considering influenza vaccination of persons who have or report a history of egg allergy.

1. Persons who have experienced only hives following exposure to egg should receive influenza vaccine with the following additional measures: [see the link to the article below for more on those additional measures- Figure 2].

a) Because studies published to date involved use of TIV, TIV rather than LAIV should be used. [TIV = Trivalent Inactivated Vaccine (vaccines made with "dead" viruses), LAIV = Live Attenuated Influenza Vaccine (vaccines made with live but weakened viruses]

b) Vaccine should be administered by a health-care provider who is familiar with the potential manifestations of egg allergy.

c) Vaccine recipients should be observed for at least 30 minutes for signs of a reaction following administration of each vaccine dose.

Other measures, such as dividing and administering the vaccine by a two-step approach and skin testing with vaccine, are not necessary.

2. Persons who report having had reactions to egg involving angioedema, respiratory distress, lightheadedness, or recurrent emesis, or persons who required epinephrine or other emergency medical intervention, particularly those that occurred immediately or within minutes to hours after egg exposure are more likely to have a serious systemic or anaphylactic reaction upon reexposure to egg proteins. Before receipt of vaccine, such persons should be referred to a physician with expertise in the management of allergic conditions for further risk assessment (Figure 2-see full article).

3. All vaccines should be administered in settings in which personnel and equipment for rapid recognition and treatment of anaphylaxis are available. ACIP recommends that all vaccination providers be familiar with the office emergency plan. [ACIP=Advisory Committee on Immunization Practices (CDC)]

4. Some persons who report allergy to egg might not be egg allergic. Those who are able to eat lightly cooked egg (e.g., scrambled eggs) without reaction are unlikely to be allergic. Conversely, egg-allergic persons might tolerate egg in baked products (e.g., bread or cake); tolerance to egg-containing foods does not exclude the possibility of egg allergy. Egg allergy can be confirmed by a consistent medical history of adverse reactions to eggs and egg-containing foods, plus skin and/or blood testing for immunoglobulin E antibodies to egg proteins.

5. A previous severe allergic reaction to influenza vaccine, regardless of the component suspected to be responsible for the reaction, is a contraindication to receipt of influenza vaccine.

There is no added sulfur in the flu vaccines approved for the 2011-2012 flu season in the US. But it is usually the protein from the egg itself that causes allergy to eggs, not the sulfur. And it is possible that some of the protein allergens might come from the eggs used in the process of growing the viruses for the vaccines, although there are only trace amounts. See the list of ingredients of the approved vaccines below.

The ingredients in these six US FDA approved 2011-2012 flu vaccines are:

Afluria from CSL Limited:

Beta-Propiolactone, Calcium Chloride, Neomycin, Ovalbumin, Polymyxin B, Potassium Chloride, Potassium Phosphate, Sodium Phosphate, Sodium Taurodeoxychoalate.

Fluvarix from GlaxoSmithKline (GSK) Biologicals:

Egg Albumin (Ovalbumin), Egg Protein, Formaldehyde or Formalin (to inactivate the virus), Gentamicin, Hydrocortisone, Octoxynol-10, á-Tocopheryl Hydrogen Succinate, Polysorbate 80 (an adjuvant), Sodium Deoxycholate, Sodium Phosphate, Thimerosal*

FluLaval from ID Biomedical Corporation:

Egg Albumin (Ovalbumin), Egg Protein, Formaldehyde or Formalin, Sodium Deoxycholate, Phosphate Buffers, Thimerosal

Fluvirin from Novartis Vaccines and Diagnostics Limited:

Beta-Propiolactone , Egg Protein, Neomycin, Polymyxin B, Polyoxyethylene 9-10 Nonyl Phenol (Triton N-101, Octoxynol 9), Thimerosal (in the multidose containers), Thimerosal* (much smaller amounts in the single-dose syringes)

Fluzone, Fluzone High-Dose, Fluzone Intradermalfrom Sanofi Pateur, Inc.:

Egg Protein, Formaldehyde or Formalin, Gelatin, Octoxinol-9 (Triton X-100), Thimerosal (only in multidose containers)

FluMist (nasal spray) from MedImmune Vaccines, Inc.:

Chick Kidney Cells, Egg Protein, Gentamicin Sulfate, Monosodium Glutamate,Sucrose Phosphate Glutamate Buffer

*Where "thimerosal" is marked with an asterisk (*) above, it indicates that the product should be considered equivalent to thimerosal-free products. This vaccine may contain trace amounts (<0.3 mcg) of mercury left after post-production thimerosal removal, but these amounts have no biological effect. JAMA 1999;282(18) and JAMA 2000;283(16)

See the related links below in the related links section for more information.

How long is the vaccine in your body?
The H1N1/09 vaccine is very quickly absorbed by your body and then it is up to your immune system to take it from there to develop a resistance to the particular strain of flu virus that was in the vaccination and your body will develop the antibodies to protect against future invasions of the same virus. The vaccine was only there long enough to trigger your immune system to begin to work on the immune process.
How long does immunity from a vaccine or having the flu last?
If you are asking, "How long will I remain protected against H1N1/09 from a vaccination or from getting sick with the flu?", then the answer to this is a little more difficult to give.

You will be protected for life against that exactstrain of the H1N1/09 virus that was contained in the vaccine or that you caught which caused you to be ill, and you will likely also have some cross-over protection from very similar strains.

However, viruses do mutate easily, and if later you are infected with another strain or mutation of the H1N1 virus, and if your immune system does not recognize it any longer because it has mutated to a different form, then you may have no immunity to that new strain. This is one reason we need to take annual vaccines for the rapidly mutating common seasonal flu strains.

See the related links section below for a link to an article on the Time/CNN Health and Science web site about this subject. Here is an excerpt from that article:

It turns out, however, that those antibodies [developed from a flu vaccine or from having the flu] - unlike those against illnesses like tetanus or whooping cough - can provide a formidable and life-long defense against the flu, as long as they're pitted against the correct strain. For an explanation, TIME asks Eric Altschuler, assistant professor of physical medicine and rehabilitation at the University of Medicine and Dentistry of New Jersey, and co-author of a recent paper in Nature about antibodies to the 1918 pandemic flu virus.

Q: How long do flu antibodies last?

A: According to our study, it appears they can last the entire lifespan of the human organism - 90 years plus...

More:
It's important to keep a record of vaccinations so the doctor knows when your child is due for a booster. Also make sure your child gets the seasonal flu vaccine each year. Having been immunized last year probably won't protect someone from getting the flu this year because flu viruses constantly change. That's why the vaccine is updated each year to include the most current common strains of the virus.

The flu vaccine reduces the average person's chances of catching the flu by up to 80% during the season. But because the flu vaccine doesn't prevent infection by all of the viruses that can cause flu-like symptoms, getting the vaccine isn't a guarantee that someone won't get sick during the flu season.