I read with interest the article, “Immune-mediated thrombocytopenia in dogs: Is vaccination a factor?” by Dr. Robert Runde in the November 1, 2012 issue of DVM360 newsmagazine. The first paragraphs of the article refer to a recently published paper on the same topic by Huang, Moore and Scott-Moncrieff (J Vet Int Med 26(1): 142-148, 2012). As someone who has been directly involved in vaccine-related issues for several decades, I generally agree with all the points and caveats raised here.
Immune-mediated hematologic diseases — namely immune-mediated hemolytic anemia/autoimmune hemolytic anemia (IMHA/AIHA) and/or immune-mediated thrombocytopenia (IMTP) — and their temporal relationship to vaccinations and other “triggering” events were first discussed many years ago by myself (JAAHA 13:437-441, 1977; Adv Vet Sci Comp Med 27:63-196, 1983), and then by Duval and Giger (J Vet Int Med 10:290-295, 1995). These earlier studies described the temporal relationship between vaccination and acute immune–mediated hemolytic disease – which still occurs today and has a poor prognosis, and immune-mediated thrombocytopenia, which generally has a better prognosis, if managed carefully. More recently, others concluded that there was no relationship between vaccination and IMHA in their case cohorts. But, you would not necessarily find a vaccine-association with these cases in all study cohorts, because there are a group of factors that can act as “triggers” of immune-mediated disease in animals – recent vaccination just happens to be one of them. While it typically occurs in genetically predisposed individuals or families (as shown in my 1983 review), it doesn’t have to only show up in them.
Common medical sense, let alone the published vaccine-associations with immune-mediated hematologic diseases, indicates that vaccinations of affected animals – even if in remission – should be avoided whenever possible. Vaccine titers can be measured instead to assure clients that their animals are protected against the more common, clinically serious infectious diseases.