The Truth About ‘Titering’ Instead of Vaccination [for dogs]

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George, my neighbor dog owner, brought up the term “Titer” test for the dog while I mentioned that I had given my Rottweiler bitch 3 core-vaccination booster shots against these viruses: rabies, parvo and distemper. I find this article “The Truth About ‘Titering’ Instead of Vaccination” by Dr. Patty Khuly dated June 28, 2010, and have the following quoted understandings.  The entire article is on this web page http://www.petmd.com/blogs/fullyvetted/2010/june/titering_or_vaccines-10182.

. “To “titer” or “titering,” as in the act of submitting a blood sample to determine whether an animal has enough antibodies to ensure immunity against a particular disease.”

. “Yes, titers can tell me that my patient has likely been vaccinated, especially when it comes to uncommon diseases like rabies (pets are not likely to have natural immunity from having been exposed to another rabid animal). But the inability to say for certain that titers are protective and/or could NOT have come from real disease is what keeps other nations from rescinding their onerous quarantine requirements.”

Detail quote:

… The world has some new verbs: To “titer” or “titering,” as in the act of submitting a blood sample to determine whether an animal has enough antibodies to ensure immunity against a particular disease.

The idea behind the surge in this verb’s popularity has to do with its use as a vaccine surrogate. So instead of receiving a vaccine against parvovirus this year, Fluffy will have her blood drawn and tested to see if her antibody levels against parvo are high enough for her immune system to overcome an attack of this virus, should she be exposed to it.

With the help of titers, animals need only receive their puppy/kitten vaccines, with the additional booster a year later, and from there on live forever free of the potential tyranny of a bad vaccine reaction. That is, as long as the antibody levels are demonstrably high, year after year.

Simple, right?

Not so fast. Here’s what I had to say about titers a couple of years ago:

The idea is to lower a pet’s risk of exposure to too many vaccines … but is it really an effective way to measure protection against disease?

The experts seem to be of one mind on this: Titers are useful in legal and regulatory settings (for travel, for example) to determine whether an animal has ever received a vaccine for a disease like rabies. Titers do NOT, however, denote protection against a given disease.

A titer only measures antibodies, not cell-mediated immunity, which is the real-world measure of protection. In fact, as I learned, pets can sometimes come up negative (unprotected) on the titers and still have plenty of perfectly protective, cell-mediated immunity.

Yes, titers can tell me that my patient has likely been vaccinated, especially when it comes to uncommon diseases like rabies (pets are not likely to have natural immunity from having been exposed to another rabid animal).  But the inability to say for certain that titers are protective and/or could NOT have come from real disease is what keeps other nations from rescinding their onerous quarantine requirements. That’s why so many countries require this test before traveling animals may enter.

 I’m still going with its recommendation to vaccinate every three years—unless my patients are sick, particularly sensitive or geriatric. In these latter cases owners are advised of their pets’ potentially increased risks due to our inability to measure their degree of vaccine protection.

… While titers may make it easier for me to sign off on a rabies certification requirements, I’ll no longer advise a client to consider a pet sufficiently vaccinated just because some lab said his antibody levels suggest that protection is likely. Nope. It simply lulls owners into a false sense of security.

(If it helps any, the American Animal Hospital Association [AAHA], the American Veterinary Medical Association [AVMA] and the American Association of Feline Practitioners [AAFP] are all on board with this view, too.)

… I am using titers in many cases to help identify serious lapses in vaccine protection (as when we don’t know whether a pet is vaccinated or not) and because cell immunity and antibody immunity have been shown to roughly correlate. But to what extent we don’t know … and there’s the rub.

Vaccines to be safe. Titers to avoid the vaccines. Which is best? The world may never know. Sigh…

Dr. Patty Khuly

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