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June 17, 2016

貓疫苗: 我們必須停止過度注射疫苗 (上)

Vaccines for Cats: We Need to Stop Overvaccinating

貓疫苗: 我們必須停止過度注射疫苗

Lisa A. Pierson, DVM
 
作者: 獸醫 Lisa A. Pierson, DVM
 
原文出處連結: http://www。catinfo。org/?link=vaccines
 
(譯註: 中英對照翻譯,沒有翻譯的部份是因為無關疫苗)

Please click on the links below to read more about the key issues associated with vaccines。  Several important statements will be repeated in different sections in case the reader does not review the entire webpage。
Many people write to me asking for advice regarding vaccines。 

However, no advice will be provided via email  If you wish to discuss the specifics of your cat's situation you will need to set up an appointment for a phone consultation after providing your cat's medical/vaccine records for my review。  My email address can be found at the bottom of this page。

IMPORTANT UPDATE - October 2014: Merial has recently brought to market a new PureVax rabies vaccine that is non-adjuvanted and is labeled for 3 years versus their original (and still available) PureVax rabies vaccine that is labeled for 1 year.

重要更新: 2014年10 月: 一家名為 Merial 的公司最近推出一種新疫苗,即 PureVax 狂犬病疫苗,沒有使用佐劑,而且效期是三年,他們原先的產品效期只有一年。

The 3-year product is the rabies vaccine that I strongly recommend.

我強力推薦效期三年的產品。

(For more information see Rabies below.)

(更多相關訊息請見以下”狂犬病”段落)
 
Overview總覽

General suggestions基本建議

Side effects副作用 Vaccine types疫苗種類

Decision-making criteria - including comments on titers 影響決定的因素包括對力價 (即抗體含量) 的看法

Conclusion結論

Supporting research相關研究
  • Age and Long-term Protective Immunity in Dogs and Cats
貓狗的年紀和長期的保護性免疫力 案例過度注射疫苗導致小狗死亡
 
Overview
總覽
vaccination is a preparation of microorganisms (pathogens), such as viruses or bacteria, that is administered to produce or increase immunity to a particular disease.  There can be no disputing that vaccines save lives but they also have the potential to cause serious side effects which will be discussed on this webpage.

疫苗是一種現成的產品,成份是微生物(病原體),例如病毒或細菌,用來製造或提高特定疾病的免疫力。疫苗的出現拯救許多生命,這一點無庸置疑,但另一方面疫苗也有可能引起嚴重的副作用,這是本文要討論的。

Before we get started on this discussion, it is important to understand that there is no single vaccine protocol that fits every situation and every person's individual comfort level.  There are many factors involved in the decision making process but at the core of each decision is:
  • risk/benefit analysis and
  • consideration of the duration of immunity (DOI) information that is available to us.
在開始討論之前,首先要瞭解的是沒有一套單一的疫苗準則,可以適用於所有狀況,以及符合所有人認為舒服妥善的作法。在做決定時有太多因素參與其中,但每個決定的思考重點是;
  • 一個風險/優點的分析,以及
  • 將免疫期相關訊息列入考量
This webpage discusses vaccine protocols that are within my comfort zone but may not be within the readers'.  It is also important to understand that a discussion involving FVRCP (herpes, calici, panleukopenia ) and FeLV (feline leukemia) vaccination is separate from one discussing rabies vaccination. This is because rabies vaccination is legally required in many areas of the world.  

本文討論的疫苗準則純粹是我個人認為妥善的作法,不見得讀者也會認同。至於狂犬病疫苗則是獨立出來,沒有和FVRCP(貓皰疹病毒、卡利西體、貓瘟,以下簡稱三合一)和FeLV(貓白血病)疫苗放在一起討論,因為在世界許多地方,狂犬病疫苗是法律規定要注射的。

Regarding DOI data: Unfortunately, many veterinarians are not considering the facts and are recommending unnecessary vaccinations.

有關免疫期數據庫:很不幸的許多獸醫沒有把這些因素列入考慮,因此建議沒有必要的疫苗注射。

The subject of vaccine administration is one of the most controversial topics in human and veterinary medical literature, making it a common area of debate - and stressful decision-making - among parents and pet owners.

在人醫和獸醫領域,疫苗管理都是最具爭議的主題之一,常見到相關爭論,人類父母和寵物主人在做決定時都備感壓力。

Given that this is an area of controversy, I want to start with a 'food for thought' question:
How often are you getting vaccinated for measles, mumps, chicken pox, tetanus, etc.?  Yearly?  Every 3 years?
I doubt it.

既然這是爭議之處,我想先問一個耐人尋味的問題:
身為人類的你,多久注射一次麻疹、腮腺炎、水痘、破傷風疫苗?每年一次?三年一次?
我可不這麼認為。

So why aren't more people questioning the reminder cards that many veterinarians send out asking for the pet to be brought in for yearly vaccines? 

那為什麼許多獸醫每年寄出通知單,提醒主人該帶寵物去做年度預防注射,卻沒有更多的人去提出質疑?

More to the heart of the matter, why are many veterinarians ignoring the current vaccine guidelines which call for a longer period of time between vaccine administration than has been the 'standard' for many years?

更重要的是,為什麼許多獸醫忽視目前的疫苗準則,也就是拉長注射期間,不再以一年為標準期間?

The evidence-based recommendation/suggestion to vaccinate less frequently than we have been doing for the past many years came out of Colorado State University approximately 18 years ago so this is not something new.

以證據為基礎,而提出疫苗不需如過去多年來所提倡的頻繁注射,是科羅拉多州立大學在十八年前就已經提出的建議,可見得這並不是什麼新鮮事。

These 'newer' guidelines are based on DOI (duration of immunity) studies showing that it is not necessary to vaccinate cats as frequently as they have been in the past.  In fact, the DOI studies show that it is not even necessary to vaccinate as frequently as every 3 years for FVRCP.

這些新準則的制定來自於對免疫期的研究,顯示貓不需要如以往般的固定打疫苗。 事實上免疫期研究顯示就三合一而言,每三年注射一次甚至是不必要的。

It is very important to understand that the current guidelines state that the FVRCP combination vaccine should not be given more frequently than every 3 years.  That is not the same as stating "these vaccines should be administered every 3 years."

請注意,根據目前的準則,三合一疫苗的注射頻率不應該高於每三年一次,這和 "每三年應該注射一次"的說法是不一樣的。

This is a significant point of confusion among some veterinarians and most lay people.  The guidelines are worded in such a way as to invite vaccine intervals that are even longer than 3 years.

對於一些獸醫和大部份沒有相關專業知識的人來說,這個措詞造成很大的混淆。疫苗準則的遣詞用字好像是認為,疫苗注射的間隔時間甚至可以長達三年以上。

A cat's immune system is not any more 'forgetful' than a human's immune system.  In other words, there is no reason to believe that they need to be vaccinated so often.  Their immune system, to the contrary, has a very good memory.

貓的免疫系統並沒有比人類的免疫系統來的健忘。換句話說沒有理由相信貓比人需要更頻繁的注射疫苗。相反的,貓的免疫系統有很好的記性。

For many years, humans have thought of vaccines as 'all good and no bad' but that line of thought cannot be further from the truth.  Given the serious side effects that can manifest themselves after a vaccine has been given, people need to start applying more critical thought when making decisions about vaccination protocols.

多年以來人類一直覺得疫苗是”只有好處沒有壞處”, 但這個想法離事實非常遙遠。 除了注射疫苗後會出現的嚴重副作用以外,人類在做決定時還需要注入更重要的思考。

It is very important to understand that no vaccine is 100% safe.
However, it is also very important to understand that vaccines save lives and there can be no debating that fact.

你必須明白沒有疫苗是百分之百安全的。
然而,你也必須明白疫苗可以救命,這是不可改變的事實。

These two facts, along with other factors discussed on this page, enter into every decision we make regarding how we vaccinate our cats.

以上兩個因素,以及本文所討論的其他因素,在我們決定為貓注射疫苗時,都必須被列入考量。

I wish that I felt comfortable saying "ask your veterinarian for the best advice regarding the vaccination of your cats" but I don't.

我真心希望可以很放心的跟你說:關於疫苗這個問題,請就近諮詢你的獸醫.但事實上我辦不到。

As noted above, many of my colleagues are simply not taking the time to carefully peruse the scientific literature that provides DOI data showing that we are over-vaccinating many of our pets.  (Rabies will be discussed separately.) 

如同先前所提,我的許多同業就是無法花時間去仔細閱讀免疫期資料所提供的科學發現,也就是說其實有許多寵物都被過度注射疫苗。(狂犬病會被獨立討論)

This webpage is not intended to be a comprehensive discussion on all matters involving vaccinations but, instead, will cover some vaccine basics, and my personal views on the subject - including how I vaccinate my own cats.

本文並不是要討論所有疫苗相關事實,相反的,只是要討論基本事項,以及我的個人觀點,包括我的貓注射疫苗的狀況。

Please note that even some (all?) of the experts who sat on the panel that came up with the AAFP (American Association of Feline Practitioners) vaccine suggestions, as well as one veterinarian who is head of the vaccine division of a major vaccine-producing company, do not vaccinate their own animals as frequently as their guidelines/suggestions/package label states. (source:  personal communication)

美國貓科獸醫協會(簡稱AAFP)疫苗委員會中的一些(還是全部?)專家,以及一個主要疫苗製造公司的疫苗部獸醫主管,並沒有如他們自己制定的準則/建議/包裝上所言,那麼頻繁的為他們的貓注射疫苗。(資料來源:私人管道)

These veterinarians acknowledge that the current suggestions/package labels do not reflect the fact that challenge studies have shown a very long duration of immunity (DOI) - lifelong,for some diseases - from just a single, properly-timed, vaccine.

這些獸醫承認目前疫苗的建議/包裝標示,並沒有反應出研究結果:即免疫期是很長的,有些單一的疫苗,如果施打時機正確,對有些疾病甚至是終生免疫。

Unfortunately, it has been hard enough to get veterinarians to switch from annual vaccines to the current 3-year protocol so it is going to be an uphill battle to get them to vaccinate even less frequently.  Therefore, I do not see changes in the AAFP suggestions coming anytime soon.

很不幸的是,要獸醫把年度預防針改為三年一次就已經夠難了,改為間隔更久再施打是難上加難。因此我並不認為美國貓科獸醫協會所做的建議在短期內會出現什麼改變。

To put this in perspective, note that the recommendation to go to a 3-year vaccine protocol came out of Colorado State University more than 18 years ago, yet there are still many (~50%) veterinarians administering annual vaccines.

建議疫苗施打間隔應該要三年以上的,是來自科羅拉多大學十八年前提出的疫苗施打準則,然而很多獸醫(約百分之五十)依然沿用年度注射的習慣。

This reluctance to change is especially true of the older generation of veterinarians (myself included having been involved in this profession for over 40 years) who lived through a time when the mortality rate from rabies, distemper, etc., was very high. Vaccines came along and saved lives - no question - but it is time to start paying more attention to the current DOI studies - some of which have been available for many years.

年紀較長的獸醫(包括我自己,我已在此行業超過四十年)尤其不願做改變.這些獸醫經過歷狂犬病、犬瘟熱死亡率很高的年代.疫苗的出現拯救了生命,無庸置疑,但是我們應該更加注意目前的免疫期研究,有些研究甚至已經出現很多年了。

I urge the reader to take the time to do their own research into this area and not necessarily rely only on your veterinarian's recommendations.  It will be up to the reader to decide how they want to handle vaccine administration in their own kittens and adult cats for FVRCP and FeLV.

我希望讀者花時間自己研讀疫苗相關資料,而不是非得單純仰賴獸醫的建議.如何幫幼貓和成貓施打三合一和貓白血病疫苗,是讀者自己的決定.

My goals in writing this page are to get the reader to:
  • stop blindly over-vaccinating their cats
  • apply more critical thought - including reading the studies
  • NEVER ALLOW AN ADJUVANT TO BE INJECTED INTO THEIR CAT
Yes, I am shouting about the last issue。 

寫這篇文章的目的是希望讀者:
  • 停止盲目的為貓過度施打疫苗
  • 慎重思考,包括閱讀相關資料與報告
  • 絕對不要讓你的貓施打有佐劑的疫苗
是的,最後一項我是用吼的.

Adjuvants are substances that are added to vaccines to purposely cause inflammation at the vaccine site in order to alert the immune system to its presence. They are used with killed vaccines to stimulate a more robust immune response but can also cause a fatal, aggressive tumor (sarcoma) at the site of vaccine injection.  (See below for a picture of "Chicken" - a sweet cat who lost her battle with this cancer.)

佐劑被加入疫苗的目的是要引起發炎,以提醒免疫系統疫苗的存在.藥廠使用死病毒去引起一個更加有力的免疫反應,但卻同時也可能在注射疫苗處造成致命的惡性腫瘤(肉瘤)。(請見以下一隻貓名為 Chicken的照片,她因為注射疫苗造成注射處惡性腫瘤而去世。)

To  be fair, adjuvanted vaccines are not the only substances that can cause sarcomas. Even non-adjuvanted (modified life) vaccines, as well as other injectable drugs, can cause these tumors.  This is why the acronym "VAS" (Vaccine Associated Sarcoma) is being dropped in favor of "ISS" (Injection Site Sarcoma).

但是佐劑並非是唯一會造成肉瘤的原因.即使是沒有佐劑(減毒)的疫苗,以及其他需要注射的藥物,都可能造成這種腫瘤.這也就是為什麼VAS,即Vaccine Associated Sarcoma疫苗注射肉瘤這個名稱已被ISS,即Injection Site Sarcoma注射部位肉瘤,所取代。

That said, at this time, it appears that adjuvanted vaccines have a higher risk rate of sarcomas when compared with non-adjuvanted vaccines.

儘管如此,和不含佐劑的疫苗比起來,似乎含佐劑的疫苗風險比較高。

Do not assume that your vet is using non-adjuvanted vaccines.  ASK before allowing any vaccine to be administered to your cat.

不要以為你的獸醫使用的是無佐劑疫苗.在注射之前,一定要先問清楚醫生使用的是什麼疫苗。

To repeat much of what I have said above:  There is nothing in the scientific literature to support annual vaccination with the FVRCP and Feline Leukemia (FeLV) vaccines.  It is well-known that:

重複我先前所寫:沒有任何科學證據,可以支持三合一和白血病需要每年注射的論點.大家都知道:
  • the vaccines commonly used for cats confer immunity for much longer than 1 year - and actually provide lifelong immunity in most instances for panleukopenia;
  • adjuvants contained in killed vaccines put cats at risk for fatal tumors (sarcomas);
  • even the non-adjuvanted FVRCP vaccines have caused sarcomas, as have the PureVax (non-adjuvanted) vaccines;
  • natural immunity to feline leukemia is very strong by the time the cat reaches ~1 year of age; and
  • there may be a link between the FVRCP vaccine and kidney inflammation.
  • 普遍被使用的貓疫苗免疫期都高出一年以上,大部份的例子可以見到貓瘟疫苗提供的是終生免疫
  • 佐劑含有死病毒,貓會有得到致命腫瘤的風險
  • 即使無佐劑的三合一疫苗都有造成惡性肉瘤的病例,沒有佐劑的PureVax疫苗也出現過此病例
  • 一歲以上的貓本身已經具備很強的白血病免疫力
  • 三合一疫苗和腎臟炎可能有關
Please note that kidney disease is the most common subject that I consult on and it is considered by many to be the number one cause - or at least a very common cause - of death in our older cats.

我最常被諮詢的是腎臟病,此病被認為是年紀比較大的貓的第一病因,如果不是第一至少是常見病因.

The diseases we most commonly vaccinate cats for are caused by viruses - not bacteria.  While it is difficult to induce long-term immunity to bacterial infections, vaccines targeted toward viruses are usually more efficient at conferring long-term immunity in the recipient.  Please keep this in mind as you read about vaccine frequency below.

常見的疫苗主要預防的是病毒引起的疾病,不是細菌。細菌感染很難達成長期免疫,所以在給予長期免疫力時,比較有效的是針對病毒感染的預防針。在你閱讀以下關於多久要打一次疫苗時,請記住這個重點.

General Vaccine Suggestions
一般的疫苗建議

(As noted above, I cannot offer individual vaccine advice outside of a phone consultation to discuss the details of your situation.)
At the end of this webpage, please see:

本文最後有收錄

Age and Long-term Protective Immunity in Dogs and Cats  

狗貓的年紀和長期免疫力

And 以及

Membranoproliferative glomerulonephritis possibly associated with over-vaccination in a cocker spaniel

一隻可卡幼犬因為過度注射疫苗,而可能引起膜增生性腎小球腎炎
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Keep in mind that a vaccine protocol is not a 'one size fits all' issue and that the medical community is lacking in definitive research in many areas of vaccinology.  This is why the AAFP and myself make suggestions regarding vaccine protocols - versus etched-in-stone statements.

請注意疫苗準則並不是一套適用於所有貓的準則,而且在許多疫苗相關領域上,醫界缺乏有力且完整的研究.這就是為什麼美國貓科獸醫協會和我自己也對疫苗準則提出建議,去面對無法改變的說法。

Everyone has a different 'take' on a risk-benefit analysis and people have to work within their own comfort zone.  What follows are suggestions that work within my comfort zone.

每個人都有一套不同的利弊分析,而且每個人覺得妥善的作法也不盡相同.以下的建議是我個人認為妥善的作法。

There are 5 viral diseases that cats are commonly vaccinated for:

貓打疫苗主要是預防以下五個病毒引起的疾病
  • herpes (rhinotracheitis) - the 'R' in FVRCP
  • calici - the 'C' in FVRCP
  • panleukopenia ("feline distemper") - the 'P' in FVRCP
  • feline leukemia - FeLV
  • rabies
  • 貓皰疹(鼻氣管炎)
  • 卡利西
  • 貓瘟
  • 白血病
  • 狂犬病
Please do not vaccinate for FIV (Feline Immunodeficiency Virus - aka "feline AIDS"), FIP (Feline Infectious Peritonitis), bordatella, giardia, or chlamydia.

請不要施打貓愛滋(FIV)、腹膜炎(FIP)、貓博德氏桿菌(或譯包氏桿茵)、梨形鞭毛蟲或披衣菌(衣原體)疫苗。

Keep in mind that if you do decide to vaccinate for FIV (an adjuvanted, and very ineffective vaccine), your cat will now test 'positive' since the FIV test cannot tell the difference between an infected cat and a vaccinated cat.

如果你還是決定要施打貓愛滋疫苗(有佐劑而且非常沒有效的疫苗),你的貓的愛滋檢驗會從此呈現陽性,因為愛滋檢驗無法判斷貓是受到感染還是施打有死病毒(即佐劑)的疫苗.

Chlamydia vaccines used to be routinely administered but this organism is no longer considered to be a 'core' pathogen.  Therefore, vaccination for chlamydia should only be considered in situations where the need can be substantiated through testing.

披衣菌(衣原體)疫苗以前是固打施打的項目,但這種細菌已經不再被視為"核心"病原.因此應該在檢查後,具體證明有其必要性,再施打披衣菌(衣原體)疫苗。

FVRCP: 三合一疫苗

Most people are familiar with the abbreviation 'FVRCP' which stands for Feline Viral Rhinotracheitis (herpes), Calici, Panleukopenia.  FVRCP is a combination vaccine that includes 3 out of the 5 vaccines that will be discussed on this webpage.

大部份的人都知道三合一預防的是貓鼻支氣管炎、卡利西病毒和貓瘟.本文要討論的是三合一疫苗.

This vaccine can either be modified live (all ML vaccines are non-adjuvanted) or killed (adjuvanted).  The route of delivery can be either injectable or intranasal .

三合疫苗使用的是弱毒(所有弱毒疫苗都是沒有含佐劑的)或死病毒(含佐劑疫苗)。給予的方式可以是注射或從鼻子滴入。

In general, only use a modified live (NON-adjuvanted) - never a killed (adjuvanted) - FVRCP vaccine, with injectable (not intranasal) being the preferred route of administration in most, but not all, instances.

基本上只要使用減毒(無佐劑)疫苗,絕不要使用死病毒(有佐劑)疫苗,就大部份的例子而言注射是比較理想的方式,但並不是全部。

Herpes and calici:  These are the upper respiratory viruses that can cause watery/swollen/ulcerated eyes (mainly herpes), sneezing, nasal congestion, and oral ulcerations.  The severity of illness ranges from very mild to severe but the mortality rate is very low.

貓鼻支氣管炎和卡利西病毒:這些是上呼吸道病毒,會造成眼睛流淚、紅腫和潰瘍(主要是貓鼻支氣管炎),打噴嚏、鼻塞,和口腔潰瘍。病狀從輕微到嚴重都有,但死亡率非常低。

Unfortunately, as is true for the 'common cold' in humans, there is no 100% effective vaccine for herpes and calici in the cat.  One reason is that these viruses mutate (change) frequently and there are many different strains.  The vaccine will not prevent infection but will, hopefully, lessen the severity of clinical signs。 

很不幸的是,和人類的"普通感冒"一樣,沒有百分之百有效的貓鼻支氣管炎和卡利西病毒疫苗.其中一個原因是這些病毒的變化過於頻繁,而且有太多不同的病毒株。疫苗無法預防感染,但是可以減輕臨床症狀,希望如此。

Panleukopenia:  This is a highly contagious virus that infects the intestines causing severe bloody diarrhea and vomiting.  This disease has a very high mortality rate.

貓瘟:這是一種高傳染性的病毒,影響的是腸道,造成很嚴重的帶血腹瀉和嘔吐.這個疾病的死亡率很高。

Do not let your kitten or cat go unprotected from panleukopenia.  This virus can cause a very cruel death.

不要讓你的貓在沒有保護的狀況下接觸到貓瘟病毒.這個病毒可能造成死亡.

My suggestions: 我的建議:

Kittens: 小貓:
Vaccinate kittens with FVRCP twice starting at 8-9 weeks of age with the second, and final kitten vaccine, administered when the kitten is no younger than 16 weeks of age.

打兩劑三合一,第一劑在貓八到九週大時施打,第二劑在貓十六週大以後施打。

The AAFP guidelines state that you can start this vaccine when the kitten is as young as 6 weeks of age but, unless there is a very high index of risk, I would definitely not vaccinate a kitten this young.

根據美國貓科獸醫協會的規則,小貓六週大便可施打三合一,但除非得到這三種病的風險很高,否則我不會在貓這麼小時就施打三合一。

We wait until the kitten is at least 16 weeks old to receive his last kitten shot because the antibodies he got from nursing on his mother will have decreased to a low enough level that his own body can respond to the vaccine in order to make his own antibodies.  (Maternal antibodies within the kitten can 'tie up' the vaccine before his body has a chance to respond to it.)

我會等到貓至少十六週大時再打最後一針,因為貓從母體得到的抗體會在這時到達低點,低到貓的身體可以自行回應疫苗以製造出自己的抗體。(小貓體內的母體抗體有可能會"綁住"疫苗,在小貓的身體有機會做出回應前。)

The AAFP guidelines suggest giving the FVRCP every 3-4 weeks until the kitten is 16 weeks of age.  This is done in an attempt to vaccinate the kitten the minute his maternal antibody level wanes to a low enough level to allow him to respond to the vaccine.  That way, there will be a minimal gap between the time his mother's antibodies stop protecting him and the time when he can start making his own antibodies.

美國貓科獸醫協會建議每三到四週便打一劑三合一,直到貓十六週大.這麼做的目的是希望小貓體內的母體抗體降到夠低時,便立刻施打疫苗,允許小貓做出回應。如此一來可以把母體抗體停止保護小貓,和小貓自行製造抗體之間的時間間隔拉到最低.

That said, I would rather not give this many vaccines to a kitten. Unless there is a high index of risk, I prefer to limit it to 2 vaccines total for the kitten series.

雖然如此,我還是寧願不要給小貓這麼多次的疫苗注射.除非貓處於這三種病的高風險環境中,否則我覺得總共施打兩次三合一便已足夠.

If you read the AAFP guidelines, there is the potential for administering 4-5 vaccines in the kitten series.  Given the fact that the FVRCP vaccine has been proven to cause kidney inflammation (nephritis), I am not comfortable following their suggestions。.

根據美國貓科獸醫協會的規章,小貓大約需要打四到五劑的三合一.但是三合一疫苗已經被證明會造成腎臟發炎,所以我個人並不認為這是一個妥善的作法.

See Membranoproliferative glomerulonephritis associated with over-vaccination in a cocker spaniel puppy at the bottom of this webpage.

請見本文底部一段有關一隻因為過度施打疫苗的可卡幼犬,引起膜增生性腎小球腎炎的病例。

The above case involved an owner who, without veterinary supervision, vaccinated his puppy 7 times - 1 time per month.  The puppy died at 7 months of age from kidney failure due to kidney inflammation.  The two most striking facts/comments in this case report are:

這隻小狗的主人在沒有獸醫的監督之下,為他的小狗施打七次疫苗,一個月一次.小狗在七個月大時因為腎發炎造成的腎衰竭而死亡.這個病例兩個最驚人的事實是:

"In addition, antigens in the complexes were similar to the vaccine antigens in the DHLPP vaccine, suggesting that the glomerulonephropathy in this puppy was secondary to frequent and unnecessary vaccination."

小狗體內的抗原和五合一DHLPP疫苗內的抗原類似,顯示小狗是因為不必要的頻繁注射疫苗,而導致膜增生性腎小球腎炎。

and。。。。而且

"Further studies are required at this time to determine the role, if any, that recent past and current vaccine protocols play in the development of protein-losing nephropathies."

在此同時也出現進一步研究的必要,以決定最近的過去以及目前的疫苗準則,在造成蛋白質流失的腎病發展上,所扮演的角色。

譯註:上述的狗五合一DHLPP疫苗是預防以下五種病
(D)distemper犬瘟熱 (H)hepatitis肝炎 (L) leptospirosis鉤端螺旋體病, (P)parainfluenza狗副流行性感冒 (P)parvovirus犬小病毒腸炎。

The last statement is very important considering the fact that chronic kidney disease is the most common subject that I consult on and that 2/3 of the kidney cells must be non-functioning before we see any elevation in blood markers such as BUN and creatinine. Therefore, we certainly may be damaging kitten kidneys by giving them 4 vaccines by the time they are 4 months old but not be aware of it.

我最常被諮詢的病是慢性腎衰竭,所以上述最後一句尤其重要.再者發現腎指數升高的時候,往往腎臟已經失去三分之二的功能.因此在貓四個月大以前,便給予四次疫苗,有可能已經對腎臟造成傷害,而我們卻渾然不知.

Put another way - if 7 vaccines in 7 months resulted in the death of a puppy, then I am not comfortable with 4 vaccines within 10 weeks for a kitten.

換句話說:如果七月打七次疫苗造成一隻小狗死亡,那麼在十週內幫小貓注射四次疫苗,我個人並不認為是妥善的作法.

Young adults:   年輕成貓:
The AAFP guidelines suggest giving a FVRCP booster 1 year after the last kitten vaccine – i.e. - when the cat is ~ 16 months of age.  However, if the kitten responds as he should to the kitten series, this booster should not be needed. The rationale behind the 1 year booster shot is to cover any kitten that did not properly respond to the kitten series.

美國貓科獸醫協會建議在最後一次施打疫苗之後,也就是當貓大約十六個月大時,每年再追打一劑三合一.然而,如果貓的身體對幼貓時施打的疫苗有反應,那麼一年後並不需要追打。一年後要追打的基本理由是,不想漏掉對小貓期疫苗沒有反應的貓.

Reasons why a kitten may not fully respond to a series of vaccines as a kitten and would benefit from a 1 year booster are:

小貓期疫苗沒有反應以及一年後追打一劑的理由是:
  1. The last kitten shot was given when he was younger than 16 weeks of age.
小貓期最後一次施打疫苗時,小貓還未滿十六週大
  1. Maternal antibodies hung on longer than 16 weeks and interfered with his immune system's ability to respond to the last vaccine.  (We have good studies showing that the maternal antibody levels are low enough in most kittens to allow them to respond to a vaccine by the time they are 8-12 weeks of age so this is an improbable scenario.)
母體抗體存在小貓體內的時間超過十六週,而且會干擾小貓的免疫系統,使其無法對最後一次疫苗作出反應.(我們有很好的研究顯示,當小貓在八到十二週大時,來自母體的抗體已經低到足以讓大部份的小貓對疫苗作出反應,所以這是一個不可能的狀況.)
  1. The kitten was in poor health when vaccinated and did not respond properly.  (Vaccines should never be administered to sick animals but, unfortunately, unhealthy animals are vaccinated more often than you may think.)
小貓在施打疫苗時健康狀況不佳,所以身體對疫苗沒有作出適當的反應.(生病的貓絕對不應該施打疫苗,但是很不幸的,不健康的動物打疫苗的狀況比你想的還要多。)
  1. The vaccine was of inadequate immunogenicity which means that the vaccine was damaged in terms of its efficacy. This could happen due to a problem within the manufacturing process or because of poor handling of the vaccine after it left the manufacturing plant.
不當引發免疫功能的疫苗,表示疫苗的效力已受到破壞.這種狀況有可能是因為製造過程有問題,或者是在疫苗離開製造地之後,沒有被小心處理.

Note that some cats are genetically 'non-responders' and never will respond to a vaccine no matter how many you give them. In these rare cases, giving a booster vaccine 1 year after the last kitten vaccine would be of no benefit。

有些貓天生無法對疫苗作出反應,而且永遠也無法作出反應,不管施打多少疫苗.像這種少見的例子,即使一年後再追加一劑疫苗也不會有好處.

Deciding to give a booster vaccine 1 year after the last kitten vaccine, or not, is a judgment call.

在打完小貓期最後一次疫苗的一年後,要不要再追打一劑,取決於飼主個人判斷.

The older a kitten is (past 16 weeks of age) when he receives his last kitten shot, the less inclined I would be to give a booster shot 1 year later

小貓期接受最後一劑疫苗的年紀越大(超過十六週),我就越不傾向於一年後追加一劑的作法.

This is because the older he is, the more mature his immune system is - and better able to respond - and the less chance there will be for the maternal antibodies to be at a high enough level to interfere with his ability to respond to a vaccine.

這是因為小貓年紀越大,免疫系統就越成熟,比較能夠作出回應,而且母體抗體高到干擾小貓自身對疫苗作出反應的能力的機會就越低。

Another option would be to test his titer (antibody level) to panleukopenia (not herpes or calici) to help you make a decision.  (More on titer testing below.)  This is what I would personally opt for.

另一個選項是測驗貓瘟力價(抗體含量)去幫助你作決定.(不是針對貓鼻支氣管炎或卡利西病毒)這是我個人會選擇的作法。

Adults: 成貓:
I do not repeat the FVRCP vaccine past the kitten shots - or past the 1-year booster as discussed above.

小貓期注射疫苗後,或是其後一年的追加施打之後,我不再施打三合一.

We certainly must stop vaccinating with FVRCP every year but taking it one step further, I do not follow the AAFP guidelines which suggest giving the FVRCP every 3 years since the risks outweigh the benefits.

我們當然必須停止每年施打三合一,再者,我並沒有遵從美國貓科獸醫協會建議的每三年施打一次三合一的作法,因為風險大於好處.

Why? 為什麼?

Consider the facts that enter into the risk-benefit analysis

考慮以下利弊得失的分析:
  1. A single, properly-timed, FVRCP vaccine confers life-long immunity to  panleukopenia (the most serious disease among the 3 that the FVRCP targets) in the vast majority of cats.  Those very few cats that may not be protected are considered to be 'non-responders' and giving them more vaccines is unlikely to help.
對多數的貓而言,單次的、時機準確的三合一疫苗,可以對貓瘟(三合一預防的病中最危險的一種)達成終生免疫.少數的貓沒有受到此疫苗提供的保護,可能因為他們是屬於對疫苗沒有反應型.給這類貓更多的疫苗也不會有幫助。
  1. Herpes and calici vaccines lack the ability to induce complete protection.  At best, they will only reduce the severity of some symptoms but will not prevent infection with these viruses and will not protect the recipient from all symptoms of disease.
貓鼻支氣管炎和卡利西病毒疫苗不具備完全保護的能力.他們充其量只能減輕某些病狀,但無法預防被這些病毒感染,而且無法保護被施打者不會出現這兩種病的所有症狀.
  1. Herpes and calici viral infections do not have a high mortality rate.  Death from these viruses is extremely rare and, if it did occur, it would most likely happen in kittenhood.
貓鼻支氣管炎和卡利西病毒死亡率不高.這些病毒造成的死亡很少.而且受到這種病毒感染的大多是小貓.
  1. Even though a non-adjuvanted FVRCP vaccine is much less likely to cause a sarcoma, sarcomas have been noted with these vaccines.
肉瘤已經被注意到是因為這些疫苗所造成,即使無佐劑疫苗造成肉瘤的機率比較低。
  1. The FVRCP vaccine has been shown to cause kidney inflammation.  Given how common chronic kidney disease is in the cat, this fact influences my vaccine decisions。
三合一疫苗顯示會造成腎臟發炎.考量慢性腎衰竭是如此常見的病,這影響了我的疫苗決定.

If you rescue/adopt an altered (spayed/neutered) adult with an unknown vaccine history, I strongly suggest running a titer for panleukopenia rather than vaccinating blindly.  If the cat is spayed or neutered, chances are she or he was vaccinated as a kitten. However, the age at which he received his last kitten vaccine (past 16 weeks of age?) will not be known so the decision to administer a vaccine, or not, is a judgment call.  This is a situation where titer testing can help out.

如果你救了或收養一隻已結紮成貓,而且疫苗注射歷史不明,我強烈建議先檢驗貓瘟力價,而不是盲目的給予疫苗.如果貓已經結紮,有可能在小貓期已注射疫苗.然而,小貓期最後一次疫苗注射時間無法確定時(是否當時年紀已超過十六週),那麼疫苗的注射與否端視主人的判斷.這時檢驗貓瘟力價可以提供幫助做判斷.

As odd as it may sound, if I rescue a neutered adult male cat with a fairly good size (empty) scrotal sac, I assume (rightly or wrongly…) that he was most likely not neutered before the age of 16 weeks.  (Male cats that are neutered very young have a very flat scrotal sac.)  Given that most cats are vaccinated when they are neutered, this gives us a hint (and nothing more than that) that the cat may very well have received a vaccine past the age of 16 weeks.

也許這聽起來很奇怪,如果我救了一隻陰囊袋頗大的已結紮公貓,我會推測(可能對也可能錯...)他很有可能不是在十六週大之前被結紮.(很小就結紮的公貓陰囊袋會很平.)因為大部份的貓在結紮時會順便打預防針,所以我們可以得到一個暗示性的線索(而且也僅止於此)那就是這隻貓很有可能在十六週大以後才注射疫苗.

Also, keep in mind that many of these stray cats have been 'traveling the streets' and may have a good dose of natural immunity to some feline diseases although that cannot be counted on definitively.

而且別忘了,許多街貓是在街道走跳的,可能身體對某些貓科疾病已經有很好的自然免疫力,當然這並非絕對.

The AAFP guidelines call for a series of 2 FVRCP vaccines to be given 3-4 weeks apart to an adult with an unknown vaccination history but the WSAVA (World Small Animal Veterinary Association) recommends that only 1 FVRCP vaccine be given with a booster vaccine 1 year later.

除了疫苗歷史不明的成貓以外,美國貓科獸醫協會建議三到四週內要打兩劑三合一,但是世界小動物獸醫協會則建議只要打一次三合一,一年後再追加一劑.

In lieu of this 1 year booster, I would suggest titer testing.

我會建議先測驗力價,代替一年後追加一劑的作法.

Studies have shown that cats over 16 weeks of age with a healthy immune system respond very well to just 1 FVRCP vaccine.

研究顯示年紀超過十六週的貓,如果有健康的免疫系統,只要一劑三合一身體就會有良好的反應.

Feline Leukemia (FeLV): 貓白血病
Feline leukemia (the disease that results from the feline leukemia virus versus a primary cancer), is a complicated disease.  It typically attacks the bone marrow of the cat but cats vary in their response to the virus.  Some cats clear the virus from their system and become FeLV 'negative,' some cats live for many years with the virus in their body but are not symptomatic, and some cats become ill and die within a few years of becoming infected.

貓白血病(貓科白血病病毒引起的病,不是原發癌)是一個複雜的病.典型的症狀是攻擊貓的骨髓,但貓對這種病毒的反應各有不同。有些貓可以把病毒清理掉,白血病呈陰性反應,有些貓則和這個病毒共存多年,而且沒有任何症狀出現,有些貓則是在感染的幾年內發病死亡。

FeLV is NOT highly contagious and its transmission requires prolonged intimate (i.e., sharing food/water, mutual grooming) contact with an infected cat.  Natural immunity is very strong in most cats by the age of 1 year.  AAFP guidelines suggest vaccinating all kittens but the vaccine is recommended in adults only if they will be in contact with a known FeLV positive cat - which would be a very rare situation.

貓白血病並不是非常容易傳染的病.長期跟被感染的貓親密相處(也就是共用食盆/水盆互相舔毛)才會被感染。大部份的貓在一歲的時候,身體已具有強壯的自然免疫力。美國貓科獸醫協會建議所有幼貓都要施打疫苗,至於對成貓的建議則是,如果成貓有跟白血病呈陽性反應的貓接觸(其實這種狀況很少),則要施打白血病疫苗。

I disagree with the recommendation to vaccinate all kittens. None of my own cats have ever been vaccinated for FeLV - not even as kittens - since they reside indoors and will not be in contact with a FeLV positive cat.

我不認同所有小貓都要打白血病疫苗的建議。我自己的貓都沒有打過白血病疫苗,即使是在小貓期,因為我的貓都住在室內,沒有機會接觸到白血病呈陽性反應的貓。

My suggestions: 我的建議是:

Do not vaccinate kittens for FeLV unless your kitten is going to be outside (rarely a safe place to be for any kitten or cat) or is going to be housed with an FeLV positive kitten or cat.

不要讓小貓注射白血病疫苗,除非你的貓會去室外(不管是小貓或大貓,室外都不是一個很安全的地方)或要去跟一隻白血病呈陽性反應的貓住在一起。

Do not vaccinate adult cats for FeLV - even if they have access to the outdoors - since natural immunity to this disease is very strong by the time the cat is ~1 year of age. If an adult cat is going to be living with a FeLV positive cat, then vaccination should be considered.

成貓也不要注射白血病疫苗,即使他們可以去室外,因為當貓一歲時,他們本身已具有這個疾病的強壯免疫力。如果一隻成貓要去跟白血病呈陽性反應的貓住在一起,才應該考慮是不是要注射疫苗。

If you are more comfortable vaccinating a cat that goes outside, please do
not vaccinate him yearly.  Vaccinating one time with a PureVax (the only NON-adjuvanted option) vaccine would fit within my comfort zone.

如果一隻可以去室外的貓,你覺得要打疫苗才比較放心,也不要每年都打.我認為放心的作法是打一次PureVax白血病疫苗(唯一沒有佐劑的選擇)。
 


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