Michael J. Day, BSc, BVMS (Hons), PhD, DSc, DECVP, FASM, FRCPath FRCVS
The WSAVA Vaccination Guidelines Group (VGG) was convened in 2006 with the remit of producing globally applicable guidelines for the vaccination of dogs and cats. The first WSAVA vaccination guidelines were published in 2007. In 2009, the VGG undertook a phase II project in which the guidelines were revised and updated (published in 2010), together with an expanded list of frequently asked questions (FAQs) and a series of disease 'fact sheets.'1 Additionally, a separate document was published for the owners and breeders of dogs and cats to provide key information about infectious disease, immunology and vaccination. These materials may all be accessed from the WSAVA website.
From 2012–2014, the VGG has undertaken a phase III project which focuses on the vaccination requirements for companion dogs and cats on the Asian continent. Members of the VGG during this phase were:
Prof. Michael J. Day, University of Bristol, UK (Chairman)
Prof. Ron Schultz, University of Wisconsin, USA
Prof. Richard Squires, James Cook University, Australia
Prof. Hajime Tsujimoto, University of Tokyo, Japan
Dr. Umesh Karkare, private practitioner, Mumbai, India
The VGG recognized that there were numerous regional challenges facing practitioners in Asia and the aims of the phase III project were:
to develop an understanding of the problems and issues,
to make recommendations to national veterinary organisations, veterinary schools and governments,
to develop a set of Asian practitioner guidelines, and
to provide education in infectious diseases, immunology and vaccinology.
Over the course of the 2-year project, the VGG visited four key Asian countries: Japan, China, India and Thailand. In addition, the VGG Chairman also travelled to Hong Kong, Indonesia, Malaysia and South Korea. Formal VGG meetings were conducted in Tokyo, Beijing, Shanghai, Delhi, Mumbai and Bangkok. During these meetings, the VGG met with academics and deans from veterinary schools, practitioners and practitioner associations, representatives of vaccine manufacturers, government regulators of vaccines and representatives from the pet insurance industry. In Tokyo, the VGG discussed Asian rabies surveillance and control with the deputy director of the OIE in the Asia Pacific. In Mumbai, the VGG discussed the work of the Blue Paw Trust in Sri Lanka with Dr. Nalinika Obeyesekere and met with Major General Kharb, the chairman of the Animal Welfare Board of India. The VGG also made site visits to representative veterinary practices, visiting six establishments in India and six in China.
During these visits, the VGG also provided a series of half-day continuing education meetings for practitioners. These were conducted in Tokyo and Osaka (370 delegates), Delhi and Mumbai (180 delegates), Beijing and Shanghai (180 delegates) and Bangkok (80 delegates).
In order to gather further data, the VGG also developed a survey questionnaire for veterinary practitioners that was administered by national associations with the assistance of industry colleagues in some cases. The questionnaire was successfully applied in Japan (113 responses), India (144 responses), China (150 responses) and Thailand (267 responses). Although the questionnaire was also offered to associations in Indonesia, Vietnam, Sri Lanka, Singapore and the Philippines, responses were not received during the course of the phase III project. The questionnaire gathered data on the demographics of the veterinary profession, the facilities available within practices, diagnostic laboratory support, canine and feline infectious diseases seen in the practice, vaccines used in the practice and vaccination protocols used for dogs and cats in the practice.
These extensive data and the VGG recommendations were summarized in a final document that was submitted for publication to the J Small Anim Pract in May 2014.2 The document has three appendices: (1) the VGG Survey, (2) a list of 80 FAQs with answers, and (3) selected references. The FAQs all arose commonly during discussions at the continuing education events in Asia. The document includes a set of recommendations concerning 'vaccine husbandry' - the storage and correct in-practice use of vaccines; an issue identified as significant by the VGG. The advice to Asian practitioners on vaccination protocols is presented as two simple sets of guidelines: The first is the 'aspirational' approach to which Asian practitioners should aim to move towards in the coming years. The aspirational approach will bring vaccination practice in Asia closer to that which is now commonplace in many other countries in the world. The second is the 'pragmatic' approach, which recognizes that right now there are numerous barriers towards adopting global vaccination practice in Asia; specifically, product availability, which is in turn driven by political and regulatory factors. The VGG encourages Asian practitioners to adopt elements of the 'annual health check' approach to the in-practice delivery of vaccination to clients. The VGG also commends the work of Asian practitioners in supporting governmental and NGO programmes for the elimination of canine rabies, and hopes that such programmes will be maintained and expanded such that the Asian countries can move towards global elimination of this disease by 2030, as proposed in the recent joint WSAVA-OIE statement on global rabies control.
The specific recommendations of the VGG for Asia are that: (1) Asian veterinary schools review and increase as needed the amount of instruction in small animal vaccinology within their undergraduate curriculum and increase the availability of pertinent postgraduate education for practitioners; (2) national small animal veterinary associations, industry veterinarians and academic experts work together to improve the scientific evidence base concerning small animal infectious diseases and vaccination in their countries; (3) national small animal veterinary associations take leadership in providing advice to practitioners based on improved local knowledge and global vaccination guidelines; and (4) licensing authorities use this enhanced evidence base to inform and support the registration of improved vaccine product ranges for use in their countries, ideally with DOI for core vaccines similar or equal to those of equivalent products available in western countries (i.e., 3 or 4 years).
Acknowledgments
The VGG gratefully acknowledges the time given by the large number of individuals who attended our meetings and contributed valuable data and local knowledge to the project. We are particularly grateful to the small animal associations and individuals who administered the questionnaire survey in the various countries, which was a demanding and time consuming task. In particular, we thank Dr. Louis Liu (Beijing Small Animal Veterinary Association), Dr. Geoffrey Chen (Shanghai Small Animal Veterinary Association) and Dr. Walasinee Moonarmart (Veterinary Practitioners Association of Thailand). The work of the VGG continues to be sponsored by MSD Animal Health. We are enormously grateful for the incredible logistical support provided by the national offices of MSD Animal Health in the four countries that we visited, and for the oversight given by Dr. David Sutton (MSD Global) and Dr. Raphael Zwijnenberg (MSD Asia-Pacific). The VGG remains an independent committee of academic experts. Our meetings are not attended by our sponsors, and our recommendations are made without the input of our sponsors.
References
1. Day MJ, Horzinek M, Schultz RD. Guidelines for the vaccination of dogs and cats. J Small Anim Pract. 2010;51:338–356.
2. Day MJ, Karkare U, Schultz RD, Squires R, Tsujimoto H. Recommendations on vaccination for Asian small animal practitioners: a report of the WSAVA Vaccination Guidelines Group. J Small Anim Pract. 2014. Submitted.