Using Titer Testing As A Healthy Alternative to Annual Vaccination
Shawn Messonnier DVM
Paws and Claws Holistic Animal Hospital
The annual/biannual (routine) administration of vaccines in pets has been one of the
most significant factors in the consistent reduction of serious canine/feline infectious
diseases. This approach has resulted in excellent disease control for infections that
were once considered important causes of morbidity and mortality, such as distemper
and parvo viral infections (unlike the situation in people where infectious diseases were
declining due to improvement in sanitation prior to the development of vaccines, even
pets living in clean and sanitary conditions can develop fatal viral diseases; vaccination
has reduced the incidence of these infections.)
Although veterinarians tend to agree that at least some vaccines are necessary, the
frequency in which they’re given, and the choice of vaccines needed, is still debated.
Studies showing minimum duration of immunity for many vaccines of at least 3 years
(and likely longer) are causing veterinarians to question the routine frequency with
which vaccines are administered. As a result, veterinarians are turning to blood antibody
titer testing to help them answer the following questions so they can make the most
appropriate recommendations to their clients.
Do ALL pets need ALL vaccines ALL years of their lives??
If “Yes,” WHY?? If, “No,” WHY NOT??
How do we know which pets need which vaccines??
Based upon current research we know that most of our vaccines, specifically the core
canine vaccines (parvo virus, distemper virus, and adenovirus) and feline vaccines
(calici, panleukopenia, and rhinotracheitis,) can produce long-lasting immunity, thus
making the need for regular vaccination for these diseases unnecessary. According to
the current standard recommendation, core vaccines should not be given any more
frequently than every three years after the initial (usually puppy and kitten) vaccine
series, because the duration of immunity (DOI) is many years and may be up to the
lifetime of the pet.
In order to ensure the existence of duration of immunity, and to determine if and when
booster vaccinations are needed, titer testing may be used as an inexpensive way to
determine antibody presence.
The 3-year recommendation for core vaccines is made on the basis of minimum
duration of immunity (DOI) studies over the past 30 years for vaccines. These studies
were done by all of the major vaccine companies, as well as by independent
researchers. The results of the studies conducted by the major manufacturers for core
vaccines demonstrated that a minimum DOI for these core vaccines was 3 years, based
on challenge and/or serologic studies.
A Healthy Alternative-Titer Testing
Despite the confusion and controversy surrounding antibody titer testing, these
serologic tests are useful for monitoring immunity to many diseases. A titer is not a
snapshot in time but more like a motion picture that plays on and on. An animal’s titer is
highest right after vaccination. The titer then decreases but stabilizes within six months
to a year and often remains at that level for many years. Titers may actually increase
over the life of the pet, indicating exposure to the infectious organism and an
appropriate immune response preventing disease. Therefore, titer testing is a reliable
measure of the ongoing immunity to specific viral diseases (Note-current
recommendations are that titer testing is an effective test for antibody-driven immunity
for all dog core vaccines and for the cat panleukopenia vaccine. In practice, titer testing
for the cat calici and herpes virus is used to determine protective immunity but it must
be kept in mind that both antibody and cell-mediated immunity is needed for protection
from these 2 diseases. In my practice, a vaccination schedule based upon titer testing
for all 3 cat diseases has protected my patients from infection in their environments.)
What are the Benefits to Titer Testing?
Titer testing has many benefits. These include the prevention of unnecessary
vaccination, allowing the doctor to individualize vaccine protocols, bonding clients to the
practice, and encouraging vaccination when needed. Titer testing is accepted by
veterinary experts and has been proven valid. As an alternative to vaccination, it is
accepted by most kennels and groomers. When done in-house or at inexpensive (usally
state diagnostic) laboratories it is cost effective and easy to perform.
How Much Does Titer Testing Cost?
Titer testing can be done inexpensively or more expensively, depending upon the
practice and which lab is used for the testing. A drawback for some clients is the
expense of titer testing. However, using my practice as an example, titer testing is under
$200 as of this writing for a complete set of titers for core vaccines for dogs and cats
(we actually do the titer testing in our hospital for dogs, but the cat titer test still must be
sent to an outside lab.) However, I’ve seen prices for more than double this amount as
other doctors send the tests to an outside reference lab which can cost quite a bit more.
What if My Veterinarian Refuses Titer Testing?
My easy answer is to find another vet! You can’t force a doctor to do something he
doesn’t want to do or doesn’t know how to interpret when he gets the results.
Fortunately, titer testing is slowly becoming accepted among mainstream doctors. As a
rule, finding a holistic veterinarian may be needed for titer testing, but the benefit is that
ongoing pet care will also be viewed from a holistic perspective, which I believe can
decrease disease and increase longevity in most pets.
When to Use Titer Testing in Practice
Since the purpose of titer testing is to demonstrate protective immunity, it should be
done in the following instances: any adult animals (1 year of age and older,) strays,
shelters/rescue groups, pets with lapsed vaccinations, and in puppies and kittens 3 or
more weeks after the last pet vaccine visit which occurs at 14 to 16 weeks of age. When
antibody is present there should not be a need to revaccinate the pet for the specific
disease being tested. If antibody titer is absent (irrespective of the serological test used)
revaccination should be considered unless there is a medical basis for not so doing.
While no test is perfect, in clinical practice titer testing has been found to be a rational
substitute for frequent vaccination, especially in pets with minimal exposure to other
What About Bordetella, Rabies, Leptospirosis, Leukemia, and Other Vaccines?
These other diseases are rare causes of disease in pets and routine immunization is not
needed or required. Bordetella vaccination in dogs should NEVER be done more than
once per year, mainly at the request of a grooming/boarding/day care facility. Rabies is
required by law (see my handout discussing the rabies vaccine for more information on
this special case.) Leptospirosis is a bacterial infection affecting people and pets,
typically transmitted by infected rodent urine. Most pets will not need this vaccine, and
in my experience, while rare, it causes more vaccine reactions (including very severe
ones) than other vaccines. Cat leukemia virus is mostly a problem of outdoor cats with
close and intimate exposure to infected cats. It is done in cats with high risk of exposure
if they cannot be made “indoor-only” cats.
Keep the following point, taken from the website of the American Animal Hospital
Association’s guidelines on dog and cat vaccines, in mind when deciding upon the need
for ongoing vaccination:”The decision to vaccinate, even with core vaccines, should be
based on a risk-benefit assessment for each pet and for each vaccine antigen. Benefits
of vaccination should be balanced against the risk of adverse events, likelihood of
exposure, and disease severity. Every effort should be made to ensure that pets are
healthy before vaccination.”
Finally, remember the following point:
Vaccination does NOT equal immunization.
A vaccinated person or pet is assumed to be immunized (protected from disease based
upon an effective immune response to the vaccine.) However, it is possible to be
vaccinated and not be immune from disease. This can happen due to vaccine type,
specific disease against which a vaccine is developed, vaccination against a specific
strain of the disease organism if the patient is infected with a different strain not
included in the vaccine, vaccination given at the wrong age of the patient, vaccination
given during illness if the immune system is unable to respond immunologically, age of
the pet and status of the immune system based upon age, maternal antibodies (present
in newborns,) and in those rare instances where the patient’s immune system is
defective and unable to respond to any vaccine. While we assume a vaccinated patient
is immunized (safe from infection,) this is only an assumption (although a logical one)
and cannot be definitively stated without proof of immune response to the vaccine
(testing of the patient, which is rarely done for practical reasons.)
Titer testing is simple and inexpensive. While not perfect, it does provide a degree of
confidence in showing protective immunity in pets in which a reduced vaccination
schedule is desired. Titer testing can prevent unnecessary vaccination of patients, save
owners money wasted on unnecessary vaccines, and can reduce or prevent acute and
chronic vaccine reactions. If vaccines are needed, titer testing can determine which
vaccines are needed and help ensure proper immunity to important viral diseases. In
my practice (and the practices of other holistic doctors,) titer testing has replaced
routine vaccination and I believe has contributed to increased longevity and health in my patients.