813_830_AAHA_AAFP Feline Vaccination Guidelines_3.8.2020.qxp_FAB 03/08/2020 13:13 Page 813 Journal of Feline Medicine and Surgery (2020) 22, 813–830 SPECIAL ARticle 2020 AAHA/AAFP Feline Vaccination Guidelines Abstract: The guidelines are a consensus report on current recommendations for vaccination of cats of any origin, authored by a Task Force of experts. The guidelines are published simultaneously in the Journal of Feline Medicine and Surgery (volume 22, issue 9, pages 813–830, DOI: 10.1177/1098612X20941784) Amy ES Stone DVM, PhD and the Journal of the American Animal Hospital Association (volume 56, issue 4, pages 249–265, Chair of 2020 AAHA/AAFP DOI: 10.5326/JAAHA-MS-7123). The guidelines assign approved feline vaccines to core (recommended Feline Vaccination for all cats) and non-core (recommended based on an individualized risk–benefit assessment) categories. Guidelines Task Force* Department of Small Animal Practitioners can develop individualized vaccination protocols consisting of core vaccines and non-core Clinical Sciences, University vaccines based on exposure and susceptibility risk as defined by the patient’s life stage, lifestyle, and place of Florida, Gainesville, Florida, USA of origin and by environmental and epidemiologic factors. An update on feline injection-site sarcomas indicates that occurrence of this sequela remains infrequent and idiosyncratic. Staff education initiatives Gary O Brummet should enable the veterinary practice team to be proficient in advising clients on proper vaccination practices DVM Veterinary Teaching Hospital, and compliance. Vaccination is a component of a preventive healthcare plan. The vaccination visit should College of Veterinary always include a thorough physical exam and client education dialog that gives the pet owner an Medicine, University of Illinois at Urbana-Champaign, understanding of how clinical staff assess disease risk and propose recommendations that help ensure Urbana, Illinois, USA an enduring owner–pet relationship. Ellen M Carozza LVT Keywords: Vaccination principles; vaccines; lifestyle; risk assessment; veterinarian; injection site; rabies; Nova Cat Clinic, Arlington, leukemia; guidelines; maternally derived antibodies Virginia, USA Philip H Kass Abbreviations: DNA (deoxyribonucleic acid); FCV (feline calicivirus); FeLV (feline leukemia virus); DVM, MPVM, MS, PhD, FHV-1 (feline herpesvirus type 1); FIP (feline infectious peritonitis); FISS (feline injection-site sarcoma); DACVPM (Specialty FPV (feline panleukopenia virus); Ig (immunoglobulin); IM (intramuscular); MDA (maternally derived in Epidemiology) Department of Population antibodies); SC (subcutaneous); WSAVA (World Small Animal Veterinary Association) Health and Reproduction, School of Veterinary Medicine, University These guidelines were prepared by a Task Force Introduction of California, Davis, Davis, California, USA of experts convened by the American Animal Hospital Association (AAHA) and the American As a medically essential and cost-effective Ernest P Petersen method of infectious disease control, vaccina- DVM, PhD, DABVP (Feline) Association of Feline Practitioners (AAFP) and Animal Hospital of Parkland, were subjected to a formal peer-review process. tion continues to be a mainstay of feline Tacoma, Washington, USA This document is intended as a guideline only, not practice and a critical component of an indi- Jane Sykes an AAHA or AAFP standard of care. These guide- vidualized preventive healthcare plan. These BVSc (Hons), PhD, lines and recommendations should not be con- guidelines provide the most current informa- DACVIM, MBA tion and recommendations for feline vaccina- University of California, strued as dictating an exclusive protocol, course Davis, Davis, California, USA of treatment, or procedure. Variations in practice tion as determined by a Task Force of experts in feline practice. The recommendations are Mark E Westman may be warranted based on the needs of the indi- BVSc (Hons), PhD, vidual patient, resources, and limitations unique evidence-guided, based on current peer- MANZCVS (Animal to each individual practice setting. Evidence- reviewed literature and data, and complement- Welfare), GradCert Ed Stud ed by clinical insights collectively derived from (Higher Ed)) based support for specific recommendations has Sydney School of Veterinary been cited whenever possible and appropriate. decades of experience. The guidelines update Science, University of the “2013 AAFP Feline Vaccination Advisory Sydney, Sydney, Other recommendations are based on practical New South Wales, Australia clinical experience and a consensus of expert opin- Panel Report” and utilize similar recommenda- tions from the 2016 “WSAVA [World Small *Corresponding author: ion. Further research is needed to document some [email protected] of these recommendations. Because each case is Animal Veterinary Association] Guide lines for different, veterinarians must base their decisions on the best available scientific evidence in conjunction with their own knowledge and experience. DOI: 10.1177/1098612X20941784 © 2020 by American Animal Hospital Association, American Association JFMS CLINICAL PRACTICE 813 of Feline Practitioners and International Society of Feline Medicine 813_830_AAHA_AAFP Feline Vaccination Guidelines_3.8.2020.qxp_FAB 03/08/2020 13:13 Page 814 SPECIAL ARticle / 2020 AAHA/AAFP feline vaccination guidelines the Vaccination of Dogs and Cats”.1,2 Both of Vaccination principles these previously published r e sources should still be considered relevant and actionable Active immunization, achieved through prop- complements to the 2020 guidelines. er vaccination, plays a critical role in the con- The guidelines continue the established trol of infectious diseases, both for individual approach of considering inclusion of core cats and for the cat population as a whole. (recommended for all cats) and non-core Some vaccines also reduce the potential for (recommended based on an individualized spread of zoonotic infections to humans (e.g., risk–benefit assessment) vaccines in an indi- rabies). The benefits of routine, widespread vidualized protocol. As explained in the vaccination are clear: the incidence of serious guidelines, a patient-specific vaccination plan disease caused by pathogenic organisms, such should consider environmental risk factors as feline panleukopenia virus (FPV), can be and life stage and lifestyle factors that deter- reduced dramatically when widespread vacci- mine the likelihood of infectious disease expo- nation is practiced. However, the quality of sure and susceptibility. For example, not all vaccine-induced immunity is influenced by feline patients originate from a home environ- the patient’s environment, the characteristics ment, and conversely, most cats described as of the vaccine, the pathogen, and the patient’s “indoor only” might find themselves periodi- immune competence. Accurate prediction of cally exposed to other cats. The guidelines the outcome of vaccination or the likelihood discuss other presentation scenarios that can Kittens may of exposure to a pathogen is impossible. potentially affect a risk–benefit assessment Therefore, it is important that veterinarians and include updates on feline injection-site be susceptible inform cat owners that vaccination is not a sarcomas (FISSs) and other vaccination- guarantee of protection. related reactions. to infectious In general, kittens are more susceptible to A key component of the guidelines are com- diseases infection and disease than adults. Thus, they prehensive, easy-to-reference tables listing represent a primary target population for approved core and non-core feline vaccines at about immunization. As part of a routine wellness and the relevant considerations for their program, the vaccination needs of all cats use. The guidelines are complemented by 1 month of age, should be assessed annually, in conjunction an online resource center at aaha.org/ perhaps as with a comprehensive physical examination, felinevaccination and supplemental materials modifying vaccination and other control at catvets.com/vaccination. The online much as recommendations as necessary based on the resources include frequently asked questions 2 weeks earlier current risk (see “Vaccination risk–benefit about vaccination that clinicians and pet own- assessment”). ers raise as well as a vaccine protocol calcula- than puppies. Kittens born to immune queens lack signifi- tor that uses a cat’s life stage and lifestyle cant transplacentally acquired antibodies4 and information to suggest an appropriate, indi- instead absorb specific maternally derived vidualized vaccination protocol. antibodies (MDA) through colostrum, which The guidelines discuss in some detail the provides important protection during early importance of staff and client education in life. Most absorption occurs within 24 hours implementing vaccination protocols and rec- of birth. However, this MDA also interferes ommendations for feline patients. This with active immunization. Serum MDA emphasis is noteworthy in view of the fact inhibits immunoglobulin (Ig)G production that many pet owners, especially cat owners, within the neonate through negative feedback associate professional veterinary care primar- mechanisms. It also neutralizes vaccine anti- ily with two events, vaccination and treatment gens and prevents them from stimulating an of acute conditions.3 Thus, a healthcare visit immune response. MDA then declines at a for the purposes of vaccination becomes an variable