{"id":1293,"date":"2013-05-01T15:54:23","date_gmt":"2013-05-01T15:54:23","guid":{"rendered":"http:\/\/phosdev.com\/todaysveterinarypractice\/?p=1293"},"modified":"2022-02-17T19:14:12","modified_gmt":"2022-02-17T19:14:12","slug":"antibody-titers-versus-vaccination","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/preventive-medicine\/antibody-titers-versus-vaccination\/","title":{"rendered":"Antibody Titers Versus Vaccination"},"content":{"rendered":"<p class=\"p1\"><span class=\"s1\">The publication of vaccination guidelines for dogs and cats (see <strong>Links to Vaccination Guidelines<\/strong>)\u2014intended to provide useful insights on the selection and use of vaccines\u2014also elicited some degree of controversy regarding implementation of these vaccination recommendations in practice.<\/span><\/p>\n<hr \/>\n<p>Editor\u2019s Note: This article was originally published in May 2013. Please use this content for reference or educational purposes, but note that it is not being actively vetted after publication. For the most recent peer-reviewed content, see our <a href=\"https:\/\/todaysveterinarypractice.com\/issue-archives\/\">issue archive<\/a>.<\/p>\n<hr \/>\n<h2 class=\"p3\"><span class=\"s1\">DURATION OF IMMUNITY CONCERNS<\/span><\/h2>\n<p class=\"p1\"><span class=\"s1\">In particular, the recommendation to administer core vaccines to adult dogs and cats at 3-year intervals (or longer) rather than annually resulted in differences of opinion among veterinarians. After all, veterinarians have been recommending annual boosters for years, doing so in accordance with manufacturer recommendations.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Therefore, the growing group of veterinarians who were skeptical of triennial vaccination recommendations began measuring antibody titers from individual patients to assess duration of immunity (DOI) and determine whether a patient required revaccination. As demand for <em>vaccine titers<\/em> increased, veterinary laboratories began offering antibody titer panels for dogs and cats while 2 companies developed in-clinic antibody tests.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">With the increased focus on antibody titers, additional questions were raised:<\/span><\/p>\n<ul class=\"ul1\">\n<li class=\"li1\"><span class=\"s1\">What are the indications for performing titers?<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">When interpreting antibody titers, what test limitations apply?<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">How should test results be interpreted when making vaccination decisions for individual patients?<\/span><\/li>\n<\/ul>\n<h2 class=\"p3\"><span class=\"s1\">CORRELATION OF TITERS &amp; IMMUNITY<\/span><\/h2>\n<p class=\"p1\"><span class=\"s1\">Antibody titers measured in laboratories and by in-clinic and antibody test kits typically record results as <em>positive<\/em> or <em>negative<\/em>, and include a brief description of the result&#8217;s significance. However, questions remain:<\/span><\/p>\n<ul class=\"ul1\">\n<li class=\"li1\"><span class=\"s1\">How well does a <i>positive<\/i> antibody titer (or test kit result) correlate with protective immunity in a patient? <\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">How well does a <i>negative<\/i> titer (or test kit result) correlate with susceptibility in a patient? <\/span><\/li>\n<\/ul>\n<p class=\"p1\"><span class=\"s1\">When interpreting antibody titers, a few facts must be clear:<\/span><\/p>\n<ol class=\"ol1\">\n<li class=\"li1\"><b><\/b><span class=\"s3\"><b>The only <i>true<\/i> test of protective immunity involves exposure (challenge) to a virulent pathogen<\/b><\/span><span class=\"s1\"> in which nonvaccinates (controls) are infected and manifest clinical illness while vaccinated animals remain healthy. Animal vaccines are licensed based on this premise.<\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s3\"><b>Interpreting antibody test results depends on understanding what results do and <i>do not<\/i> represent.<\/b><\/span><span class=\"s1\"> In the clinical setting, antibody levels offer diverse and distinct clinical applications (see <b>It&#8217;s All About PIE<\/b>). <\/span><\/li>\n<li class=\"li1\"><b><\/b><span class=\"s3\"><b>Different classes of antibody, also called immunoglobulin (Ig), have specialized functions<\/b><\/span><span class=\"s1\"> (identified and categorized as IgA, IgG, IgE, or IgM). In veterinary medicine, the antibody titers used to assess protective immunity typically represent the IgG class. <\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">When using an in-clinic test kit to measure (qualitative or semiquantitative) antibody levels, <\/span><span class=\"s3\"><b>results are reported as either <i>positive<\/i> (indicates protection) or <i>negative<\/i> (indicates susceptibility) and must be correlated with <i>gold standard<\/i> laboratory tests<\/b><\/span><span class=\"s1\">, such as virus neutralization (VN) or hemagglutination inhibition (HI), in order to accurately represent a defined threshold of antibody. Both in-clinic tests have been correlated through VN, HI, or challenge testing results. While the correlation studies were conducted independently through universities, the data is available through the respective companies that manufacture the in-clinic test kits.<\/span><\/li>\n<\/ol>\n<p class=\"p1\"><span class=\"s1\">Today, in-clinic titer test kits for canine distemper (CDV), canine parvovirus (CPV), canine adenovirus (CAV), and feline parvovirus (panleukopenia, FPV) correlate well with appropriate gold standard tests. Therefore, when these in-clinic tests are performed properly:<\/span><\/p>\n<ul>\n<li><span class=\"s1\">A <b><i>positive<\/i><\/b> test result indicates the patient <i>does have protective levels<\/i> of antibody against the virus. <\/span><\/li>\n<li><span class=\"s1\">A <b><i>negative<\/i><\/b> test result indicates the patient <i>does not have protective levels<\/i> of circulating antibody. However, a <b><i>negative<\/i><\/b> test result <i>does not necessarily define susceptibility.<\/i><\/span><b><\/b><\/li>\n<\/ul>\n<div class=\"orange-box\">\n<h2>IT\u2019S ALL ABOUT PIE<\/h2>\n<ul>\n<li><span class=\"s5\"><b>Protection (P):<\/b><\/span><span class=\"s1\"> Some, but not all, antibody results correlate well with protection (eg, canine and feline parvovirus). A patient with a positive titer or test result for parvovirus antibody can be considered protected.<\/span><\/li>\n<li><b><\/b><span class=\"s7\"><b>Infection (I):<\/b><\/span><b> <\/b><span class=\"s1\">On the other hand, antibody presence can represent evidence of active infection (eg, feline immunodeficiency virus). <\/span><\/li>\n<li><b><\/b><span class=\"s5\"><b>Exposure (E):<\/b><\/span><span class=\"s1\"> Other antibody test results indicate prior exposure to an infectious agent (eg, Ehrlichiosis) or vaccine (eg, rabies) and do not predict either protection or active infection.<\/span><\/li>\n<\/ul>\n<\/div>\n<h2><span class=\"s1\">ANTIBODY DEVELOPMENT LIMITATIONS<\/span><\/h2>\n<p><span class=\"s1\"><b>Seroconversion<\/b>, the antibody response that follows vaccination, can be identified for most vaccines administered to dogs and cats. However, the development of antibody does not necessarily equate to <b>protective immunity<\/b>.<\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/05\/Screen-Shot-2015-06-24-at-1.44.37-PM.png\"><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-5143 size-full aligncenter\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/05\/Screen-Shot-2015-06-24-at-1.44.37-PM.png\" alt=\"Screen Shot 2015-06-24 at 1.44.37 PM\" width=\"436\" height=\"232\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/05\/Screen-Shot-2015-06-24-at-1.44.37-PM.png 436w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/05\/Screen-Shot-2015-06-24-at-1.44.37-PM-300x160.png 300w\" sizes=\"(max-width: 436px) 100vw, 436px\" \/><\/a><\/p>\n<h3><span class=\"s1\">Feline Calicivirus &amp; Herpesvirus<\/span><\/h3>\n<ul>\n<li class=\"li1\"><span class=\"s1\">Even if <b>antibody test results<\/b> are <i>positive<\/i> after feline herpesvirus (FHV) and feline calicivirus (FCV) vaccination, results <i>do not correlate well with protective immunity<\/i>; these results are not generally recommended for use when making vaccination decisions for an individual cat.<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">The correlation between the <b>gold standard<\/b> antibody test for FHV-1 (VN) and protection is only <i>fair<\/i>; <b>cell-mediated immunity<\/b> is a <i>better<\/i> correlate of protection against FHV-1. <\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">The correlation between the <b>gold standard test<\/b> for FCV (VN) and protection is <i>fair to good<\/i>.<\/span><\/li>\n<\/ul>\n<h3><span class=\"s1\">Rabies<\/span><\/h3>\n<p><span class=\"s1\">Rabies antibody titers, as determined by <b>fluorescent antibody virus neutralization<\/b> (FAVN), are only available through a limited number of certified laboratories. It is important to note that a rabies virus antibody titer <i>cannot<\/i> be interpreted as an index of immunity in lieu of revaccination.<\/span><\/p>\n<div class=\"orange-box\">\n<h3><span class=\"s1\">Factors that influence antibody response following vaccination include:<\/span><\/h3>\n<ul>\n<li><span class=\"s1\">Age <\/span><\/li>\n<li><span class=\"s1\">Antigen type <\/span><\/li>\n<li><span class=\"s1\">Vaccination history <\/span><\/li>\n<li><span class=\"s1\">Health status<\/span><\/li>\n<li><span class=\"s1\">Genetics <\/span><\/li>\n<li><span class=\"s1\">Maternally-derived antibody (MDA)<\/span><\/li>\n<\/ul>\n<\/div>\n<h2><span class=\"s1\">INDICATIONS FOR ANTIBODY TESTING<\/span><\/h2>\n<p><span class=\"s1\">The following indications apply to antibody tests for CAV-1, CDV, CPV, and FPV because these results correlate well with gold standard testing:<\/span><\/p>\n<p><span class=\"s1\"><b>1. Evaluation of Immune Response Following Initial Administration of Core Vaccines<\/b><\/span><\/p>\n<p><span class=\"s1\">If a client would like to determine whether a young dog\/cat responded to the initial vaccination series (usually 3 doses), in-clinic test kits provide an excellent means of identifying those that did respond versus those that did not and, therefore, remain susceptible.<\/span><\/p>\n<p><span class=\"s1\"><b>2. Management of Infection Among Vaccinates<\/b><\/span><\/p>\n<p><span class=\"s1\">For veterinarians faced with treating confirmed parvovirus infection in a well vaccinated dog or cat, antibody testing can be used to rapidly determine whether the affected animal developed a protective immune response following the initial vaccination series.<\/span><\/p>\n<p><span class=\"s1\">A <i>positive antibody test<\/i> suggests the vaccinated patient was infected during a period of susceptibility (eg, in the presence of MDA). <\/span><\/p>\n<p><span class=\"s1\">Patients with a <i>negative test result<\/i> are likely to be susceptible (genetic) non-responders (or low-responders). <\/span><\/p>\n<p><span class=\"s1\">The antibody test <i>does not<\/i> distinguish vaccine-induced seroconversion from that caused by infection.<\/span><\/p>\n<p><span class=\"s1\"><b>3. Determination of Antibody Level in Lieu of Revaccination<\/b><\/span><\/p>\n<p><span class=\"s1\">For patients with a history of a known, or suspected, serious vaccine adverse event (reaction), evaluating the level of antibody will determine whether the patient has previously developed a protective immune response to vaccination. Patients with a <i>positive test result<\/i> can avoid revaccination and potential risk for an adverse event.<\/span><\/p>\n<p><span class=\"s1\">If, on the other hand, a patient with a history of a serious vaccine adverse event is tested for antibody and has a <i>negative test result<\/i>, the decision whether or not to administer vaccine is more complicated because:<\/span><\/p>\n<ul>\n<li><span class=\"s1\">Among previously vaccinated animals, immune <i>memory<\/i> (B-lymphocytes) can be sustained for many years despite declining antibody levels; exposure to a pathogenic virus (eg, distemper or parvovirus) can result in a rapid and protective anamnestic response. <\/span><\/li>\n<li><span class=\"s1\">Prior history of a vaccine adverse reaction is not predictive of future risk.<\/span><\/li>\n<li><span class=\"s1\">Immunization may not be optional, regardless of the antibody status of the individual (eg, rabies).<\/span><\/li>\n<\/ul>\n<p><span class=\"s1\"><b>4. Assessment of Adult Dogs &amp; Cats with an Unknown Vaccination History<\/b><\/span><\/p>\n<p><span class=\"s1\">Clientele who have adopted an adult dog\/cat that has no known vaccine history may elect to avoid vaccination if a protective level of immunity can be determined serologically.<\/span><\/p>\n<p><span class=\"s1\"><b>5. Antibody Testing in Lieu of Annual Revaccination<\/b><\/span><\/p>\n<p><span class=\"s1\">International guidelines for administration of core vaccines to adult dogs and cats consistently recommend revaccination schedules of no more <i>often<\/i> than every 3 years for core antigens (CAV-1*\/CDV\/CPV and FCV\/FHV\/FPV). However, with regard to rabies vaccination, veterinarians must follow state or local laws.<\/span><\/p>\n<p><span class=\"s1\"><b>6. Management of Infection Risk Among Animals Entering a Shelter<\/b><\/span><\/p>\n<p><span class=\"s1\">Immunization status of young animals presented to animal shelters is often unknown. Because the infection risk among shelter-housed dogs and cats is high, determining antibody status of an animal at time of entry allows vaccination and separation (foster) of animals deemed <i>susceptible<\/i> until a <i>positive<\/i> test result is obtained.<\/span><\/p>\n<p><span class=\"s1\"><b>7. Management of Outbreaks Within an Animal Shelter<\/b><\/span><\/p>\n<p><span class=\"s1\">Antibody test kits offer shelters a management advantage when faced with an infectious disease outbreak involving CDV, CPV, or FPV. Identifying and separating animals with <i>positive<\/i> (protected) test results from those with <i>negative<\/i> (susceptible) results may help avoid unnecessary euthanasia.<\/span><\/p>\n<p><span class=\"s1\">When feasible, susceptible animals should be isolated from the general population, which limits propagation of the outbreak. Isolated, seronegative survivors can be placed or adopted once the incubation period for the infectious agent has passed (2 weeks for CPV and FPV; 6 weeks for CDV).<\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/05\/Screen-Shot-2015-06-24-at-1.44.48-PM.png\"><img decoding=\"async\" class=\"wp-image-5144 size-full aligncenter\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/05\/Screen-Shot-2015-06-24-at-1.44.48-PM.png\" alt=\"Screen Shot 2015-06-24 at 1.44.48 PM\" width=\"567\" height=\"176\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/05\/Screen-Shot-2015-06-24-at-1.44.48-PM.png 567w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/05\/Screen-Shot-2015-06-24-at-1.44.48-PM-300x93.png 300w\" sizes=\"(max-width: 567px) 100vw, 567px\" \/><\/a><\/p>\n<p><em>*All antibody tests detect antibodies against CAV-1; however, the vaccine antigen protects against CAV-2 (a respiratory pathogen), which also cross protects against the more serious, systemic CAV-1 (canine hepatitis virus).<\/em><\/p>\n<h2><span class=\"s1\">INTERPRETATION OF ANTIBODY TEST RESULTS<\/span><\/h2>\n<p><span class=\"s1\">The following interpretations apply to antibody test results for CAV-1*, CDV, CPV, and FPV, reported by a reputable diagnostic laboratory or obtained from an in-clinic test kit:<\/span><\/p>\n<ol class=\"ol1\">\n<li class=\"li1\"><span class=\"s1\">A <b><i>positive<\/i><\/b> antibody test result in an <\/span><span class=\"s3\"><b>unvaccinated, but healthy dog or cat<\/b><\/span><span class=\"s1\"> suggests prior exposure to and recovery from infection; the patient has <b>protective immunity<\/b>.<\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">A <b><i>positive<\/i><\/b> antibody test result in a <\/span><span class=\"s3\"><b>previously vaccinated dog or cat <\/b><\/span><span class=\"s1\">correlates well with <b>protective immunity<\/b>. <\/span><\/li>\n<li class=\"li1\"><span class=\"s1\">A <b><i>negative<\/i><\/b> antibody test result in a <\/span><span class=\"s3\"><b>previously vaccinated dog or cat<\/b><\/span><span class=\"s1\"> must be interpreted on the basis of age and prior vaccination history. <\/span>\n<ul class=\"ul2\">\n<li class=\"li1\"><b><i><\/i><\/b><span class=\"s1\"><b><i>Negative<\/i><\/b> test result in <\/span><span class=\"s3\"><b>protected patient<\/b><\/span><span class=\"s1\">: Over time, antibody levels in a previously vaccinated adult dog or cat that is not revaccinated (or naturally exposed) may fall to <i>negative<\/i> levels. Memory cells (B-lymphocytes), however, can persist longer than antibody. Exposure to virulent virus is expected to rapidly boost the patient&#8217;s antibody response and protect.<\/span><\/li>\n<li class=\"li1\"><b><i><\/i><\/b><span class=\"s1\"><b><i>Negative<\/i><\/b> test result in <\/span><span class=\"s3\"><b>susceptible patient<\/b><\/span><span class=\"s1\">: A puppy or kitten that is antibody <i>negative<\/i> following administration of initial core vaccine series is considered <i>susceptible<\/i> to infection if exposed. These patients may be (genetic) non-responders (or low-responders) or received the vaccine during a period when interfering levels of MDA were present.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<div class=\"orange-box\">\n<p><span class=\"s1\"><b>Core Vaccine Administration &amp; Antibody Testing<\/b><\/span><\/p>\n<ul>\n<li><span class=\"s1\">Current vaccination guidelines recommend administration of the last dose of core vaccines at 14 to 16 weeks of age in puppies and 16 weeks of age in kittens.<\/span><\/li>\n<li><span class=\"s1\">Antibody titers may be determined as early as 2 to 4 weeks following completion of initial vaccination series.<\/span><\/li>\n<li><span class=\"s1\">A puppy or kitten that is seronegative at 18 weeks of age should be revaccinated not less than 2 weeks following the last dose. Antibody testing can then be performed as early as 2 weeks following administration of this last vaccine dose.<\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"orange-box\">\n<h3><span class=\"s1\">Links to Vaccination Guidelines<\/span><\/h3>\n<ul>\n<li><span class=\"s3\"><b>2011 AAHA Canine Vaccination Guidelines:<\/b><\/span><span class=\"s1\"> aahanet.org\/PublicDocuments\/CanineVaccineGuidelines.pdf <\/span><\/li>\n<li><b><\/b><span class=\"s1\"><b>2006 American Association of Feline Practitioners Feline Vaccine Advisory Panel Report:<\/b><\/span><span class=\"s9\"> catvets.com\/uploads\/PDF\/2006VaccinationGuidelines JAVMA.pdf <\/span><\/li>\n<li><b><\/b><span class=\"s1\"><b>2010 WSAVA Guidelines for the Vaccination of Dogs and Cats:<\/b><\/span><span class=\"s9\"> wsava.org\/sites\/default\/files\/VaccinationGuidelines2010.pdf<\/span><\/li>\n<\/ul>\n<\/div>\n<p><span class=\"s1\">CAV = canine adenovirus; CDV = canine distemper; CPV = canine parvovirus; DOI = duration of immunity; FCV = feline calicivirus; FHV = feline herpesvirus; FAVN = fluorescent antibody virus neutralization; FPV = feline parvovirus (panleukopenia); HI = hemagglutination inhibition; Ig = immunoglobulin; MDA = maternally-derived antibody; VN = virus neutralization<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The publication of vaccination guidelines for dogs and cats (see Links to Vaccination Guidelines)\u2014intended to provide useful insights on the selection and use of vaccines\u2014also elicited some degree of controversy regarding implementation of these vaccination recommendations in practice.<\/p>\n","protected":false},"author":1,"featured_media":2748,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":1207,"footnotes":""},"categories":[374],"tags":[13],"class_list":["post-1293","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-may-june-2013","tag-peer-reviewed","clinical_topics-preventive-medicine"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Antibody Titers Versus Vaccination | Today&#039;s Veterinary Practice<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" 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