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| Vital Vaccination: Kennel cough ReVisited today's Veterinary Practice July/August 2014 74 tvpjournal.com Nosodes are not recommended for the treatment or pre- vention of CIRD because: • Values for composition, concentration, and purity of ingredients are not standardized. • Nosodes are not subject to regulatory oversight. • No studies have been published documenting either safety or efficacy. VACCINATION PROTOCOL There is no definition of a universal vaccination protocol applicable to all dogs. In fact, the availability of a diverse selection of vaccines against one or more agents of CIRD (Table 2) continues to raise the questions: • Which vaccines should be administered? • When should vaccines be administered? • At what intervals should vaccines be administered? Core & Noncore Vaccines • Core: Parenteral vaccines against CDV and CAV-2 are considered core and indicated in all dogs. 10 • Noncore: Vaccines for B bronchiseptica, CPiV, and CIV are considered noncore, or optional, and indicated in dogs with known or likely risk for exposure to other dogs, espe- cially in kennels or co-housed environments; most dogs fall into this category. Vaccination is not indicated for dogs with strictly limited, or no, exposure to other dogs. • Note: The canine (enteric) coronavirus vaccine is not effective against the antigenically distinct canine respi- ratory coronavirus. table 2. types of Vaccines available for immunizing dogs against ciRd ANTIGEN(S) PREPARATION INITIAL VACCINATION REVACCINATION (BOOSTER) Parenteral (subcutaneous) B bronchiseptica • 1-ml single dose vial • inactivated, antigen cell extract • 2 doses, 2–4 weeks apart • ≥ 8 weeks of age annual single dose in dogs with sustained risk for exposure a,b CDV + CPiV and CAV-2 • commonly 1-ml dose in combination with cPV • Modified-live virus • 3-dose series recom- mended (initial puppy core vaccination series) • between ≥ 6 weeks of age and 14–16 weeks of age single booster recommended within 1 year of initial 3-dose series; thereafter, triennial vac- cination recommended for all dogs CIV • 1-ml single dose vial • Killed virus • 2 doses, 2–4 weeks apart required regardless of age annual single dose in dogs with sustained risk for expo- sure Intranasal (mucosal) B bronchiseptica • 0.5-ml total volume • attenuated, avirulent bacteria • single dose recommended • ≥ 3 weeks of age Revaccinate annually B bronchiseptica + CPiV • 1 ml total volume c • attenuated, avirulent live bac- teria with modified live virus • single dose recommended • ≥ 3 weeks of age Revaccinate annually B bronchiseptica + CPiV and CAV-2 • 0.5-ml total volume • attenuated, avirulent live bac- teria with modified live virus • single dose recommended • ≥ 3 weeks of age Revaccinate annually Oral (mucosal) B bronchiseptica • 1 ml total volume (the entire dose should be administered at the same time) • attenuated, avirulent live bacteria • single dose recommended • ≥ 8 weeks of age Revaccinate annually a a. Manufacturer recommendation b. duration of immunity studies have not been published c. May be reduced to 0.5 mL total volume by reducing volume of diluent used The overall quality of protection a dog derives from vaccination against CIRD is most likely corre- lated to the route of administration and the number of antigens administered.