Vaccination Safety Tips

As a holistic veterinarian, many of my patients (horses, dogs, cats) come to me because their caregivers want my help with vaccination plans. Vaccination plans need to be individualized based on environment, medical issues and past response to vaccination.
Environmental issues include: 
exposure to ticks, mosquitoes and other disease carrying insects
weather conditions (summer vs. winter)
travel plans or exposure to other animals who travel (e.g. shows, events, or dog parks vs animals that don’t go anywhere)
Medical issues:
veterinary vaccines are labelled for use in healthy animals only. This means we cannot vaccinate animals who are acutely ill. Special considerations need to be made for animals with chronic illnesses such as Cushings disease, Lyme disease, diabetes, asthma, COPD, skin conditions, cancer, etcetera.
Past response to vaccination—3 categories
1) Individuals that have had vaccine reactions (swelling, stiffness, lethargy, mild colic, low-grade fever) or other immune system problems: It is especially important for these patients to have minimal vaccines while still maintaining protection against fatal diseases. Rabies vaccine is legally required for dogs and cats. 
2) Individuals that have had life-threatening vaccine reactions (trouble breathing, wheezing, abnormal coughing, vomiting, diarrhea, seizures, hives, delayed reaction autoimmune issues, collapse) or severe immune system problems: These few individuals should not be vaccinated at all with the vaccine that caused the reaction. 
3) Individuals that have never had a problem with vaccines: Considerations can be made to prevent them from developing problems.
Basic recommendations for anyone getting vaccines:
Make sure animal is not acutely ill. Postpone vaccines if animal is lethargic, has respiratory symptoms (nasal discharge/cough), loose manure/stool, etcetera.
Postpone vaccinations when female animal is in heat. Pregnant animals and babies require special vaccine protocols. 
Separate vaccines from each other as much as possible. It is best to not give them all at one time. Giving them all together is overstimulating for the immune system. This makes reactions more likely, and if a reaction occurs, we won’t know which vaccine caused the reaction. Separate administration of vaccines by at least 2 weeks. 
I recommend having a veterinarian administer the vaccines. They can make individualized recommendation and will be available to help if your horse has a reaction. If you are administering the vaccines yourself, I recommend buying the vaccine from a veterinarian. Our distributors know how to ship and store vaccines properly, and so do we. I would not count on an employee of a big box store to realize that there is a problem if they are unpacking a box of vaccine from shipping and it is warm or frozen….
Consider doing vaccine titers to check status of immunity rather than just vaccinating for everything every year. This allows us to minimize the number of vaccines given while making sure the animal has needed protection. This is really a must for animals that have had a reaction or have chronic illness. This is also beneficial for healthy animals to prevent future vaccine reactions, hyperactive immune system problems and autoimmune issues.