The other day I happened to be standing behind the front desk at the hospital, waiting to speak with one of the receptionists. It was pretty quiet, as morning appointments were finished, and surgeries were not yet started. One of our supply distributor representatives came in, along with a drug company rep who I have known for many years (and through her work with multiple companies). Both of them are wonderful people, with a great deal of experience and knowledge of the veterinary industry. After catching up for a few minutes, they began to talk about why they were stopping in. In other words, they began doing their jobs.
Drug and supplier reps are often very helpful to veterinarians. They keep us aware of new products and services, and let us know when drugs are going to in short supply or when prices are going up. If we unexpectedly run out of something we need they will move mountains to get it to us, even if it means driving it over from a warehouse in another state. Many have helped us with equipment repairs or loaner units if something has to be sent off for service. I love my reps, so what I am about to share must not be taken as a criticism of them.
As our conversation continued, my reps asked, do we use a 3 year vaccine protocol at the hospital? Of course we do, this is the current standard of all the veterinary colleges and veterinary organizations. I also added that I do titers, and other extended protocols. The reps wondered about vaccinating for leptospirosis and Lyme. I explained I am not personally in favor of lepto vaccines, and am disappointed in the efficacy of most Lyme vaccines. I also shared some of my observations and personal experiences with reactions. Things went a bit downhill from there — discussion about the need for yearly lepto and Lyme vaccines, lepto’s zoonotic potential (keeping in mind that the vast majority of human cases of lepto are in Hawaii), how “smooth” and “reaction free” the new lepto/Lyme combination vaccine was, and more. Note that it was never mentioned that there are over 253 serovars (strains) of lepto, and vaccines protect against only three or four. Or that vaccination does not prevent infection, but rather lessens the severity. Lepto vaccination also does not stop shedding of bacteria in the urine, meaning it doesn’t protect humans. I was saddened as I saw the reps’ faces and realized they did not know more about the products they were promoting than their companies had told them. I expect it’s about the same for those selling cars, household appliances, or vacuums.
And then it hit me — the reps, who knew me but obviously not my philosophy of practice, and the big drug companies they worked for, were treating me like a vaccine salesman, not a veterinarian. Selling me a product that I could in turn sell to my clients, each year. Now I did not spend ten years at Cornell and over a hundred thousand dollars in student loans to spend my days pumping vaccines into dogs. I want to use my knowledge, experience, and skills to solve health problems. Or better yet prevent them. Which in many cases means NOT giving vaccines. Why? Either the dog is either already protected, not at risk for the disease, the disease poses no significant risk, or the vaccine is not very effective. Vaccines are not why I became a veterinarian — in fact, I often cringe when I have to pull a vaccine out of the refrigerator. But the most common reason an owner brings a dog to a veterinary hospital is they got a postcard in the mail that he was due for a “shot.” And the first thing most veterinarians look at when they review the medical record of their next appointment — what vaccines is the dog due for? Do veterinarians not see how they are not putting their patients’ health first when they look to the vaccines before anything else? Or have we just become creatures of habit that go from one appointment to the next, doing what is dictated by the computer generated reminders in our patients’ records?
I am not anti-vaccine. I support the thoughtful and careful use of vaccines, as supported by the latest (and sometimes the older — let’s face it, we’ve known the distemper parvo vaccines lasts 7-15 years since 1998) research. I advocate all the things we can do to promote health in our pets, from species appropriate nutrition to regular health testing to the best integrative (conventional and alternative) medicine has to offer. From acupuncture to MRI’s, herbs and supplements to the latest cancer drugs, physical therapy to laparoscopic surgery, veterinarians can do so much more than “give a shot.” It’s time that was recognized, and put into action FIRST by all of us. Otherwise, we ARE just vaccine salesmen.