VETERINARY VACCINES-KILLED

Classification | Detailed evidence-based information

Substances Included Synonyms

Therapeutic Toxic Class

1) VETERINARY BIOLOGICAL PRODUCTS FOR PASSIVE IMMUNIZATION

a) For additional information about modified live virus vaccines for veterinary use, please see the "VETERINARY VACCINES, LIVE MODIFIED" management. Commonly used killed veterinary vaccines (Plumb, 1989; Kirk, 1986; Kirk, 1989; Talbot, 1990):

    VACCINE TYPE      TYPICAL TRADE  INTENDED  LIVE*
     (INFECTING        NAMES/ MFG.   SPECIES   VACCINE
      ORGANISM)
------------------------------------------------------
A.  BOVI SERA
     (ANTISERUM)       Colo Serum    cattle     N
B.  BOVINE
    RHINOTRACHEITIS    Triangle      cattle     Y
------------------------------------------------------
C.  BOVINE VIRAL
     DIARRHEA          Triangle       cattle     Y
D.  BRUCELLA ABORTUS,
     45/20 BACTERIN       ---          cattle    Y
------------------------------------------------------
E.  BRUCELLA OVIS         ---         sheep      Y
F.  CAMPYLOBACTER
     FOETUS            Colo Serum     cattle     N
------------------------------------------------------
G.  CANINE CORONAVIRUS  Duramune      dogs       N
H.  CHLAMYDIA PSITTACI  Psittacoid    cats,      Y
                          ---         sheep      N
------------------------------------------------------
I.  CLOSTRIDIUM         Fermicon      cattle     N
     CHAVOEI-SEPTICUM
J.  ENCEPHALOMYELITIS,  Cephalovac    horses     Y
     EQUINE
------------------------------------------------------
K.  ERYSIPELAS          Colo Serum    swine      N
L.  FELINE LEUKEMIA     Leukocell     cats       Y
------------------------------------------------------
M.  HEMOPHILUS SOMNUS   Somnubac      cattle     N
N.  INFECTIOUS BURSAL     ---         chickens   Y
     DISEASE
------------------------------------------------------
O.  INFLUENZA, EQUINE   Equi-Flu      horses     N
P.  LEPTOSPIRA          Leptomune 5   dogs,
                                       swine     N
------------------------------------------------------
Q.  LYME DISEASE          ---         dogs       N
R.  NEWCASTLE DISEASE     ---         chickens   Y
S.  PSEUDORABIES        PR Vac        swine      Y
------------------------------------------------------
T.  RABIES              Endurall-K,   dogs, cats Y
                         Imrab,
                         Rabguard,
                         others
U.  RHINOPNEUMONITIS    Pneumabort-K  horses     Y
------------------------------------------------------
V.  SALMONELLA DUBLIN-  Quatricon,    cattle     Y
       TYPHIMURIUM       others
W.  STREPTOCOCCUS EQUI  Equibac       horses     N
------------------------------------------------------
X.  TETANUS             Colo Serum    horses etc N
Y.  WART VACCINE        Haver         cattle     N
*Live Vaccine Also Available

Specific Substances

1) Killed veterinary vaccines
2) Veterinary Vaccines, Killed
3) VACCINES, VETERINARY, KILLED
4) VETERINARY BIOLOGICAL PRODUCTS, KILLED

Available Forms Sources

1) These agents are available from multiple sources. They are usually supplied as single dose or multiple dose vials, sometimes requiring reconstitution or dilution before use.

Overview

Life Support

Clinical Effects

0.2.1)

A) Limited data are available regarding the adverse human effects of most veterinary biological agents. KILLED VACCINES DO NOT CONTAIN INFECTIOUS AGENTS AND CANNOT TRANSMIT INFECTION. Hypersensitivity, local tissue injury, and secondary infection of a wound site are possible.
B) Egg proteins may be found in various vaccines due to propagation in eggs. Egg proteins can be potentially reactive/allergenic.
C) Various antibiotics and preservatives are found in many vaccines, usually in relatively small amounts.
D) Some vaccines may contain thimerosal, an elemental mercury compound used as a preservative. In newborns, administration of thimerosal-containing vaccines has been shown to result in measurable serum mercury levels. The amount of mercury contained in any single dose of a vaccine is unlikely to cause significant adverse effects in a normal healthy adult.

0.2.3)

A) Fever may occur as a result of secondary infection of a wound site. Tachycardia, hypotension, and respiratory distress may occur following anaphylactoid reaction.

0.2.5)

A) Tachycardia and hypotension may be noted as part of a severe hypersensitivity reaction.

0.2.6)

A) Bronchospasm and respiratory distress may be noted as part of a hypersensitivity reaction.

0.2.7)

A) Acute disseminated encephalomyelitis has been reported following exposures to inactivated veterinary vaccines.

0.2.14)

A) Local ischemia and/or dermal manifestations of hypersensitivity have been reported.

0.2.15)

A) OIL ADJUVANT-CONTAINING PRODUCTS - These may cause SEVERE VASOSPASM following injection, sufficient to cause tissue necrosis, particularly when injected into finger pulp or tendon sheaths.
B) ALUM ADJUVANT or ALUMINUM HYDROXIDE ADJUVANT CONTAINING PRODUCTS - An intense dose-related inflammatory reaction may occur in some patients.

0.2.19)

A) Hypersensitivity reactions, both local and systemic, may occur. Serum sickness-like reaction (may be delayed up to 2 weeks) may follow parenteral exposure to animal-derived products.

Laboratory Monitoring

Treatment Overview

0.4.2)

A) Ingestion is unlikely to cause serious toxicity; gastric decontamination is generally not warranted.

0.4.3)

A) Move patient from the toxic environment to fresh air. Monitor for respiratory distress. If cough or difficulty in breathing develops, evaluate for hypoxia, respiratory tract irritation, bronchitis, or pneumonitis.
B) OBSERVATION: Carefully observe patients with inhalation exposure for the development of any systemic signs or symptoms and administer symptomatic treatment as necessary.
C) INITIAL TREATMENT: Administer 100% humidified supplemental oxygen, perform endotracheal intubation and provide assisted ventilation as required. Administer inhaled beta-2 adrenergic agonists, if bronchospasm develops. Consider systemic corticosteroids in patients with significant bronchospasm (National Heart,Lung,and Blood Institute, 2007). Exposed skin and eyes should be flushed with copious amounts of water.

0.4.4)

A) DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.

0.4.5)

A) OVERVIEW

1) Infection and/or sensitization may occur through skin lesions following dermal exposure. Carefully cleanse the area.
2) DECONTAMINATION: Remove contaminated clothing and jewelry and place them in plastic bags. Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).

0.4.6)

A) Treatment should be supportive and directed at existing symptoms. Hypersensitivity reactions may occur. Infection may follow contamination of injection sites.
B) If the injected material contains an OIL ADJUVANT, the patient should receive immediate medical evaluation. If significant vasospasm or a compartment syndrome occurs, incision of the area with intraoperative irrigation of all affected tissue planes has been recommended (CSM, 1987) (a list of some vaccines known, in some types, to contain oil adjuvants appears in Section 3.15).
C) If the injected material contains an ALUM ADJUVANT or ALUMINUM HYDROXIDE ADJUVANT, an intense inflammatory reaction may occur in some patients. Where such a reaction occurs, anti-inflammatory therapy may be desirable, including the oral or parenteral use of non-steroidal antiinflammatory agents (e.g., ibuprofen, naproxen) and/or corticosteroids (e.g. prednisone, methylprednisolone)(A list of some vaccines known to contain alum or aluminum hydroxide adjuvants appears in Section 3.15).

Clinical Effects

Summary Of Exposure

Vital Signs

3.3.1)

A) Fever may occur as a result of secondary infection of a wound site. Tachycardia, hypotension, and respiratory distress may occur following anaphylactoid reaction.

3.3.2)

A) Bronchospasm and/or respiratory distress may occur as part of an anaphylactoid reaction.

3.3.3)

A) Temperature elevation may occur following exposure, either as a result of infection or inflammatory response.

3.3.4)

A) Anaphylactoid reactions might be expected to result in hypotension in some individuals.

3.3.5)

A) Tachycardia might be expected as part of a hypersensitivity reaction.

Heent

3.4.3)

A) Irritation may occur following direct exposure.
B) Conjunctivitis may occur as part of a hypersensitivity response.

Cardiovascular

3.5.1)

A) Tachycardia and hypotension may be noted as part of a severe hypersensitivity reaction.

3.5.2)

A) TACHYARRHYTHMIA

1) Tachycardia and/or hypotension may develop as part of an anaphylactoid response.

Respiratory

3.6.1)

A) Bronchospasm and respiratory distress may be noted as part of a hypersensitivity reaction.

3.6.2)

A) BRONCHOSPASM

1) Bronchospasm and/or respiratory distress may occur as part of an anaphylactoid response.

Neurologic

3.7.1)

A) Acute disseminated encephalomyelitis has been reported following exposures to inactivated veterinary vaccines.

3.7.2)

A) ENCEPHALOMYELITIS

1) Following inadvertent injection of 10 mL of hog vaccine containing pomona bacteria, parvovirus, leptospira and Erysipelothrix rhusiopathiae (Farrow Sure), an acute disseminated encephalomyelitis, an inflammatory demyelinating disease of the central nervous system has been reported (Dodick et al, 1998).

Hematologic

3.13.2)

A) LEUKOCYTOSIS

1) Leukocytosis may be associated with either hypersensitivity reactions or active infection.

Dermatologic

3.14.1)

A) Local ischemia and/or dermal manifestations of hypersensitivity have been reported.

3.14.2)

A) HYPERSENSITIVITY REACTION

1) HYPERSENSITIVITY - Dermal manifestations of hypersensitivity may be noted, including pruritus with hives (Crosby et al, 1986).

B) GENERALIZED EXFOLIATIVE DERMATITIS

1) OIL-ADJUVANT-CONTAINING VACCINES - These products may result in local skin sloughing as well as deep underlying injury (CSM, 1987).

Musculoskeletal

3.15.1)

3.15.2)

A) VASOSPASM

1) OIL-ADJUVANT CONTAINING VACCINES - These products have been reported to "cause intense vascular spasm." This may be so severe that entire digits or tendons may be compromised (CSM, 1987). The injected material itself may result in local pressure build-up particularly after the development of local edema.
2) The following table contains those vaccines ascertained to contain potentially toxic adjuvants to humans. However, not all preparations of these vaccines may contain the listed agent. The package insert should be consulted, when available, to determine the contents of the exact vaccine preparation to which exposure has occurred. The table below is probably not an exhaustive listing, although it contains all relevant information available to us at the time this document was last revised.
3) OIL ADJUVANT -

a) Brucella abortus 45/20 bacterin
b) Brucella ovis
c) Infectious bursal disease
d) Newcastle disease

B) ISCHEMIA

1) WITH POISONING/EXPOSURE

a) Amputation of Digit

1) A 20-year-old herdsman inadvertently injected his fifth digit (proximal interphalangeal joint) with approximately 1 mL under high pressure of combined bovine inactivated vaccine in an oil-based emulsion, and developed increasing swelling and tenderness. Surgical decompression and debridement were required with lipid based fluid removed. IV antibiotic therapy was also started. The incisions were surgically closed 48 hours later and the patient was discharged. Ongoing pain and swelling continued with negative wound cultures, surgical debridement and decompression were repeated. Approximately, one week after the initial injury, necrotic tissue and ischemia around the middle and proximal phalanges of the finger were noted and amputation of the finger at the metacarpophalangeal joint was performed. The patient progressed well following amputation. It was felt that swelling within the flexor tendon sheath caused by the injected oil compromised blood flow to the finger (O'Neill et al, 2005).

C) INJECTION SITE INFLAMMATION

1) ALUM ADJUVANT or ALUMINUM HYDROXIDE CONTAINING VACCINES - These products may cause an intense inflammatory response, particularly at the site of injection. At appropriate doses, this is an intended response resulting in enhanced production of immunity. However, with variation in response between species and between products, an exaggeration of the desired pharmacologic effect of the adjuvant may occur, resulting in toxic effects. Therapy should be directed at reducing the inflammatory response where clinically appropriate. Effective agents may include non-steroidal antiinflammatory agents (such as ibuprofen or naproxen) and corticosteroids (such as prednisone or methylprednisolone).
2) The following table contains those vaccines ascertained to contain potentially toxic adjuvants to humans. However, not all preparations of these vaccines may contain the listed agent. The package insert should be consulted, when available, to determine the contents of the exact vaccine preparation to which exposure has occurred. The table below is probably not an exhaustive listing, although it contains all relevant information available to us at the time this document was last revised.
3) ALUM/ALUMINUM HYDROXIDE ADJUVANT -

a) Campylobacter foetus
b) Clostridium chauvoei/septicum
c) Clostridium hemolytica
d) Encephalomyelitis vaccine
e) Haemophilus somnus
f) Leptospira vaccine for SWINE
g) Salmonella
h) Streptococcus equi

Immunologic

3.19.1)

A) Hypersensitivity reactions, both local and systemic, may occur. Serum sickness-like reaction (may be delayed up to 2 weeks) may follow parenteral exposure to animal-derived products.

3.19.2)

A) ACUTE ALLERGIC REACTION

1) Most veterinary biological products are potential sensitizers. As they are comprised of animal proteins, they may stimulate immunoglobulin production to the contained proteins and thereby set the stage for future hypersensitivity reactions.
2) Many also contain antibiotics and preservatives such as penicillin, streptomycin, gentamicin, amphotericin B, phenol and/or thimerosal (Colorado Serum Co, 1988). Individuals who have already been sensitized to these agents may be at increased risk of hypersensitivity reactions. Others are at risk of becoming sensitized to these agents.
3) Many vaccines are propagated in eggs and, therefore, contain egg proteins. Egg proteins are potentially reactive and allergenic.

Laboratory Monitoring

Monitoring Parameters Levels

4.1.1)

A) No specific laboratory studies have been proven to be of value in the management of most of these agents. Serial titer measurements may serve to document the development of an immune response if it occurs following vaccine exposure.

Treatment

Life Support

Monitoring

Oral Exposure

6.5.1)

A) SUMMARY -

1) Ingestion is unlikely to cause serious toxicity; gastric decontamination is generally not warranted.

6.5.2)

A) ACTIVATED CHARCOAL

1) Activated charcoal is unlikely to be necessary, and is of unproven efficacy following ingestion with these products, but may be used where GI decontamination is felt to be indicated.
2) CHARCOAL ADMINISTRATION

a) Consider administration of activated charcoal after a potentially toxic ingestion (Chyka et al, 2005). Administer charcoal as an aqueous slurry; most effective when administered within one hour of ingestion.

3) CHARCOAL DOSE

a) Use a minimum of 240 milliliters of water per 30 grams charcoal (FDA, 1985). Optimum dose not established; usual dose is 25 to 100 grams in adults and adolescents; 25 to 50 grams in children aged 1 to 12 years (or 0.5 to 1 gram/kilogram body weight) ; and 0.5 to 1 gram/kilogram in infants up to 1 year old (Chyka et al, 2005).

1) Routine use of a cathartic with activated charcoal is NOT recommended as there is no evidence that cathartics reduce drug absorption and cathartics are known to cause adverse effects such as nausea, vomiting, abdominal cramps, electrolyte imbalances and occasionally hypotension (None Listed, 2004).

b) ADVERSE EFFECTS/CONTRAINDICATIONS

1) Complications: emesis, aspiration (Chyka et al, 2005). Aspiration may be complicated by acute respiratory failure, ARDS, bronchiolitis obliterans or chronic lung disease (Golej et al, 2001; Graff et al, 2002; Pollack et al, 1981; Harris & Filandrinos, 1993; Elliot et al, 1989; Rau et al, 1988; Golej et al, 2001; Graff et al, 2002). Refer to the ACTIVATED CHARCOAL/TREATMENT management for further information.
2) Contraindications: unprotected airway (increases risk/severity of aspiration) , nonfunctioning gastrointestinal tract, uncontrolled vomiting, and ingestion of most hydrocarbons (Chyka et al, 2005).

6.5.3)

A) ACUTE ALLERGIC REACTION

1) SUMMARY

a) Mild to moderate allergic reactions may be treated with antihistamines with or without inhaled beta adrenergic agonists, corticosteroids or epinephrine. Treatment of severe anaphylaxis also includes oxygen supplementation, aggressive airway management, epinephrine, ECG monitoring, and IV fluids.

2) BRONCHOSPASM

a) ALBUTEROL

1) ADULT: 2.5 to 5 milligrams in 2 to 4.5 milliliters of normal saline delivered per nebulizer every 20 minutes up to 3 doses. If incomplete response administer 2.5 to 10 mg every 1 to 4 hours as needed, or 10 to 15 mg/hr by continuous nebulization as needed (National Heart,Lung,and Blood Institute, 2007). CHILD: 0.15 milligram/kilogram (minimum 2.5 milligrams) per nebulizer every 20 minutes up to 3 doses. If incomplete response administer 0.15 to 0.3 mg/kg (up to 10 mg) every 1 to 4 hours as needed, or 0.5 mg/kg/hr by continuous nebulization (National Heart,Lung,and Blood Institute, 2007).

3) CORTICOSTEROIDS

a) Consider systemic corticosteroids in patients with significant bronchospasm.
b) PREDNISONE: ADULT: 40 to 80 milligrams/day. CHILD: 1 to 2 milligrams/kilogram/day (maximum 60 mg) in 1 to 2 divided doses divided twice daily (National Heart,Lung,and Blood Institute, 2007).

4) MILD CASES

a) DIPHENHYDRAMINE

1) SUMMARY: Oral diphenhydramine, as well as other H1 antihistamines can be used as indicated (Lieberman et al, 2010).
2) ADULT: 50 milligrams orally, or 10 to 50 mg intravenously at a rate not to exceed 25 mg/min or may be given by deep intramuscular injection. A total of 100 mg may be administered if needed. Maximum daily dosage is 400 mg (Prod Info diphenhydramine HCl intravenous injection solution, intramuscular injection solution, 2013).
3) CHILD: 5 mg/kg/24 hours or 150 mg/m(2)/24 hours. Divided into 4 doses, administered intravenously at a rate not exceeding 25 mg/min or by deep intramuscular injection. Maximum daily dosage is 300 mg (Prod Info diphenhydramine HCl intravenous injection solution, intramuscular injection solution, 2013).

5) MODERATE CASES

a) EPINEPHRINE: INJECTABLE SOLUTION: It should be administered early in patients by IM injection. Using a 1:1000 (1 mg/mL) solution of epinephrine. Initial Dose: 0.01 mg/kg intramuscularly with a maximum dose of 0.5 mg in adults and 0.3 mg in children. The dose may be repeated every 5 to 15 minutes, if no clinical improvement. Most patients respond to 1 or 2 doses (Nowak & Macias, 2014).

6) SEVERE CASES

a) EPINEPHRINE

1) INTRAVENOUS BOLUS: ADULT: 1 mg intravenously as a 1:10,000 (0.1 mg/mL) solution; CHILD: 0.01 mL/kg intravenously to a maximum single dose of 1 mg given as a 1:10,000 (0.1 mg/mL) solution. It can be repeated every 3 to 5 minutes as needed. The dose can also be given by the intraosseous route if IV access cannot be established (Lieberman et al, 2015). ALTERNATIVE ROUTE: ENDOTRACHEAL ADMINISTRATION: If IV/IO access is unavailable. DOSE: ADULT: Administer 2 to 2.5 mg of 1:1000 (1 mg/mL) solution diluted in 5 to 10 mL of sterile water via endotracheal tube. CHILD: DOSE: 0.1 mg/kg to a maximum of 2.5 mg administered as a 1:1000 (1 mg/mL) solution diluted in 5 to 10 mL of sterile water via endotracheal tube (Lieberman et al, 2015).
2) INTRAVENOUS INFUSION: Intravenous administration may be considered in patients poorly responsive to IM or SubQ epinephrine. An epinephrine infusion may be prepared by adding 1 mg (1 mL of 1:1000 (1 mg/mL) solution) to 250 mL D5W, yielding a concentration of 4 mcg/mL, and infuse this solution IV at a rate of 1 mcg/min to 10 mcg/min (maximum rate). CHILD: A dosage of 0.01 mg/kg (0.1 mL/kg of a 1:10,000 (0.1 mg/mL) solution up to 10 mcg/min (maximum dose 0.3 mg) is recommended for children (Lieberman et al, 2010). Careful titration of a continuous infusion of IV epinephrine, based on the severity of the reaction, along with a crystalloid infusion can be considered in the treatment of anaphylactic shock. It appears to be a reasonable alternative to IV boluses, if the patient is not in cardiac arrest (Vanden Hoek,TL,et al).

7) AIRWAY MANAGEMENT

a) OXYGEN: 5 to 10 liters/minute via high flow mask.
b) INTUBATION: Perform early if any stridor or signs of airway obstruction.
c) CRICOTHYROTOMY: Use if unable to intubate with complete airway obstruction (Vanden Hoek,TL,et al).
d) BRONCHODILATORS are recommended for mild to severe bronchospasm.
e) ALBUTEROL: ADULT: 2.5 to 5 milligrams in 2 to 4.5 milliliters of normal saline delivered per nebulizer every 20 minutes up to 3 doses. If incomplete response administer 2.5 to 10 mg every 1 to 4 hours as needed, or 10 to 15 mg/hr by continuous nebulization as needed (National Heart,Lung,and Blood Institute, 2007).
f) ALBUTEROL: CHILD: 0.15 milligram/kilogram (minimum 2.5 milligrams) per nebulizer every 20 minutes up to 3 doses. If incomplete response administer 0.15 to 0.3 milligram/kilogram (maximum 10 milligrams) every 1 to 4 hours as needed OR administer 0.5 mg/kg/hr by continuous nebulization (National Heart,Lung,and Blood Institute, 2007).

8) MONITORING

a) CARDIAC MONITOR: All complicated cases.
b) IV ACCESS: Routine in all complicated cases.

9) HYPOTENSION

a) If hypotensive give 500 to 2000 milliliters crystalloid initially (20 milliliters/kilogram in children) and titrate to desired effect (stabilization of vital signs, mentation, urine output); adults may require up to 6 to 10 L/24 hours. Central venous or pulmonary artery pressure monitoring is recommended in patients with persistent hypotension.

1) VASOPRESSORS: Should be used in refractory cases unresponsive to repeated doses of epinephrine and after vigorous intravenous crystalloid rehydration (Lieberman et al, 2010).
2) DOPAMINE: Initial Dose: 2 to 20 micrograms/kilogram/minute intravenously; titrate to maintain systolic blood pressure greater than 90 mm Hg (Lieberman et al, 2010).

10) H1 and H2 ANTIHISTAMINES

a) SUMMARY: Antihistamines are second-line therapy and are used as supportive therapy and should not be used in place of epinephrine (Lieberman et al, 2010).

1) DIPHENHYDRAMINE: ADULT: 25 to 50 milligrams via a slow intravenous infusion or IM. PEDIATRIC: 1 milligram/kilogram via slow intravenous infusion or IM up to 50 mg in children (Lieberman et al, 2010).

b) RANITIDINE: ADULT: 1 mg/kg parenterally; CHILD: 12.5 to 50 mg parenterally. If the intravenous route is used, ranitidine should be infused over 10 to 15 minutes or diluted in 5% dextrose to a volume of 20 mL and injected over 5 minutes (Lieberman et al, 2010).
c) Oral diphenhydramine, as well as other H1 antihistamines, can also be used as indicated (Lieberman et al, 2010).

11) DYSRHYTHMIAS

a) Dysrhythmias and cardiac dysfunction may occur primarily or iatrogenically as a result of pharmacologic treatment (epinephrine) (Vanden Hoek,TL,et al). Monitor and correct serum electrolytes, oxygenation and tissue perfusion. Treat with antiarrhythmic agents as indicated.

12) OTHER THERAPIES

a) There have been a few reports of patients with anaphylaxis, with or without cardiac arrest, that have responded to vasopressin therapy that did not respond to standard therapy. Although there are no randomized controlled trials, other alternative vasoactive therapies (ie, vasopressin, norepinephrine, methoxamine, and metaraminol) may be considered in patients in cardiac arrest secondary to anaphylaxis that do not respond to epinephrine (Vanden Hoek,TL,et al).

B) SUPPORT

1) Treatment should be supportive and directed at observed symptoms and abnormalities.

Inhalation Exposure

6.7.1)

A) Terminate exposure as soon as possible.
B) Move patient from the toxic environment to fresh air. Monitor for respiratory distress. If cough or difficulty in breathing develops, evaluate for hypoxia, respiratory tract irritation, bronchitis, or pneumonitis.
C) OBSERVATION: Carefully observe patients with inhalation exposure for the development of any systemic signs or symptoms and administer symptomatic treatment as necessary.
D) INITIAL TREATMENT: Administer 100% humidified supplemental oxygen, perform endotracheal intubation and provide assisted ventilation as required. Administer inhaled beta-2 adrenergic agonists, if bronchospasm develops. Consider systemic corticosteroids in patients with significant bronchospasm (National Heart,Lung,and Blood Institute, 2007). Exposed skin and eyes should be flushed with copious amounts of water.

6.7.2)

A) ACUTE ALLERGIC REACTION

1) Hypersensitivity reactions may occur following inhalation of foreign proteins, particularly in sensitized individuals. Treatment with corticosteroids, diphenhydramine, and/or epinephrine, as clinically appropriate, should be employed when these occur. Refer to the section on Hypersensitivity Reactions for further details.

B) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Eye Exposure

6.8.1)

A) EYE IRRIGATION, ROUTINE: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, an ophthalmologic examination should be performed (Peate, 2007; Naradzay & Barish, 2006).

6.8.2)

A) ACUTE ALLERGIC REACTION

1) Hypersensitivity reaction may occur following conjunctival contact with foreign substances. Local treatment and/or systemic treatment as detailed above should be employed as clinically appropriate.

B) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Dermal Exposure

6.9.1)

A) DERMAL DECONTAMINATION

1) Careful cleansing of the area is warranted. Where transdermal puncture wounds may have occurred, consider tetanus prophylaxis.
2) DECONTAMINATION: Remove contaminated clothing and wash exposed area thoroughly with soap and water for 10 to 15 minutes. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).

6.9.2)

A) ACUTE ALLERGIC REACTION

1) Hypersensitivity reactions may develop. If so, topical and/or systemic therapy with epinephrine, corticosteroids, and/or diphenhydramine should be employed as clinically appropriate. Refer to the section on Hypersensitivity Reactions for further details.

B) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Abstracts

Case Reports

1) CASE REPORT - Acute disseminated encephalomyelitis was reported in a 52-year-old man 4 weeks after the accidental injection of 10 mL of a hog vaccine containing pomona bacteria, parvovirus, leptospira and Erysipelothrix rhusiopathiae (Farrow Sure). The patient developed a rapidly progressive encephalopathy unresponsive to prednisone. Brain biopsy revealed perivascular demyelination with histiocytes, lymphocytes, and gliosis. The patient later recovered after multiple sessions of plasmapheresis (Dodick et al, 1998). Permanent sequelae included impaired memory, learning, concentration, reasoning and problem solving and emotional lability.

Range Of Toxicity

Therapeutic Dose

7.2.1)

A) GENERAL

1) Insufficient information exists to determine the human therapeutic or toxic doses of these agents.

Pharmacology Toxicology

Pharmacologic Mechanism

Toxicologic Mechanism

Physicochemical

Animal Toxicology

Clinical Effects

11.1.1)

A) POULTRY

1) INFECTIOUS BURSAL DISEASE -

a) VACCINES AVAILABLE/ZOONOTIC - Not zoonotic; inactivated vaccine available
b) SPECIES USED IN - Chickens
c) TRANSMISSION/OCCURRENCE - Contact with infected material
d) ADVERSE EFFECTS OF VACCINE - Unknown; killed vaccine is in oil adjuvant and may cause local reaction

2) NEWCASTLE DISEASE -

a) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; live culture vaccine available, which is pathogenic for humans (Schnurrenberger & Hubbert, 1981); inactivated vaccine also available
b) SPECIES USED IN - Chicken
c) TRANSMISSION/OCCURRENCE - Inhalation; ingestion; conjunctival contact of secretions
d) ADVERSE EFFECTS OF VACCINE - Killed vaccine is in oil adjuvant and may cause local reaction. 25% of a large herd of turkey hens had severe granulomatous lesions on their legs at slaughter after vaccination with oil adjuvant vaccine 15 weeks before (Swarbrick, 1991).

11.1.2)

A) BOVINE VIRAL DIARRHEA/BVD -

1) VACCINES AVAILABLE/ZOONOTIC - Not zoonotic
2) SPECIES USED IN - Cattle
3) TRANSMISSION/OCCURRENCE - Direct contact
4) ADVERSE EFFECTS OF VACCINE - Unknown; some of these vaccines contain heavy adjuvants that may cause a local reaction.

B) CAMPYLOBACTER -

1) VACCINES AVAILABLE/ZOONOTIC - Killed bacterin available for C. foetus; may be zoonotic
2) SPECIES USED IN - Cattle
3) TRANSMISSION/OCCURRENCE - Ingestion of contaminated feed or water; transplacental to fetus
4) ADVERSE EFFECTS OF VACCINE - Unknown; contains alum precipitate which may cause local reaction.

C) CLOSTRIDIUM CHAUVEOI/SEPTICUM -

1) VACCINES AVAILABLE/ZOONOTIC - Bacterin and toxoid available; may be zoonotic
2) SPECIES USED IN - Juvenile cattle, sheep
3) TRANSMISSION/OCCURRENCE - Wound in contact with spores from soil, dust, intestinal contents, contaminated vehicle (such as a penetrating nail, etc)
4) ADVERSE EFFECTS OF VACCINE - Unknown; contains alum precipitate which may cause local reaction.

D) HEMOPHILUS SOMNUS -

1) VACCINES AVAILABLE/ZOONOTIC - Killed bacterin available; not zoonotic
2) SPECIES USED IN - Cattle
3) TRANSMISSION/OCCURRENCE - Direct contact
4) ADVERSE EFFECTS OF VACCINE - Unknown; killed bacterin contains aluminum hydroxide which may cause local reaction.

E) INFECTIOUS BOVINE RHINOTRACHEITIS -

1) VACCINES AVAILABLE/ZOONOTIC - Not zoonotic; killed vaccine available
2) SPECIES USED IN - Cattle
3) TRANSMISSION/OCCURRENCE - Direct contact
4) ADVERSE EFFECTS OF VACCINE - Unknown

F) SALMONELLA -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; killed bacterin and bovine-origin antiserum are available.
2) SPECIES USED IN - Juvenile cattle
3) TRANSMISSION/OCCURRENCE - Fecal/oral; carrier states are common; has a wide host range; occasionally spread by arthropod mechanical vectors
4) ADVERSE EFFECTS OF VACCINE - Unknown; killed bacterin contains alum-precipitated cultures which may cause local reaction.

G) WART VACCINE -

1) VACCINES AVAILABLE/ZOONOTIC - Killed vaccine of bovine origin; probably not zoonotic
2) SPECIES USED IN - Cattle
3) TRANSMISSION/OCCURRENCE - Direct contact
4) ADVERSE EFFECTS OF VACCINE - Unknown

11.1.3)

A) CANINE CORONAVIRUS -

1) VACCINES AVAILABLE/ZOONOTIC - Probably not zoonotic
2) SPECIES USED IN - Dogs
3) TRANSMISSION/OCCURRENCE - Fecal/oral
4) ADVERSE EFFECTS OF VACCINE - Unknown

B) LEPTOSPIROSIS -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; killed bacterin available
2) SPECIES USED IN - Dogs, swine
3) TRANSMISSION/OCCURRENCE - Contact with infected urine or directly; penetrates mucous membranes and abraded skin; venereal in swine
4) ADVERSE EFFECTS OF VACCINE - Unknown; killed bacterin is in oil adjuvant and may cause local reaction.

C) LYME DISEASE -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic. Killed bacterin available
2) SPECIES USED IN - Approved for use only in dogs
3) TRANSMISSION/OCCURRENCE - Vector tick Ixodes family; horses, dogs, deer mice reservoirs
4) ADVERSE EFFECTS OF VACCINE - There is no evidence of direct Lyme disease transmission between domestic animals and their owners (Greene, 1991). There have been no immune-mediated reactions reported with the bacterin (Mansfield, 1996).

D) RABIES -

a) Focal necrotizing granulomatous panniculitis has been associated with subcutaneous injection of rabies vaccine in dogs and cats (Hendrick & Dunagan, 1991).
b) Post-vaccinal encephalitis has not been reported with killed rabies vaccine.

11.1.5)

A) EQUINE ENCEPHALOMYELITIS -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; killed vaccine combination of Eastern, Western, and Venezualan forms available
2) SPECIES USED IN - Horses
3) TRANSMISSION/OCCURRENCE - Spread by arthropod vector after feeding on reservoir host
4) ADVERSE EFFECTS OF VACCINE - Unknown; some vaccines are adjuvanted with aluminum hydroxide and may cause local reaction.

B) INFLUENZA -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; killed vaccine available
2) SPECIES USED IN - Horses
3) TRANSMISSION/OCCURRENCE - Inhalation; usually species-specific; isolated transmissions from swine to humans and human to dog
4) ADVERSE EFFECTS OF VACCINE - Unknown; killed vaccines may contain aluminum phosphate which may cause local reaction.

C) RHINOPNEUMONITIS -

1) VACCINES AVAILABLE/ZOONOTIC - Not zoonotic
2) SPECIES USED IN - Horses
3) TRANSMISSION/OCCURRENCE - Contact with contaminated material
4) ADVERSE EFFECTS OF VACCINE - Unknown

D) STRANGLES/STREPTOCOCCUS EQUI -

1) VACCINES AVAILABLE/ZOONOTIC - Killed bacterin available; probably not zoonotic
2) SPECIES USED IN - Horses
3) TRANSMISSION/OCCURRENCE - Inhalation, direct contact, ingestion
4) ADVERSE EFFECTS OF VACCINE - Some bacterins contain aluminum hydroxide gel which have caused local irritation and occasional abscesses.

E) TETANUS -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; toxoid and antitoxin are available
2) SPECIES USED IN - Horses; occasionally cattle, sheep, swine
3) TRANSMISSION/OCCURRENCE - Wound contamination by C. tetani spores from soil or human or herbivore waste
4) ADVERSE EFFECTS OF VACCINE - Unknown

11.1.6)

A) FELINE LEUKEMIA -

1) VACCINES AVAILABLE/ZOONOTIC - Not zoonotic. Retrovirus from same family as HIV; killed vaccine only
2) SPECIES USED IN - Cats only
3) TRANSMISSION/OCCURRENCE - Transmitted via saliva, blood, and sexual contact between cats
4) ADVERSE EFFECTS OF VACCINE - focal necrotizing granulomatous panniculitis has been associated with subcutaneous injection of feline leukemia vaccine for cats. It has been suggested that vaccine-associated fibrosarcomas may have this as its cause. Incidence of fibrosarcoma is 10 to 12 cases per 100,000 feline leukemia or rabies vaccines given (Fox, 1995).

B) RABIES -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; modified live and killed vaccines available
2) SPECIES USED IN - Dogs and cats
3) TRANSMISSION/OCCURRENCE - Bite or contamination of fresh wound with saliva of infected animal
4) ADVERSE EFFECTS OF VACCINE - Focal necrotizing granulomatous panniculitis has been associated with subcutaneous injection of rabies vaccine in dogs and cats (Hendrick & Dunagan, 1991). It has been suggested that vaccine-associated fibrosarcomas may have have this as its cause. Incidence of fibrosarcoma is 10 to 12 cases per 100,00 feline leukemia or rabies vaccines given (Fox, 1995).

C) RINGWORM/MICROSPORUM CANIS

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; killed vaccine available.
2) SPECIES USED IN - Cats
3) TRANSMISSION/OCCURRENCE - Direct contact with infected animal or person may be be carried on formites (bedding/grooming supplies).
4) ADVERSE EFFECTS OF VACCINE - A small percentage of post-vaccinal reactions have been observed, including swelling or transient nodules, temporary alopecia, and soreness at the injection site. All post-vaccinal reactions were transient in lab and field safety studies (Fort Dodge Laboratories, 1994).

11.1.9)

A) BRUCELLA OVIS -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; killed bacterin is available in New Zealand
2) SPECIES USED IN - Sheep
3) TRANSMISSION/OCCURRENCE - Direct contact
4) ADVERSE EFFECTS OF VACCINE - Contains oil adjuvant which may cause local reaction

B) CHLAMYDIA -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; modified live vaccine available. Killed vaccine is used in sheep.
2) SPECIES USED IN - Cats, sheep
3) TRANSMISSION/OCCURRENCE - One human case of chlamydiosis has been associated with feline pneumonitis (Schnurrenberger & Hubbert, 1981), but not with the bacterin.
4) ADVERSE EFFECTS OF VACCINE - Unknown

11.1.10)

A) ERYSIPELAS -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; inactivated bacterin available
2) SPECIES USED IN - Swine
3) TRANSMISSION/OCCURRENCE - Contact with infected material
4) ADVERSE EFFECTS OF VACCINE - Unknown

B) LEPTOSPIROSIS -

C) PSEUDORABIES -

1) VACCINES AVAILABLE/ZOONOTIC - Not zoonotic. Killed vaccine available
2) SPECIES USED IN - Swine
3) TRANSMISSION/OCCURRENCE - Direct contact
4) ADVERSE EFFECTS OF VACCINE - Unknown

11.1.13)

A) OTHER

1) FERRETS -

a) RABIES -

1) VACCINES AVAILABLE/ZOONOTIC - Zoonotic; killed vaccine Imrab 3 is available from Rhone Merieux for annual subcutaneous vaccine in ferrets
2) SPECIES USED IN - Dogs, cats, and ferrets
3) TRANSMISSION/OCCURRENCE - Bite or contamination of fresh wound with saliva of infected animal
4) ADVERSE EFFECTS OF VACCINE - Unknown

Treatment

11.2.1)

A) GENERAL TREATMENT

1) Begin treatment immediately.
2) Remove the patient and other animals from the source of contamination.
3) ANAPHYLAXIS - The use of any biological, such as vaccines, may cause an anaphylactoid reaction. Vaccines should not be administered outside of a medical environment unless the necessary supportive care and equipment is immediately available.

a) Mild cases (urticaria only) may be treated with antihistamines, with or without epinephrine. Treatment of severe cases includes oxygen supplementation, aggressive airway management (may need intubation), epinephrine, EKG monitoring, and IV fluids (if hypotensive).

4) Treatment should always be done on the advice and with the consultation of a veterinarian. Additional information regarding treatment of poisoned animals may be obtained from a Board Certified (ABVT) Veterinary Toxicologist (check with nearest veterinary school or veterinary diagnostic laboratory) or the National Animal Poison Control Center.
5) ANIMAL POISON CONTROL CENTERS

a) ASPCA Animal Poison Control Center, An Allied Agency of the University of Illinois, 1717 S. Philo Rd, Suite 36, Urbana, IL 61802, website www.aspca.org/apcc
b) It is an emergency telephone service which provides toxicology information to veterinarians, animal owners, universities, extension personnel and poison center staff for a fee. A veterinary toxicologist is available for consultation.
c) The following 24-hour phone number is available: (888) 426-4435. A fee may apply. Please inquire with the poison center. The agency will make follow-up calls as needed in critical cases at no extra charge.

11.2.2)

A) GENERAL

1) MAINTAIN VITAL FUNCTIONS: Secure airway, supply oxygen, and begin supportive fluid therapy if necessary.

11.2.5)

A) GENERAL TREATMENT

1) ANAPHYLAXIS -

a) AIRWAY - Maintain a patent airway via endotracheal tube or tracheostomy.
b) EPINEPHRINE - For severe reactions. DOGS: 0.5 to 1 milliliter of 1:10,000 (DILUTE) solution intravenously or subcutaneously; CATS: 0.5 ml of 1:10,000 (DILUTE) solution intravenously or intramuscularly. Be sure to dilute epinephrine from the bottle (1:1000) one part to 9 parts saline to obtain the correct concentration (1:10,000). If indicated, dose may be repeated in 20 minutes.
c) FLUID THERAPY - If necessary, begin fluid therapy at maintenance doses (66 milliliters solution/kilogram body weight/day intravenously) or, in hypotensive patients, at high doses (up to shock dose 60 milliliters/kilogram/hour). Monitor for urine production and pulmonary edema.
d) ANTIHISTAMINES/STEROIDS - Administer doxylamine succinate (1 to 2.2 milligrams/kilogram subcutaneously or intramuscularly every 8 to 12 hours), dexamethasone sodium phosphate (1 to 5 milligram/kilogram intravenously every 12 to 24 hours), or prednisolone (1 to 5 milligram/kilogram intravenously every 1 to 6 hours). Diphenhydrinate may also be used in dogs and cats at a dose of 0.5 mg/kg PO every 8 hours.

2) LOCAL REACTIONS -

a) Treat symptomatically. Permanent scarring may occur.
b) Food animal carcasses or parts thereof may be condemned at slaughter.

Continuing Care

11.4.1)

11.4.1.2) DECONTAMINATION/TREATMENT

A) GENERAL TREATMENT

Kinetics

11.5.1)

A) GENERAL

1) Animal kinetics vary depending on the preparation and the animal species involved.

References

General Bibliography

10)

11)

12)

13)

14)

15)

16)

17)

18)

19)

20)

21)

22)

23)

24)

25)

26)

27)

28)

29)

30)

31)

32)

33)

FeedBack

VETERINARY VACCINES-KILLED

Classification | Detailed evidence-based information

Therapeutic Toxic Class

Specific Substances

Available Forms Sources

Life Support

Clinical Effects

Laboratory Monitoring

Treatment Overview

Summary Of Exposure

Vital Signs

Heent

Cardiovascular

Respiratory

Neurologic

Hematologic

Dermatologic

Musculoskeletal

Immunologic

Monitoring Parameters Levels

Life Support

Monitoring

Oral Exposure

Inhalation Exposure

Eye Exposure

Dermal Exposure

Case Reports

Therapeutic Dose

Pharmacologic Mechanism

Toxicologic Mechanism

Clinical Effects

Treatment

Continuing Care

Kinetics

General Bibliography