It has come to my attention (and no doubt, the attention of the pet owners and the veterinary community at large) that there are an awful lot of horror stories circulating online regarding the safety – or apparent lack thereof – of Nobivac’s Lepto 4 vaccine, as well as canine vaccinations in general.
Now, just to make it clear from the start, I’m in no way affiliated with Nobivac (who make the Lepto 4 vaccine), or with their parent company Merck Animal Health USA. Nor am I affiliated with any other vaccine manufacturer.
And, as a vet who’s actively trying to move away from clinical practice into full-time freelance writing, I don’t have any reason to lie to you.
My 5-year-plan is to be earning a living writing, not vetting. So y’all aren’t paying my salary, if you vaccinate your dog.
Not that you were before either, to be fair; vets don’t work on commission. I get paid the same wage either way.
So yeah – before you come for me in the comments section, just be aware that I’m going into this post entirely with an open mind, and really so should you.
I’ll be entirely fair whilst remaining – as always on VeryRealVet – brutally honest.
Now, it would be humanly impossible for me to collate and unpick all of the anti-vacc and anti-L4 content out there. So, I’ve decided to choose just one source to investigate: the arguably most reputable anti-vacc source.
The creme-de-la-creme of anti-vacc community: the Canine Health Concern survey results. The results of this large-scale survey were initially published in 1996, later extensively added to, and an initial scanning of the results seems to raise some very scary-sounding concerns about vaccinating dogs.
You can find it here:
I want to see how the results of this study tie in to the extensive animal health and medical knowledge I already have as a vet; what matches, what doesn’t match. What’s got a basis in fact, and what might be unfounded. After all, this blog prides fact, truth and evidence above all else.
I’ll give credit where it’s due, but I’m also not above calling out bullshit when I see it.
I have shortened CHC’s publication down to it’s key points, solely because it was more than 15 pages of teeny tiny font on Google Docs, and I have a life offline. Please rest assured though, that I have not selectively edited it to try and make it appear any more or less legit. That’s not how I roll.
Let’s get started.
Unwrapping Canine Health Concern’s “Study”
FYI – The reason I have put bendy fingers around “study”, is that really, the process CHC went through would be more accurately described as a survey; actually, they themselves use “survey” rather than study to define their data.
The reason I hesitate to use the term study, is that there were a few intrinsic biases, as well as a lack of control group here. You certainly could use the term study if you wanted. But you’d be using it fairly loosely.
What they said:
‘A questionnaire was devised with the help of Christopher Day, Jean Dodds DVM, and Dr Viera Scheibner. Some 30,000 readers of Dog World magazine were invited to participate:…In addition, all members of Canine Health Concern were mailed with a questionnaire, and some members of CHC (very kindly) circulated the questionnaire to friends and neighbours….The total number of dogs surveyed was 3,800.’
Ok, so it’s a fairly large scale survey, which is good in terms of believability. However, the main issue here is a type of bias present in the recruitment process. A large number of study participants, possibly the majority (they don’t specify) were recruited from the CHC mailing list.
CHC defines itself as a website dedicated to ‘exposing the truth about the influence of big business on your pets’. It would therefore seem reasonable to assume that they might have a readership with an already-established dislike of large veterinary corporations such as vaccine manufacturers.
The website contains content suggesting that commercial dog food and veterinary vaccines may be responsible for everything from dogs suddenly dying, to “short attention span” (even stating they are 99% confident that vaccination causes short attention span in dogs).
Whilst I am endeavouring not to prematurely label any of this as conspiracy theory-esque, it does seem somewhat reminiscent of the MMR vaccine autism scare in children, which was then extensively investigated and ultimately found to be false.
The shady science of the original study, which raised concerns that the MMR vaccine could be causing autism, was revealed and should serve as a stark reminder that not all science is scientific. Some studies aren’t worth the paper they’re printed on, or, in modern society, the bandwidth they occupy.
Unfortunately though, it took nearly two decades for UK immunization rates to recover, and during this time more than 12,000 cases of measles, hundreds of hospitalizations, hundreds of cases of serious, long-lasting complications and at least three deaths are recorded as a result of the scare.
Tangent over, and getting back to CHC’s survey, my concern as a scientist is that if the study population is biased, the results are also very likely to be biased, and may not be trustworthy.
The “Forgetful” Phenomenon
What they said:
‘For the purposes of this survey, we asked all participants to list their dogs’ illnesses, and tell us how soon they started after the date of vaccination.’
So, this means 100% of the raw data in the study took the form of questionnaire answers from these potentially biased owners. No cold hard facts; nothing confirmed by looking at medical histories, by scientists or by lab tests.
With respect, this study is rather anecdotal. It’s possible that some number of anti-vacc owners adapted their answers on the basis of, well, not liking vaccinations, and/or large veterinary corporations.
Furthermore as a vet, it’s come to my attention that some owners aren’t always really aware of what’s going on with their pet, health wise. To explain what I mean by this, I’ll give just a couple of examples:
a) I explain to Mrs Jones that her cat has kidney disease. She appears to understand in the consult. Mrs Jones then phones up a week later to discuss “Fluffy’s bladder problem”, which she has been researching on google and decided to start a supplement for. Note: kidneys and bladder are entirely different.
b) I explain to Mrs Brown that her dog could have liver disease, kidney disease, or something else going on, and that we won’t know unless we do tests. Mrs Brown declines tests for now, on the basis of cost. I then overhear Mrs Brown the following week in the waiting room, telling her neighbor that her dog just got diagnosed with “liver and kidney disease” and is here for a follow up.
Catch my drift?
In fact, this “forgetful” phenomenon is exceptionally well known in the medical community.
The famous study below confirmed what we doctors already knew to be true: that ‘40-80% of medical information provided by healthcare practitioners is forgotten immediately. The greater the amount of information presented, the lower the proportion correctly recalled’.
So, with the best will in the world, even if we give the study participants the benefit of the doubt, and assume that none of these pet owners were biased against vaccines or veterinary corporations, we have to assume that they may have forgotten between 40-80% of the facts regarding their pet’s medical history.
This could certainly include which diseases their pets have been categorically diagnosed with (rather than mentioned by the vet in passing, or as a possibility), and the exact date these conditions first started.
And that’s if the pet owners fully understood the information provided in the first place. I’m not suggesting for a second that pet owners are stupid; far from it. My consult room is frequented by engineers, business managers, and human medical professionals, as well as many other highly qualified and intelligent individuals.
But vets do have a very specific type of in-depth knowledge gained from a minimum of 5 years of full-time university level medical education exclusively relating to animal health and medical science. This can’t really be emulated by most pet owners, even those who are highly intelligent, and even those who have done extensive amounts of googling.
I’m not trying to offend you; I’m just being upfront. For comparison’s sake, I’m a campervan lover who has owned four vans over ten years. I spend excessive amounts of time googling campervan related issues, especially when something breaks!
But I would never assume that this rudimentary grasp could match the level of understanding a mechanic, engineer or campervan specialist has.
What they said:
‘The hypothesis is that, if vaccination has no adverse effect or even bearing on subsequent illness, then illnesses will occur in equal numbers at any time during the twelve months after vaccination. In fact, the results so far gathered show a distinct skew or bias towards illness occurring within the first three months after vaccination…
…Some diseases showed a distinct bias towards occurring at nine months or more after vaccination had taken place. These are arthritis and heart conditions. We do, though, ask why these illnesses should all be clustered together at around the nine month period?…If vaccination had no bearing, then there should by rights be an even spread of occurrence throughout the twelve month period…The first, astounding, finding of our initial survey results showed that, overall, 55% of all illnesses reported by participants occurred within the first three months of vaccination. This has risen to 66% in the second analysis. If the vaccine had no bearing on the illness, you would expect to see no more than 25% occurring within that three month time frame.’
This is certainly interesting and warrants further investigations. But the reader should also be made aware that data clusters happen, and they don’t always have a meaning.
I would love for this study to be repeated with a control group whereby the dogs were given a sugar pill on day one, rather than a vaccination, to see whether or not data clusters happened in the control group too.
What they said:
‘The original observation was tested using a standard t-Test which resulted in a t value of 5.39 with alpha at 0.001%. This means that a statistician would be 99.999% confident that vaccines are related to the subsequent illnesses.’
I’m not a statistician but as far as my relatively basic understanding goes, the t-Test is a very reasonable choice. Thumbs up for that.
So, no obvious issues with the statistical analysis here; only the aforementioned concerns that the study population may have been biased, or affected by the “forgetful” phenomenon.
Arthritis – What they said:
‘2.7% of all dogs surveyed had arthritis. Of these, 71.8% were diagnosed nine months plus after vaccination. Arthritis in humans has been positively linked to vaccines. The fact that the onset of arthritis clusters at the nine month period indicates that vaccine-induced arthritis has a longer incubation period, or takes longer for overt physical symptoms to manifest. At a 95% confidence interval, we believe that arthritis is caused by vaccination.’
My first thought as a vet is that I would like to know what ages were the dogs at the time of vaccination, and at supposed diagnosis of arthritis, because 80% of dogs over 8 years of age, have osteoarthritis in at least one joint.
What’s more, I would want to know what criteria they used to decide these dogs had arthritis, because I doubt every owner in the study spent £300-£3000 on getting X-rays and/or CT scans and/or arthroscopy at that 9-month mark!
Furthermore, to make the statement that the arthritis developed at the 9 month mark, you’d also have to be able to prove it wasn’t there before, undetected.
Maybe the dog already had arthritis for months or years, and the owner is only noticing it now. Frankly, from experience, the vast majority of owners who have an arthritic pet aren’t aware their pet is arthritic until I point out that it’s examination is not normal, and nor is the way it’s walking.
So – was arthritis proven to be there at 9 months? Was it proven to be absent, before? Did the dog actually see a vet at the 9 month mark, or did the owner make the assumption of arthritis because the dog pulled up lame after a walk? Did the vet carry out tests to confirm the diagnosis?
Could it have just been a thorn in the foot? Honestly, with data this flimsy who the hell knows.
CHC then goes on to discuss in detail the results from two studies relating to rheumatoid arthritis in human children, resulting from the rubella vaccination, which is about as relevant as a smacked bottom and here’s why: Dogs get osteoarthritis. Dogs do not get rheumatoid arthritis.
In fact, I can’t think of any mammal except for human beings and pigs that does get rheumatoid arthritis. It’s an entirely different disease, with a different pathogenesis.
Scientifically, it makes sense that a vaccine could contribute to rheumatoid arthritis, when you understand how this disease works. It does not make sense for a vaccine to cause osteoarthritis, however.
Diarrhoea and vomiting – What they said:
‘Where dogs had diarrhoea, 68% of cases occurred within the first three months following vaccination. 4.9% of dogs surveyed had diarrhoea at some stage. This could be a mild anaphylactic reaction. Anaphylactic reactions can be an indication that encephalitis might follow…
…Where owners reported vomiting in their dogs, 72.5% occurred within 3 months of vaccination. 3% of dogs surveyed were reported to have vomited. This, of course, can be described as an anaphylactic reaction which can develop into encephalitis….Vomiting after vaccination can be expressed as a vaccine reaction, as a certainty at the 95% confidence interval.’
I was a bit surprised that a leap was made from diarrhoea straight to anaphylaxis.
Most dogs have the odd sloppy poo. This may be weekly, monthly, whatever. Diarrhoea is crazy common, and usually the odd loose stool is absolutely nothing to worry about, especially if you can link it to your dog having eaten a dog treat, or a different flavor of dog food.
Or maybe your dog needs to be wormed. Or has been scavenging under the kitchen table, or eating something nasty out on a walk. Likewise vomiting is pretty common and the most frequent cause as far as I’m aware is dietary indiscretion.
CHC do not elucidate what they defined as ‘diarrhoea’ for the purposes of this study. One loose poo? Two? Several? How loose? Mr Whippy, cowpat, porridge? I need details. Likewise – vomiting once, after eating something dodgy, or a bout of repeated vomiting requiring medical intervention?
Without further details, to make the assumption that vaccines are dangerous because pet owners report their dog experienced diarrhoea or vomiting within several months of being vaccinated, is cowpat in it’s own right.
And to tantalizingly suggest that, if your dog gets the runs after a vaccine you should expect encephalitis to follow, has the air of scaremongering to it. And that’s totally unnecessary, based on the very limited and somewhat flimsy data the survey presents.
Allergies and skin problems – What they said:
‘Where dogs had allergies, 55.6% started within the first three months after vaccination. 3.8% of dogs surveyed had allergies. This indicates that vaccines do, indeed, ‘sensitise’ an organism. At 99% confidence, we are certain that allergies are triggered by vaccines…
…Where dogs had skin problems, 46.2% started within three months after vaccination. 5.4% of dogs surveyed had skin problems. This, again, supports the contention that vaccines sensitise an organism. Again, with a 99% confidence, we can be certain that vaccines cause skin problems.’
CHC may have hit on some truth here. Because actually, it does make sense from a scientific, medical standpoint, that vaccinations may worsen or even precipitate allergies in some individuals.
I do just want to point out one issue, and that’s with CHC’s statement that the allergies ‘started’ within three months: specifically my problem is the use of the word ‘started’.
I would be suspicious that at least some the cases of allergies didn’t ‘start’ within 3 months of vaccine; they probably just got exacerbated, ie, the pet experienced a flare up, which tends to happen due to a combination of immune system overdrive as well as increased exposure to the allergen or allergens.
Most atopic (allergic) dogs aren’t allergic to just one thing, but to say, 5-8 specific allergens, such as chicken, beef, yeast, dust mites, timothy grass, oak tree, dandelion…you get the idea.
Here’s a simplified example of how allergies in dogs work, and how different levels of exposure produce different levels of itching.
Our example dog, Fred, is allergic to dandelions, dust mites and beef.
So yeah, in summary, I agree; vaccinations (including the Lepto 2, Lepto 4 and other vaccinations) may contribute to development or worsening of allergies in some individual dogs. Crucially, more research needs to be done, for us to fully understand any link.
But in the meantime, if you have an allergic dog, or own a breed with a predisposition towards allergies, it’s probably a risk-benefit situation, and you should weigh up the pros and cons for your individual pet (in discussion with your vet) prior to deciding whether to vaccinate or not.
Autoimmune disease – What they said:
‘54.8% of dogs in the survey developed this condition within the first three months after vaccination….[autoimmune] related diseases, at a 95% confidence interval, are vaccine-related.’
The first thing I want to know here is how many dogs surveyed developed auto-immune disease, and whether they were counting allergies or not (since allergies are technically an autoimmune condition).
Other than allergies, autoimmune disease is really quite rare. So I would imagine out of the 3800 dogs surveyed, they may have only had one or two cases of non-allergy autoimmune disease, which is too small of a sample size to be drawing any conclusions from.
That said, as we already learned there may be some links between vaccination and allergies, so off the back of that, it does make some sense that vaccinations may be responsible for some cases of autoimmune disease.
Other things that we strongly suspect can trigger autoimmune disease in certain individuals, in fairly rare cases, including antibiotics and pain medications such as meloxicam.
So, my take home from this is that I would always consider it a risk-benefit situation; weighing up the risks of not vaccinating, against the risk of autoimmune disease.
Colitis – What they said:
‘Where dogs had colitis, 56.9% occurred within the first three months after vaccination. 2.7% of dogs surveyed had colitis. This finding may help current research seeking to establish the vaccine/colitis/irritable bowel link in humans. At 95% confidence, the survey indicates strongly that colitis is a sequel to vaccination…Crohn’s disease, an inflammatory bowel disease which can affect any part of the digestive tract in humans, has been associated with vaccination by Dr Andrew Wakefield of the Royal Free Hospital in London (The Lancet Vol 345, 1995).’
Now, this is noteworthy; CHC are citing research by Andrew Wakefield. Remember we already discussed the phony MMR vaccine-autism scare? The dodgy and rather unscientific science that terrified well-meaning parents into not vaccinating their children, with disastrous consequences?
Well, the MMR-autism scare was pioneered by none other than Dr Andrew Wakefield.
Whose research, we now know, should perhaps be taken with a pinch of salt.
Other than that interesting observation, my commentary for this paragraph is much the same as for diarrhoea, because vets tend to use the terms ‘diarrhoea’ and ‘colitis’ interchangeably, given that colitis is simply the scientific term for ‘inflamed colon’, the most common cause of diarrhea in dogs.
So, if owners took their dog to the vet, or indeed undertook some solo googling, they likely came across the term ‘colitis’ and remembered this term alongside diarrhoea when responding to the survey.
Dry eye/conjunctivitis – What they said:
‘Where dogs had dry eye or conjunctivitis, 56.9% occurred within the first three months after vaccination. 2.5% of dogs surveyed had this complaint… At 99% confidence, we are certain that dry eye and conjunctivitis can be caused by vaccines. Frick and Brooks’ research highlighting the incidence of atopic dermatitis following vaccination showed that conjunctivitis could also be involved. Conjunctivitis is described as a Type 1 hypersensitivity reaction in the Concise Oxford Veterinary Dictionary.’
Like with allergies, CHC may be on to something here, in particular with regards to dry eye, the proper name for which is keratoconjunctivitis sicca (KCS).
In dogs, KCS usually develops as a result of immune-mediated destruction of the lacrimal gland, which produces the vitally important “watery” part of the tear film.
Many of these cases are “idiopathic”, a fancy way of saying we have no idea why it happened. But the veterinary scientific community does suspect that this immune-mediated attack may be triggered by a variety of different factors, including sulfonamide drugs, canine distemper virus infection, and long-term use of atropine. It’s possible that vaccines also belong on that list.
And we know too that KCS has links to other auto-immune conditions such as atopy (allergic skin); so really, we should consider KCS part of an auti-immune syndrome.
As discussed above, I would agree that it’s well within the realms of possibility that vaccinations (Lepto 4 and others) may increase the likelihood of auto-immune conditions developing, or increase the severity of a pre-existing auto-immune condition.
As such, I think we do have to consider that vaccination may indeed be a risk factor for developing KCS and other autoimmune conditions, and I am firmly of the opinion that more, higher quality research needs to be done in this area.
Epilepsy and ataxia – What they said:
‘At 95% confidence, it is very probable that ataxia (muscle incoordination caused by lesions throughout the nervous system) is caused by vaccines, with a high percentage starting within three months of vaccination…
…Where dogs had epilepsy, 65.5% occurred within the first three months following vaccination. 2.1% of the dogs surveyed had epilepsy. Epilepsy is essentially a neurological condition; scientific evidence has already been given to explain that vaccines can cause brain palsy and lesions, leading to epilepsy (this is tied in with encephalitis, admitted by vaccine manufacturers to be a possible effect of vaccination). The surveys allows a 99% certainty that epilepsy can be caused by vaccines, and that the most common cause of epilepsy in dogs is vaccines’
First and foremost, I would really like to see a citation included here, that is, a link to the source of the ‘scientific evidence’ explaining that vaccines can cause brain problems. Because in order to assess whether this claim has any credibility or not, I’d need to see the source evidence, which sadly is not provided.
I’m relatively neutral towards most of this paragraph, remaining firmly in the camp of this survey being too flimsy to draw conclusions from and higher quality research being necessary.
However – I do think it’s excessive to claim off the back of the above that ‘the most common cause of epilepsy in dogs in vaccines’. This is especially true given that in dogs, idiopathic epilepsy is highly breed specific, and much evidence points to it having a largely genetic origin.
Nervous/worrying disposition and behavioural problems – What they said:
‘Where dogs exhibited a nervous or worrying disposition, 54.8% began to do so within three months post-vaccination. 2.8% of dogs surveyed suffered from this complaint. This is THE certainty of the survey! It has the highest t-score of any group, i.e., 19.9. Combined with another category – behavioural problems – we can say without a shadow of a doubt that vaccines cause total personality changes in dogs…
…Where owners reported behavioural problems, 55.4% occurred within three months after vaccination. 2.5% of all dogs surveyed had behavioural problems. This, then, supports Dr Harris L Coulter‘s hypothesis that much human violence, sociopathy and criminality is vaccine linked, and has its basis in brain damage caused by vaccines. At a 99% confidence interval, we are now certain that behavioural problems are largely vaccine related...
…The law firm Dawbarns says of autistic children (autism is thought to be a range symptoms including brain damage): “Before they were vaccinated they (according to their parents) were developing perfectly normally, passing all milestones and showing none of the classical signs of autism. After being vaccinated they regressed (sometimes only within a few days), losing metal, physical and social skills.” Dawbarns adds, “If a teenager takes Ecstasy and becomes ill or dies, it is IMMEDIATELY concluded that the illness or death was caused by the drug. But if a child becomes ill or dies after vaccination, it is dismissed as mere coincidence.”’
Given the data at hand, it’s quite the stretch to suggest that the root cause of behavioural problems in dogs is vaccination. Certainly, no objective scientist worth their weight would read this study and conclude ‘without a shadow of a doubt’ that this is the case.
CHC also quotes a law firm which was involved in trying to sue on behalf of parents who believed or at least claimed, that vaccinations caused autism in their children. There is simply no way that this quote can be seen as scientific, or anything but exceptionally biased.
The lawyers here are presumably being paid a princely sum to convince the listener that the vaccine is at fault. And, to round up, the link between the MMR vaccine and autism was ultimately firmly disproven.
I also found the statement that ‘much human violence, sociopathy and criminality is vaccine linked’ particularly eyebrow-raising, given that human beings have been tearing each other apart and generally raping, pillaging and murdering one another for many, many centuaries prior to the instigation of modern day vaccine regimens.
Tumour growth at vaccine site: What they said:
‘Where dogs had tumours or growths at vaccination site, 67.9% occurred within three months of vaccination. 1.1% of all dogs surveyed suffered from this occurrence. It is well recorded in the medical/veterinary literature that cancer/tumours can (and do) grow at vaccine sites. With 95% confidence, we are certain that tumours or growths at vaccination sites are caused by the vaccination process itself.’
I am in agreement with CHC on this one; tumors probably are more likely to occur at vaccination site, than elsewhere. For example, vaccine site sarcoma is a well recognised phenomenon in cats, and it seems likely to me that a similar locally carcinogenic phenomenon occurs with vaccinations in dogs.
It’s probably only a very small increase in risk – but an increase in risk likely exists, nonetheless, and pet owners should be aware of it so that they can make an informed decision.
Dogs contracting the diseases they were vaccinated against – What they said:
‘Hepatitis – 63.6% occurred within three months of vaccination
Parainfluenza – 50% occurred within three months of vaccination (note: it is highly probable that parainfluenza can be caused by vaccines, at 95% confidence interval)
Parvovirus – 68.2% occurred within three months of vaccination (note: at 95% confidence, this satisfies the one-tail test but not the two-tail. More data would allow us to prove whether vaccines cause the disease they are designed to prevent, in this case parvovirus)
Distemper – 55.6% occurred within three months of vaccination
Leptospirosis – 100% of dogs contracted leptospirosis within three months of vaccination (note: according to the data we have, leptospirosis is related to vaccination at a 90% confidence interval.)
With the exception of distemper and leptospirosis, where not enough dogs with the disease were recorded, all of the above satisfy a z alpha score of more than three. This means that we are 99.53% certain that there is a strong causal link between vaccination and the onset of the diseases.’
Note that CHC admits here that not enough dogs with leptospirosis or distemper were included in the survey, to draw any meaningful statistical results. Did you miss it? Easily done, since despite this admission CHC go ahead and draw a conclusion anyway.
On the basis of insufficient sample size (probably only one or two individuals), we have to discount any conclusions relating to leptospirosis and distemper here. Otherwise, it’s just shoddy science.
With regards to hepatitis, I’d want to know how this was diagnosed, and whether a liver biopsy was carried out (seems unlikely) in these cases to try and establish a cause for the hepatitis. The canine hepatitis vaccine only protects against a very specific, quite rare type of hepatitis caused by an adenovirus; many other types of hepatitis (all vastly more common than viral hepatitis) also exist.
With regards to parvovirus, as CHC states, more data would be needed to draw any conclusions. For both parvovirus and parainfluenza, I would want to know if the diagnosis was confirmed or not, especially given that several other conditions can masquerade as parainfluenza, including Bordetella bronchiseptica infection and a whole host of other common upper respiratory tract infections affecting dogs.
- Given the recruitment process for CHC’s survey, we need to assume results may be intrinsically biased.
- Given the “forgetful” phenomenon, we need to assume CHC’s survey results may not be fully accurate.
- Whilst vaccines are important in terms of protecting pets against potentially deadly diseases, they likely do have links to allergies/skin disease, autoimmune disease, dry eye and tumour growth at the vaccination site.
- It would be incorrect to assume based on the results of this survey that vaccines are to blame for canine cases of arthritis, epilepsy and behavioral changes in particular.
- More research, of a better quality and more objective standard, is needed in regards to links between vaccination and canine atopic dermatitis; in my opinion, a link likely exists.
- Overall, it is clear to me that CHC’s results are biased and unobjective; but that does not mean there aren’t a few important lessons to be learned here, and a few areas identified that need further research.
I hope you found this post helpful in terms of unwrapping some of the information that exists online in regards to canine vaccinations, and that is helps you make an informed decision.
Where would you like to head next?