Prophylaxe der kaninen Parvovirose

Zusammenfassung

Wenngleich Impfstoffe, v. a. die gegen das kanine Parvovirus (CPV), heutzutage als sehr sicher gelten, können in seltenen Fällen dennoch postvakzinale Nebenwirkungen auftreten. Hierzu zählen zum einen milde Symptome, die sich kurz (innerhalb weniger Tage) nach der Impfung entwickeln (z. B. gastrointestinale Symptome, Fieber, reduziertes Allgemeinbefinden, Lymphadenopathie). Sie werden als Folgen der Replikation des Impfvirus gewertet und sind ein Anzeichen für eine gute Immunantwort. Die ebenfalls kurz nach der Impfung vorkommenden anaphylaktischen Reaktionen können lebensbedrohlich sein. Betroffene Hunde zeigen Symptome wie Ödeme, Speicheln, Erbrechen, Durchfall, Hypotension und/oder Schock. Oft ist unklar, welcher Bestandteil des Impfstoffs die anaphylaktische Reaktion ausgelöst hat. Es ist daher wichtig, Hunde mit vorangegangenen anaphylaktischen Reaktionen nur noch mit unbedingt notwendigen Komponenten zu impfen. Sind Wiederholungsimpfungen notwendig, z. B. weil sich keine Antikörper gegen CPV nachweisen lassen, sollte besser eine Monovakzine gegen CPV (und ggf. gegen weitere notwendige Komponenten) verwendet werden. Ein Wechsel des Impfstoffherstellers beugt möglicherweise ebenfalls einer erneuten anaphylaktischen Reaktion vor. Die längere Zeit nach Impfung auftretenden Autoimmunkrankheiten, z. B. die immunmediierte hämolytische Anämie (IMHA), könnten die Folge einer zu häufigen Vakzination von Hunden sein oder durch Impfung getriggert werden. So wurden einige Hunde mit IMHA einige Wochen vor Ausbruch der Erkrankung geimpft. Bei diesen Hunden sollten weitere Impfungen unbedingt vermieden werden.

Abstract

Although nowadays vaccines, especially those against canine parvovirus (CPV), are considered to be safe, vaccine-associated adverse events (VAAEs) can occur in rare cases. Some VAAEs are mild and manifest shortly (within a few days) after vaccination (e. g. gastrointestinal signs, fever, reduced general condition, lymphadenopathy). These signs are likely a result of vaccine virus replication and indicate a good immune response. Anaphylactic reactions can also occur promptly following vaccine administration and might be life threatening. Affected dogs show clinical signs such as edema, salivation, vomiting, diarrhea, hypotension, and/or shock. Since it is often unclear which component of the vaccine carries responsibility for the anaphylactic reaction it is important to limit future vaccinations of these dogs to indispensable components only. When revaccination is unavoidable, e. g. because antibodies against CPV cannot be detected, combined vaccines should not be used and CPV (and other components, if needed) should preferably be vaccinated separately. Changing the vaccine manufacturer might also prevent further anaphylactic reactions. Finally, there are VAAEs occurring after a prolonged period of time. In dogs, it is discussed that autoimmune diseases, such as immune-mediated hemolytic anemia (IMHA), can be a consequence of excessive vaccination or in the least be triggered by vaccination. Numerous dogs with IMHA are reported to have a history of receiving a vaccination within a few weeks before the onset of clinical sings. In such dogs, further vaccinations should generally be avoided.

Schlüsselwörter

Kanines Parvovirus - CPV - Hund - Immunisierung - Impfstoff - Vakzine - MLV - anaphylaktische Reaktion - Autoimmunkrankheit

Key words

Canine parvovirus - CPV - dog - vaccination - immunization - vaccine - MLV - anaphylactic reaction - autoimmune disease

Publication History

Received: 01 March 2021

Accepted: 16 June 2021

Article published online:
23 August 2021

• Literatur

• 1 StIKo Vet am FLI. Leitlinie zur Impfung von Kleintieren. 5. Aufl.. 2021: 1-187
• 2 Hustead DR. What you can and cannot learn from reading a vaccine label. Vet Clin North Am Small Anim Pract 2001; 31: 539-556 DOI: 10.1016/S0195-5616(01)50608-7.
• 3 Bundesministerium der Justiz und für Verbraucherschutz, Bundesamt für Justiz. Verordnung über Sera, Impfstoffe und Antigene nach dem Tiergesundheitsgesetz (Tierimpfstoff-Verordnung, TierImpfStV). https://www.gesetze-im-internet.de/tierimpfstv_2006/BJNR235500006.html Stand: 22.06.21
• 4 Bundesministerium für Ernährung Landwirtschaft und Verbraucherschutz. Gesetz zur Vorbeugung vor und Bekämpfung von Tierseuchen (Tiergesundheitsgesetz, TierGesG). https://www.gesetze-im-internet.de/tiergesg/BJNR132400013.html Stand: 22.06.21
• 5 Flemming D. The potential for liability in the use and misuse of veterinary vaccines. Vet Clin North Am Small Anim Pract 2001; 31: 515-523 DOI: 10.1016/S0195-5616(01)50605-1.
• 6 Meyer EK. Vaccine-associated adverse events. Vet Clin North Am Small Anim Pract 2001; 31: 493-514 DOI: 10.1016/S0195-5616(01)50604-X.
• 7 Sykes JE. Immunization. In: Sykes JE. ed. Canine and Feline Infectious Diseases. 1st ed.. St. Louis, Missouri, USA: Elsevier Saunders; 2014: 119-130 DOI: 10.1016/B978–1-4377–0795–3.00012–0
• 8 Roth JA. S11A factors influencing vaccine duration of immunity. https://www.researchgate.net/publication/238103210_S11A_Factors_Influencing_Vaccine_Duration_of_Immunity Stand: 22.06.21
• 9 European Medicines Agency. Recommendation on harmonising the approach to causality assessment for adverse reactions to veterinary medicinal products, reference number EMEA/CVMP/PhVWP/552/2003-Rev.1. https://www.ema.europa.eu/en/veterinary-regulatory/post-authorisation/pharmacovigilance/guidance/recommendation-harmonising-approach-causality-assess​ment-adverse-events-veterinary-medicinal Stand: 22.06.21
• 10 Fine PE. Methodological issues in the evaluation and monitoring of vaccine safety. Ann N Y Acad Sci 1995; 754: 300-308 DOI: 10.1111/j.1749-6632.1995.tb44463.x.
• 11 Day MJ. Vaccine side effects: Fact and fiction. Vet Microbiol 2006; 117: 51-58 DOI: 10.1016/j.vetmic.2006.04.017.
• 12 Moore GE, HogenEsch H. Adverse vaccinal events in dogs and cats. Vet Clin North Am Small Anim Pract 2010; 40: 393-407 DOI: 10.1016/j.cvsm.2010.02.002.
• 13 Moore GE, Guptill LF, Ward MP. et al. Adverse events diagnosed within three days of vaccine administration in dogs. J Am Vet Med Assoc 2005; 227: 1102-1108
• 14 Riedl M, Truyen U, Reese S. et al. Prevalence of antibodies to canine parvovirus and reaction to vaccination in client-owned, healthy dogs. Vet Rec 2015; 177: 597 DOI: 10.1136/vr.103271.
• 15 Duval D, Giger U. Vaccine-associated immune-mediated hemolytic anemia in the dog. J Vet Intern Med 1996; 10: 290-295
• 16 Martinod S. Adverse effects of vaccination. In: Pastoret PP, Blancou J, Vannier P. et al., eds. Veterinary Vaccinology. 1st ed.. Amsterdam, Niederlande: Elsevier Science; 1997: 574-580
• 17 Ford RB. Vaccines and vaccinations. The strategic issues. Vet Clin North Am Small Anim Pract 2001; 31: 439-453
• 18 Day MJ, Horzinek MC, Schultz RD. et al. WSAVA Guidelines for the vaccination of dogs and cats. J Small Anim Pract 2016; 57: 1-45 DOI: 10.1111/jsap.2_12431.
• 19 Tizard IR. The use of vaccines. In: Tizard IR. ed. Veterinary Immunology. 10th ed.. St. Louis, Missouri, USA: Elsevier; 2018: 274-284
• 20 Wenzel A, Thomas J. Pharmakovigilanzreport Tierimpfstoffe: Analyse der Nebenwirkungsmeldungen aus den Jahren 2018 und 2019. DTBl 2020; 68: 1496-1500
• 21 Albrecht N, Ottiger HP. Vaccinovigilance Schweiz: Gemeldete unerwünschte Wirkungen während der letzten 13 Jahre. Schweiz Arch Tierheilk 2016; 158: 251-258
• 22 Zaugg I, Hermann N, Ottiger HP. Vaccinovigilance: Gemeldete unerwünschte Wirkungen immunologischer Tierarzneimittel im Jahr 2019. Schweiz Arch Tierheilk 2020; 162: 617-624
• 23 StIKo Vet am FLI. Empfehlungen zur guten Impfpraxis in der Veterinärmedizin. 2018: 1-18
• 24 Cußler K. Nebenwirkungen von Impfungen beim Kleintier. bpt-Kongress München; Deutschland: 2019: 108-114
• 25 Miyaji K, Suzuki A, Shimakura H. et al. Large-scale survey of adverse reactions to canine non-rabies combined vaccines in Japan. Vet Immunol Immunopathol 2012; 145: 447-452 DOI: 10.1016/j.vetimm.2011.12.023.
• 26 Geretschläger A. Deutsche Pinscher: Über die richtige Diagnose verzögerter Impfreaktionen. Vet J 2014; 67: 48-52
• 27 Ford RB, Larson LJ, McClure KD. et al. 2017 AAHA Canine Vaccination Guidelines. J Am Anim Hosp Assoc 2017; 53: 243-251 DOI: 10.5326/jaaha-ms-6741.
• 28 Liese J, Reinhardt D. Impfen und Allergien. In: Spiess H, Heininger U. Hrsg. Impfkompendium. 6. Aufl.. Stuttgart: Thieme; 2005: 55-66
• 29 Povey RC, Carman PS. Risks of vaccination. In: Pastoret PP, Blancou J, Vannier P. et al., eds. Veterinary Vaccinology. Amsterdam, Niederlande: Elsevier Science; 1997: 546-551
• 30 Day MJ, Schultz RD. Vaccination. In: Day MJ, Schultz RD. eds. Veterinary Immunology – Principles and Practice. 2nd ed.. Boca Raton, Florida, USA: CRC Press Taylor & Francis Group; 2014: 233-247
• 31 Kennedy LJ, Lunt M, Barnes A. et al. Factors influencing the antibody response of dogs vaccinated against rabies. Vaccine 2007; 25: 8500-8507 DOI: 10.1016/j.vaccine.2007.10.015.
• 32 Taguchi M, Namikawa K, Maruo T. et al. Effects of body weight on antibody titers against canine parvovirus type 2, canine distemper virus, and canine adenovirus type 1 in vaccinated domestic adult dogs. Can J Vet Res 2012; 76: 317-319
• 33 Decaro N, Desario C, Elia G. et al. Occurrence of severe gastroenteritis in pups after canine parvovirus vaccine administration: A clinical and laboratory diagnostic dilemma. Vaccine 2007; 25: 1161-1166 DOI: 10.1016/j.vaccine.2006.10.020.
• 34 Greene CE, Levy J. Immunoprophylaxis. In: Greene CE. ed. Infectious Diseases of the Dog and Cat. 4th ed.. St. Louis, Missouri, USA: Saunders Elsevier; 2012: 1163-1205
• 35 Brooks R. Adverse reactions to canine and feline vaccines. Aust Vet J 1991; 68: 342-344
• 36 Tizard IR. The major histocompatibility complex. In: Tizard IR. ed. Veterinary Immunology. 10th ed.. St. Louis, Missouri, USA: Saunders Elsevier; 2018: 100-107
• 37 Gray A, Evans C, Kidd A. Suspected adverse reactions to medicines during 1989. Vet Rec 1990; 126: 376-378
• 38 Maddison JE. Adverse drug reactions: Report of the Australian Veterinary Association Adverse Drug Reaction Subcommittee, 1993. Aust Vet J 1994; 71: 53-57
• 39 Tjälve H. Adverse reactions to veterinary drugs reported in Sweden during 1991–1995. J Vet Pharmacol Ther 1997; 20: 105-110
• 40 Dodds WJ. Vaccination protocols for dogs predisposed to vaccine reactions. J Am Vet Med Assoc 2001; 37: 211-214 DOI: 10.5326/15473317-37-3-211.
• 41 Ohmori K, Sakaguchi M, Kaburagi Y. et al. Suspected allergic reactions after vaccination in 85 dogs in Japan. Vet Rec 2005; 156: 87-88
• 42 Day MJ. Vaccine safety in the neonatal period. J Comp Pathol 2007; 137: 51-56 DOI: 10.1016/j.jcpa.2007.04.019.
• 43 Hoffmann A, Schwedinger E, Werner G. et al. Pharmakovigilanzreport Tierimpfstoffe. Analyse der Nebenwirkungsmeldungen im Jahr 2015. DTBI 2016; 8: 1176-1178
• 44 Rogger P, Herrmann N, Ottiger HP. Vaccinovigilance: Gemeldete unerwünschte Wirkungen immunologischer Tierarzneimittel im Jahr 2018. Schweiz Arch Tierheilk 2019; 161: 299-306
• 45 Gershwin LJ. Adverse reactions to vaccination: From anaphylaxis to autoimmunity. Vet Clin North Am Small Anim Pract 2018; 48: 279-290 DOI: 10.1016/j.cvsm.2017.10.005.
• 46 Day MJ, Schultz RD. Hypersensitivity mechanisms. In: Day MJ, Schultz RD. eds. Veterinary Immunology – Principles and Practice. 2nd ed.. Boca Raton, Florida, USA: CRC Press Taylor & Francis Group; 2014: 139-152
• 47 Ohmori K, Masuda K, Maeda S. et al. IgE reactivity to vaccine components in dogs that developed immediate-type allergic reactions after vaccination. Vet Immunol Immunopathol 2005; 104: 249-256 DOI: 10.1016/j.vetimm.2004.12.003.
• 48 Bishop Y. The Veterinary Formulary. 6th ed.. London, GB: Pharmaceutical Press; 2005: 390
• 49 Koppen S, de Groot R, Neijens HJ. et al. No epidemiological evidence for infant vaccinations to cause allergic disease. Vaccine 2004; 22: 3375-3385 DOI: 10.1016/j.vaccine.2004.02.033.
• 50 Frick OL, Brooks DL. Immunoglobulin E antibodies to pollens augmented in dogs by virus vaccines. Am J Vet Res 1983; 44: 440-445
• 51 Tater KC, Jackson HA, Paps J. et al. Effects of routine prophylactic vaccination or administration of aluminum adjuvant alone on allergen-specific serum IgE and IgG responses in allergic dogs. Am J Vet Res 2005; 66: 1572-1577
• 52 Garden OA, Kidd L, Mexas AM. et al. ACVIM consensus statement on the diagnosis of immune-mediated hemolytic anemia in dogs and cats. J Vet Intern Med 2019; 33: 313-334
• 53 Carr AP, Panciera DL, Kidd L. Prognostic factors for mortality and thromboembolism in canine immune-mediated hemolytic anemia: A retrospective study of 72 dogs. J Vet Intern Med 2002; 16: 504-509 DOI: 10.1892/0891–6640(2002)016<0504:pffmat>2.3.co;2.
• 54 Weinkle TK, Center SA, Randolph JF. et al. Evaluation of prognostic factors, survival rates, and treatment protocols for immune-mediated hemolytic anemia in dogs: 151 cases (1993–2002). J Am Vet Med Assoc 2005; 226: 1869-1880
• 55 Dodds WJ. Vaccine safety and efficacy revisited: Autoimmune an allergic diseases on the rise. Vet Forum 1993; 10: 67-71
• 56 Dodds WJ. More bumps on the vaccine road. In: Schultz RD. ed. Advances in Veterinary Medicine, Volume 41, Veterinary Vaccines and Diagnostics. San Diego, Kalifornien, USA: Academic Press; 1999: 715-732
• 57 Dodds WJ. Bleeding disorders in animals. 30th Congress of the World Small Animal Veterinary Association (WSAVA) 2005. https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11196&meta=generic&catId=30756&id=3854231 Stand: 31.08.19
• 58 Huang AA, Moore GE, Scott-Moncrieff JC. Idiopathic immune-mediated thrombocytopenia and recent vaccination in dogs. J Vet Intern Med 2012; 26: 142-148 DOI: 10.1111/j.1939-1676.2011.00850.x.
• 59 Putsche JC, Kohn B. Primary immune-mediated thrombocytopenia in 30 dogs (1997–2003). J Am Vet Med Assoc 2008; 44: 250-257 DOI: 10.5326/0440250.
• 60 Graham PA, Nachreiner RF, Refsal KR. et al. Lymphocytic thyroiditis. Vet Clin North Am Small Anim Pract 2001; 31: 915-933
• 61 Hogenesch H, Azcona-Olivera J, Scott-Moncrieff C. et al. Vaccine-induced autoimmunity in the dog. In: Schultz RD. ed. Advances in Veterinary Medicine, Volume 41, Veterinary Vaccines and Diagnostics. San Diego, Kalifornien, USA: Academic Press; 1999: 733-747
• 62 Scott-Moncrieff JC, Glickman NW, Glickman LT. et al. Lack of association between repeated vaccination and thyroiditis in laboratory Beagles. J Vet Intern Med 2006; 20: 818-821 DOI: 10.1892/0891-6640(2006)20(818:loabrv)2.0.co;2.
• 63 Bergmann M, Freisl M, Hartmann K. et al. Antibody response to canine parvovirus vaccination in dogs with hypothyroidism treated with levothyroxine. Vaccines 2021; 9: 180
• 64 European Advisory Board on Cat Diseases ABCD. Adverse reactions to vaccination. http://www.abcdcatsvets.org/adverse-reactions-to-vaccination/ ​Stand: 22.06.21
• 65 Lappin MR, Jensen WA, Jensen TD. et al. Investigation of the induction of antibodies against Crandell-Rees feline kidney cell lysates and feline renal cell lysates after parenteral administration of vaccines against feline viral rhinotracheitis, calicivirus, and panleukopenia in cats. Am J Vet Res 2005; 66: 506-511
• 66 Finch NC, Syme HM, Elliott J. Risk factors for development of chronic kidney disease in cats. J Vet Intern Med 2016; 30: 602-610 DOI: 10.1111/jvim.13917.
• 67 Intervet Deutschland GmbH. Fachinformation zu Nobivac SHP. https://portal.dimdi.de/websearch/servlet/Gate;jsessionid=​AFDC55C1058B0B94D99B1F3F6E36B949?accessid=pharmnet_par_freeinfo&query=enr=2603542 Stand: 22.06.21
• 68 American Type Culture Collection (ATCC). MDCK (NBL-2) (ATCC CCL-34™): General information and characteristics. https://www.lgcstandards-atcc.org/products/all/CCL-34.aspx Stand: 22.06.21
• 69 Tizard I. Risks associated with use of live vaccines. J Am Vet Med Assoc 1990; 196: 1851-1858
• 70 Collins JR. Seizures and other neurologic manifestations of allergy. Vet Clin North Am Small Anim Pract 1994; 24: 735-748
• 71 Schrauwen E, Van Ham L. Postvaccinal acute polyradiculoneuritis in a young dog. Prog Vet Neurol 1995; 6: 68-70
• 72 Gehring R, Eggars B. Suspected post-vaccinal acute polyradiculoneuritis in a puppy. J S Afr Vet Assoc 2001; 72: 96 DOI: 10.4102/jsava.v72i2.626.
• 73 Cußler K, Schwedinger E. Pharmakovigilanz für Qualität, Wirksamkeit und Unbedenklichkeit von Tierarzneimitteln, Nebenwirkungen nach Impfung von Deutschen Pinschern. DTBI 2012; 12: 1715-1716
• 74 Leppänen M. Penikkatautirokotus ja pinserit. http://www.pinserit.fi/Penikkatautirokotus_ja_pinserit.pdf Stand: 22.06.21
• 75 Holm A. Bivirkninger ved vaccination af tysk pincher. Dansk Veterinaertidsskrift 2006; 89: 36-37
• 76 Tjälve H. Biverkningar vid vaccinationer av mellanpinschrar. Svensk Veterinärtidning 2006; 58: 19-20
• 77 Lund A. Forekommer bivirkninger etter vaksinasjon av Pinscher i Norge?. Norsk Veterinaertidsskrift 2009; 121: 536-538
• 78 Tizard IR. Immune complexes and neutrophil-mediated hypersensitivity. In: Tizard IR. ed. Veterinary Immunology. 10th ed.. St. Louis, Missouri, USA: Elsevier; 2018: 357-366
• 79 Curtis R, Barnett KC. The ‘blue eye’ phenomenon. Vet Rec 1983; 112: 347-353
• 80 Carmichael LE, Medic BL, Bistner SI. et al. Viral-antibody complexes in canine adenovirus type 1 (CAV-1) ocular lesions: Leukocyte chemotaxis and enzyme release. Cornell Vet 1975; 65: 331-351
• 81 Tizard IR. Immunity to viruses. In: Tizard IR. ed. Veterinary Immunology. 10th ed.. St. Louis, Missouri, USA: Elsevier; 2018: 297-309
• 82 Babiuk LA. Heterologous vaccines. In: Pastoret PP, Blancou J, Vannier P. et al., eds. Veterinary Vaccinology. 1st ed.. Amsterdam, Niederlande: Elsevier Science; 1997: 264-265
• 83 Wright NG. Canine adenovirus: Its role in renal and ocular disease: A review. J Small Anim Pract 1976; 17: 25-33
• 84 Tizard IR. Immune-mediated inflammatory disease. In: Tizard IR. ed. Veterinary Immunology. 10th ed.. St. Louis, Missouri, USA: Elsevier; 2018: 423-434
• 85 Kohn B, Garner M, Lübke S. et al. Polyarthritis following vaccination in four dogs. Vet Comp Orthop Traumatol 2003; 16: 6-10 DOI: 10.1055/s-0038-1632747.
• 86 Bell SC, Carter SD, Bennett D. Canine distemper viral antigens and antibodies in dogs with rheumatoid arthritis. Res Vet Sci 1991; 50: 64-68
• 87 May C, Carter SD, Bell SC. et al. Immune responses to canine distemper virus in joint diseases of dogs. Rheumatology 1994; 33: 27-31 DOI: 10.1093/rheumatology/33.1.27.
• 88 Dougherty SA, Center SA, Shaw EE. et al. Juvenile-onset polyarthritis syndrome in Akitas. J Am Vet Med Assoc 1991; 198: 849-856
• 89 Schattner A. Consequence or coincidence? The occurrence, pathogenesis and significance of autoimmune manifestations after viral vaccines. Vaccine 2005; 23: 3876-3886 DOI: 10.1016/j.vaccine.2005.03.005.
• 90 Clements DN, Gear RN, Tattersall J. et al. Type I immune-mediated polyarthritis in dogs: 39 cases (1997–2002). J Am Vet Med Assoc 2004; 224: 1323-1327
• 91 LaFond E, Breur GJ, Austin CC. Breed susceptibility for developmental orthopedic diseases in dogs. J Am Vet Med Assoc 2002; 38: 467-477 DOI: 10.5326/0380467.
• 92 McMurray M. Weimaraner warning. Can Vet J 2001; 42: 417
• 93 Safra N, Johnson EG, Lit L. et al. Clinical manifestations, response to treatment, and clinical outcome for Weimaraners with hypertrophic osteodystrophy: 53 cases (2009–2011). J Am Vet Med Assoc 2013; 242: 1260-1266 DOI: 10.2460/javma.242.9.1260.
• 94 Foale RD, Herrtage ME, Day MJ. Retrospective study of 25 young Weimaraners with low serum immunoglobulin concentrations and inflammatory disease. Vet Rec 2003; 153: 553-558
• 95 Harrus S, Waner T. Aizenberg. et al. Development of hypertrophic osteodystrophy and antibody response in a litter of vaccinated Weimaraner puppies. J Small Anim Pract 2002; 43: 27-31
• 96 Crumlish PT, Sweeney T, Jones B. et al. Hypertrophic osteodystrophy in the Weimaraner dog: Lack of association between DQA1 alleles of the canine MHC and hypertrophic osteodystrophy. Vet J 2006; 171: 308-313 DOI: 10.1016/j.tvjl.2004.11.015.
• 97 Roth JA. Mechanistic bases for adverse vaccine reactions and vaccine failures. In: Schultz RD. ed. Advances in Veterinary Medicine, Volume 41, Veterinary Vaccines and Diagnostics. San Diego, Kalifornien, USA: Academic Press; 1999: 681-700
• 98 Kreth HW. Immunität und Schutzimpfungen. In: Spiess H, Heininger U. Hrsg. Impfkompendium. 6. Aufl.. Stuttgart: Thieme; 2005: 9-23
• 99 Day MJ, Schoon HA, Magnol JP. et al. A kinetic study of histopathological changes in the subcutis of cats injected with non-adjuvanted and adjuvanted multi-component vaccines. Vaccine 2007; 25: 4073-4084 DOI: 10.1016/j.vaccine.2007.02.049.
• 100 Vascellari M, Melchiotti E, Bozza MA. et al. Fibrosarcomas at presumed sites of injection in dogs: Characteristics and comparison with non-vaccination site fibrosarcomas and feline post-vaccinal fibrosarcomas. J Vet Med A Physiol Pathol Clin Med 2003; 50: 286-291
• 101 Brunner CJ, Swango LJ. Canine parvovirus infection: Effects on the immune system and factors that predispose to severe disease. Compend Contin Educ Vet 1985; 7: 979-989
• 102 Kesel ML, Neil DH. Combined MLV canine parvovirus vaccine: Immunosuppression with infective shedding. Vet Med Small Anim Clin 1983; 78: 687-691
• 103 Mastro JM, Axthelm M, Mathes LE. et al. Repeated suppression of lymphocyte blastogenesis following vaccinations of CPV-immune dogs with modified-live CPV vaccines. Vet Microbiol 1986; 12: 201-211
• 104 Krakowka S, Olsen RG, Axthelm MK. et al. Canine parvovirus infection potentiates canine distemper encephalitis attributable to modified live-virus vaccine. J Am Vet Med Assoc 1982; 180: 137-139
• 105 Phillips TR, Schultz RD. Failure of vaccine or virulent strains of canine parvovirus to induce immunosuppressive effects on the immune system of the dog. Viral Immunol 1987; 1: 135-144 DOI: 10.1089/vim.1987.1.135.
• 106 Strasser A, May B, Teltscher A. et al. Immune modulation following immunization with polyvalent vaccines in dogs. Vet Immunol Immunopathol 2003; 94: 113-121
• 107 Roth JA, Spickler AR. Duration of immunity induced by companion animal vaccines. Anim Health Res Rev 2010; 11: 165-190 DOI: 10.1017/s1466252310000150.