Credit: Arnd Bronkhorst PhotographyIn the late 1800s, Louis Pasteur produced the first laboratory-developed vaccines, which were for chicken cholera (Pasteurella multocida), anthrax and swine erysipelas. In 1885 he created a rabies vaccine. Almost 100 years before that, in 1796, Edward Jenner had successfully used cowpox material to create immunity to smallpox, which through technological changes to his method over the next 200 years, eventually resulted in the worldwide eradication of the dreaded smallpox.
The 20th century was an active time for vaccine research and development. With the birth of the science of bacteriology, developments rapidly followed. Antitoxins and vaccines against the human scourges of diphtheria, tetanus, anthrax, cholera, plague, typhoid, tuberculosis and more were developed through the 1930s. Methods for growing viruses in the laboratory led to rapid discoveries and the creation of vaccines for polio, measles, mumps and rubella. In this century, vaccine research using recombinant DNA technology and innovative delivery systems are leading scientists in new directions. In short, vaccinations are amazing!1, 2
Equine veterinarians carry this legacy forward by providing horse owners with thoughtful recommendations for vaccination programs grounded in science. Because they are educated to critically evaluate scientific claims, veterinarians are uniquely positioned to sort through the competing claims made by manufacturers and their marketing materials. There is good evidence that horse owners value this expertise.
The 2012 AAEP Horse Owner-Trainer Veterinary Services Survey revealed that veterinarians are highly valued and trusted, with a strong majority of the 6,148 respondents saying that they value their veterinarians’ opinions more than anything they might read on the Internet. These horse owners have such a level of trust that 89% report that they “always” or “almost always” take their primary veterinarians’ advice when it comes to vaccinations.
Although 72% have used their primary veterinarians for vaccinations in the past year, half said they gave all (23%) or some (27%) of the vaccinations themselves and of these, 79% say they did so in order to save money. Those most likely to give vaccines themselves are those in the racing industry, the Western states and in the 18- 40 age bracket. Least likely are those who are affluent, highly educated and living in more urban settings or in the Northeast.3
While these findings might make it seem as though horse owners have devalued having veterinary involvement in the vaccination of their mounts, much of their behavior is simply driven by the desire to save money. Vaccinations are widely available from a variety of sources, both on the Internet and at feed and farm stores. Most veterinarians have experienced the phone calls from clients who want exhaustive recommendations for which vaccines to purchase online. Some doctors have even been asked to administer these vaccines when they are at a clients’ barn for another reason.
Time to take a deep breath and remember that both clients and veterinarians have the same goal: healthy horses. Each of these touch points is an opportunity for educating the client and building a relationship that might lead to a more fulfilling professional interaction in the future. Why are the clients asking for recommendations? Because they value your knowledge! Why are they asking you to administer the vaccines they bought somewhere else? Because they value your clinical expertise! Rather than being irritated, try to see this situation as an opportunity.
An annual or biannual farm visit by a veterinarian for each horse in your practice provides an occasion for a physical exam, a body condition scoring, a dietary review, a dental exam and an airing of any owner concerns. With more than 85% of horse owners considering their horses to be family members or pets, according to the 2013 AVMA Pet Owner and Demographics Sourcebook,4 having this careful attention given to their animals is a service that can be highly valued. The key is to market the visits as an integrated wellness program that will help prevent the development of serious (and expensive) health problems and potentially save money in the long run. Providing individualized vaccination recommendations is a natural part of this service, whether you administer them or not. The value lies in the health checkup that the visit affords.
Aging Equines
Older horses often have subtle early signs of Cushing’s disease (PPID) that are easily spotted by veterinarians, but are missed entirely by owners. They also frequently have changing dietary needs and dental issues. Some have arthritis or other musculoskeletal issues. Those with non-pigmented skin might be developing squamous cell carcinoma; gray horses might be troubled by melanomas. The list of serious conditions that could be mitigated with early recognition is long. Many of these retired horses no longer have exposure to respiratory viruses and might not need the same vaccines they did as younger athletes; meanwhile, their aging immune systems might make them more vulnerable to other diseases.
The trusted input of a veterinarian from an overall health perspective can improve the quality and quantity of an older horse’s remaining years.
Competitive and Active Horses
Horses in the prime of their lives are often used for athletic pursuits either year-’round or seasonally. A spring visit before beginning a season of competition or trail riding provides an opportunity to address any soundness concerns, foot issues or other medical problems. Perhaps the horse “tied up” several times last summer, or he developed hives regularly. Maybe since your last visit he has had a problem with thrush, tail rubbing or excess tears wetting his face on one side. Depending on his lifestyle, your recommendations for vaccines will vary. By changing the focus of an annual visit from vaccines to overall wellness, veterinarians can once again truly be an indispensable part of these horses’ lives.
Cost of Services
While only 24% of respondents in the 2012 AAEP Horse Owner-Trainer Veterinary Services Survey said that low-cost veterinary services were extremely important to them, 46% revealed that they use their primary veterinarians as little as possible in order to keep costs down, and 42% would use them more if the cost was lower. However, 86% said they use their primary veterinarians for routine care and examinations; clearly, owners recognize the value provided.
As the economy has continued to improve, practices all over the U.S. are seeing horse owners utilizing their services with more regularity. This upswing in financial confidence is an opportune time to market annual wellness visits. Most veterinarians have been providing these health reviews in some form or another whenever they perform vaccinations, but they have typically charged only for the vaccines rather than for the consultation.
When owners understand the value of this service, they are more than willing to pay for it. The horse owners surveyed repeatedly revealed that they want veterinarians who exhibit compassion, explain medical and husbandry issues in an understandable way, seek and respect the opinion of the owner and take plenty of time with them. Having a meaningful relationship with the professionals they choose is important to them. Health exams are an excellent way to form these bonds; they are a real contrast to the quick vaccine visits that so many clients experience.
Wellness in Practice
Practices have different approaches to providing vaccination services. At New England Equine Medical and Surgical Center in Dover, New Hampshire, a wellness program has been introduced. According to owner Mike Davis, DVM, DACVS, “The New England Equine Wellness Program is designed to eliminate the guesswork of knowing when to schedule routine vaccinations, deworming and dental care. It provides stressfree scheduling for the complete wellness program and gives peace of mind, knowing that your horse has the best preventative healthcare possible at an affordable price.”
The practice offers three types of programs: pleasure, performance and geriatric.
On the other side of the country, Montana Equine Medical and Surgical Center concentrates on helping its clients make wise choices for the stock they own. “With our knowledge of emerging technologies and tried-and-true vaccines, as well as local and national disease epidemiology, our team at Montana Equine is exceptionally well-qualified to help our clients design a vaccine strategy that works for their particular circumstances,” said practice owner Pete Heidman, DVM, DACVIM.
Take-Home Message
“Taking back vaccines” really means taking back a lead role in the health of your patients. Instead of trying to compete with the other sources of vaccines on price alone, try competing instead on service and comprehensive, compassionate and knowledgeable care. Consider offering a comprehensive annual exam that includes needed vaccines at as part of that service.
To minimize time you spend advising clients who will end up buy vaccines from other sources, prepare written guidelines, send information in electronic newsletters and provide links to AAEP recommendations on your website and social media.
Share stories of patients who achieved better health through annual exams using these same channels. Simply giving a shot is not where your value as a veterinarian lies; serving as a trusted resource and providing primary health care for a beloved family member or talented athlete is where you can shine for many years.
Resources
1. “The History of Vaccines.” Accessed 5/11/2015. http://www.historyofvaccines. org/content/timelines/all
2. M. Lombard , P. Pastoret, M. Moulin. “A brief history of vaccines and vaccination.” Rev. sci. tech. Off. int. Epiz., 2007, 26 (1), 29-48. Accessed 5/11/2015. http:// www.oie.int/doc/ged/d4000.pdf
3. AAEP Touch Research Results. Accessed 5/15/2015. https://touch.aaep.org/
4. American Veterinary Medical Association, “US Pet Ownership and Demographics Sourcebook.” (Schaumburg: AVMA, 2012)
