In the past, annual revaccinations were the standard of care after a puppy had been given her initial vaccines. However, research has shown that the duration of immunity is actually longer than one year, and the new standard protocol recommends revaccination every three years. Holistic veterinarians and many integrative veterinarians believe that dogs maintain their immunity even longer than three years for many diseases and don't need vaccination so frequently. Many holistic veterinarians prefer to use a titer before administering another vaccine.

A high titer count reveals a high level of immunity to the disease, while a low titer count indicates that the dog is still susceptible to the disease. Antibody levels can be measured with the distemper virus, parvovirus, adenovirus, and Lyme disease, but they are not available for bordatella, parainfluenza virus, or coronavirus.

If you decide not to vaccinate your dog because you are concerned about an adverse reaction, plan on taking your dog to the veterinarian once every three years for titers. Ask your veterinarian about the expense of having a titer and decide in advance if this fits your budget. Many veterinarians charge the same amount for a titer that they would for a vaccine.