Risk-Based Vaccination Protocols for Horses
Know when your horse might need one of these important vaccines

Vaccination serves as a core component of equine preventive medicine that can help keep your horse and others safe from dangerous and potentially deadly diseases. Ideally, equine veterinarians administer vaccines early in the year to prepare horses’ immune systems for the coming months when they will likely have the most exposure to some potentially infectious pathogens.
Core vaccines are a necessary part of all horses’ yearly wellness plans with their veterinarians. Regardless of your horse’s activity level, housing, or use, the American Veterinary Medical Association (AVMA) and American Association of Equine Practitioners (AAEP) recommend vaccinating horses annually against diseases that have the potential to affect public (horse and human) health, must be vaccinated against by law, or can cause severe disease or death. These include rabies, tetanus, West Nile virus, and Eastern and Western equine encephalomyelitis (EEE and WEE).
“Core (equine) vaccines are those vaccines that are recommended for all horses, at least annually,” says Elizabeth Davis, DVM, PhD, Dipl. ACVIM, professor and associate dean of clinical programs at Kansas State University’s College of Veterinary Medicine, in Manhattan. “These are diseases that we should recognize that a horse could contract while standing in a pasture, and they are typically diseases that if infected, will be likely to result in serious if not life-threatening and possibly zoonotic (contagious to humans, in the case of rabies) disease.”
Veterinarians administer risk-based vaccines, however, based on a horse’s potential to contract certain diseases, after the owner and veterinarian perform a risk-benefit analysis. Risk-based vaccine plans can vary regionally and should be tailored to the individual horse or farm. When managing a group of horses, combining meticulous biosecurity practices with a strict vaccination protocol can help reduce disease risk.
Risk-Based Vaccines for Horses
Most often, horse owners and their veterinarians determine what risk-based vaccines, if any, a horse could benefit from based on his location, workload, frequency of travel, and resident herd status (i.e., how much the horses leave the farm and commingle with others). The AAEP lists the available risk-based vaccines as:
- Anthrax Horses can contract this serious, septicemic (caused by the spread of bacteria and their toxins in the bloodstream) disease through inhalation, contamination of a wound, ingestion, or mechanical transmission by blood-sucking insects. Horses in geographic locations with alkaline soil are at the highest risk because this environment supports Bacillus anthracis (the causative bacterium) spore survival. Anthrax carries a high mortality rate and can be transmitted between animals of different species.
- Equine influenza is the most common respiratory disease in horses and is highly contagious. The virus can spread rapidly through aerosolized droplets distributed when infected horses cough and clear their airways. The most common clinical signs include coughing and abnormal respiratory sounds but also fever, edema, and enlarged lymph nodes.
- Botulism This is the most potent known biological toxin, produced by the bacterium Clostridium botulinum. It causes neurologic clinical signs beginning with weakness and quickly progressing to paralysis and often death. The bacterium can be found in decaying animal carcasses or plant material, and horses contract it by inadvertently ingesting it while grazing or eating hay.
- Leptospirosis Infected animals, including wildlife, spread the causative bacteria, Leptospira, through urine and other bodily fluids. Horses can be exposed via open wounds or the mucous membranes, most commonly via water or soil. Clinical signs can include uveitis (ocular inflammation), placentitis or abortion in pregnant mares, or acute renal failure.
- Potomac horse fever While this infection most commonly occurs in horses in the eastern United States residing near the Potomac River, cases have been reported worldwide. Horses are most likely to be infected with the causative bacterium, Neorickettsia risticii, between late spring and early fall. N. risticii has a complex life cycle, first infecting parasites of freshwater snails, which the snails release when the water is warm, then infecting larval stages of aquatic insects such as caddisflies, mayflies, damselflies, dragonflies, and stoneflies. These aquatic flies thrive abundantly during specific times of the year and can serve as a reservoir for potential infection during the summer and fall months; typically, horses ingest the flies after they’re attracted to lights in the barn and fall into horses’ feed buckets and hay, or they can ingest them in water. Clinical signs vary but can include diarrhea, fever, mild/moderate colic, and acute laminitis.
- Snakebite In areas where venomous snakes such as rattlesnakes and copperheads are abundant, horses have a higher risk of getting bitten, which can lead to death if not treated immediately. Clinical signs can vary based on the type of snake but typically include pain and swelling at the site of the bite. After horses have recovered from snakebite, veterinarians typically monitor them for heart failure or kidney damage, which can occur in the weeks following the bite.
- Strangles, caused by the bacterium Streptococcus equi subspecies equi, most commonly infects young horses. Some infected horses might become carriers for an extended time, meaning they can shed S. equi for months or years. This disease is highly transmissible through both direct (i.e., nose to nose contact between horses) and indirect (i.e., a horse drinking from a water bucket that an infected horse used) contact between horses. Infected horses typically exhibit clinical signs such as fever and nasal discharge or pus draining from ruptured lymph nodes around the throat.
- Rotavirus This viral infection is spread through the fecal-oral route and is a common cause of illness and death in foals, though it can be largely prevented by vaccinating the dam during pregnancy. Infected foals typically have diarrhea, are lethargic, and will not eat. Although a vaccine for foals exists, there is no published research showing evidence that the vaccine can provide them significant protection.
- Equine viral arteritis While typically not life-threatening to adult horses, equine arteritis virus is spread through respiratory secretions in close quarters (i.e., horses stabled near one another), fomites (brushes, humans, etc.), and breeding. Equine viral arteritis can cause abortion in mares, death in young foals, and stallions typically become lifelong carriers. Clinical signs of equine viral arteritis can vary greatly from fever and depression to localized swelling of the limbs (especially hind limbs), scrotum or mammary glands, and underside of the abdomen.
- Equine herpesvirus-1 and -4 are most common in horses that commingle with horses from other farms. Both are spread by direct and indirect contact and in many cases establish latent (hidden) infection in horses that then become asymptomatic carriers. Clinical signs of EHV-1 include respiratory disease, abortion, and neurologic defects, while EHV-4 typically causes respiratory disease.
- Venezuelan equine encephalomyelitis Horses living in Southern Texas, California, Louisiana, Mississippi, Alabama, and the west coast of Florida have the highest risk of contracting this disease, which is most often seen in Central and South America. This virus is also typically transmitted through mosquitoes. Venezuelan equine encephalomyelitis can cause fever, depression, paralysis, gait abnormalities, and seizures, but the prognosis depends upon the subtype of the virus.
Assessing Your Horse’s Risk
“It is important to make a risk-based decision to understand what is best for the individual horse and the population in which it lives,” says Noah Cohen, VMD, MPH, PhD, Dipl. ACVIM, professor of equine internal medicine, Patsy Link professor of equine research, and associate department head for research and graduate studies in the Department of Clinical Sciences at Texas A&M University’s School of Veterinary Medicine and Biomedical Sciences, in College Station. Not all risk-based vaccines are necessary for every horse, and some might be harmful to certain groups of horses, he adds.

Practitioners might recommend vaccinating horses based on the resident farm population’s risk. An older horse that stays on the farm could have a decreased risk of developing some diseases, but his veterinarian might recommend vaccinating him because young show horses also live on the property.
“Vaccinating the older horse might strengthen herd immunity even if it has little impact for the individual horse,” says Cohen. “Risk-based vaccination should be considered case-by-case (where the case might be a horse, a herd, or both) and there is subjectivity in this decision-making process. For example, a veterinarian might recommend that horses be vaccinated for strangles at a farm with a history of this disease, but not for other horses living in settings where the disease is considered low risk. Another veterinarian might say vaccinating all horses for strangles would reduce the burden of disease for all horses.”
Practitioners often decide which risk-based vaccines a horse should receive based on geographic location, likelihood of exposure, and the horse’s use, adds Davis. “Working directly with a licensed veterinarian is the best way to establish a protocol that is appropriate for a specific horse or situation,” she says. The AAEP consistently collaborates with researchers to develop and publish current recommendations for equine veterinarians and owners to access.
Horses that travel frequently, are exposed to horses from other farms, and are in stressful situations such as horse shows are more likely to develop respiratory disease, notes Davis. “Intense exercise and long-distance travel have been shown to reduce immune function when combined with exposure to other horses that may be shedding pathogens,” she says.
For example, show horses that stable near horses from other farms at competitions or travel with strange horses to and from shows might be more likely to contract EHV-1 and/or -4 than horses that do not have contact with others; therefore, it is important to maintain vaccine protocols as outlined by sport governing bodies such as US Equestrian. “In most instances, show regulations require proof of vaccination against EIV/EHV-1/4 at least every six months,” says Davis. “These vaccines must be maintained on a regular basis and must be administered by a licensed veterinarian.”
Common Risk-Based Vaccine Misconceptions
“A myth that is sometimes shared is that horses maintained on a farm setting or used for breeding are not at risk for disease other than those included with core vaccines,” says Davis. “It is important to recognize that horses leaving and returning to a property can potentially pose risk to other residents.” Horses that live close to others, especially those that share a fence line with horses from another farm, are also at an increased risk of contracting disease even if it might not appear that way, she adds.
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Dr. Noah Kohen
“The risks posed by vaccines have been the subject of much misinformation in both human and veterinary medicine,” says Cohen. “There is little doubt that the benefits of vaccines vastly outweigh the risks. As an equine veterinarian, I hate to think where we would be without vaccines for tetanus, West Nile virus, or rabies.”
Vaccines should always be given to otherwise healthy horses to minimize the risk of adverse reactions.
“In the rare circumstances when an adverse reaction occurs from a vaccine in a healthy horse, it is perceived as more harmful than when an adverse reaction occurs from using a medication used to treat an illness,” Cohen adds. “Preventing disease is a much more effective way of controlling disease than treating cases, but curing an animal of disease is often more compelling to horse owners than preventing disease in a healthy horse.”
Even if a horse develops a disease shortly after vaccination, it’s important to understand it might be coincidental; while adverse reactions do occur, they are much rarer than coincidental events, says Cohen. They are also often—but not always—relatively minor. “The diseases prevented are more serious than the most commonly reported adverse reactions such as swelling or soreness at the vaccine site,” he says. “The USDA’s Center for Veterinary Biologics that licenses vaccines for veterinary medicine has always set a high bar for safety of vaccines, and my limited experience has been that companies that manufacture vaccines consider (product) safety to be just as important as efficacy.”
Take-Home Message
Work closely with your veterinarian to develop a risk-based vaccine plan. Evaluate needs of the individual horse, the herd in which he lives, geographic location, age, and use before determining necessary vaccines. Preventing disease is one of the best ways to improve equine health and welfare. “I think people forget how valuable vaccines are for equine health,” says Cohen. “Failure to vaccinate horses appropriately increases risks for the individual horse, the horses in its population, and—for some diseases like rabies—human health as well.”

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