This is a hot topic at work right now. It's comping up on "heartworm season" so we recommend an annual heartworm or 4DX test for all dogs in addition to using a heartworm preventative either year-round or thaw to freeze. We all have different opinions on the importance of vaccines and bloodwork, which is something I, and the other technicians at work, understand.
Our clinic recommends an annual DHPP combo vaccine, and we follow the WI state law of three year rabies vaccines after the initial one year. Those two (Rabies and DHPP) are considered the "core" vaccinations (communicable/zoonotic and life threatening). If I were in need of compromise in order to save on cost. I would likely let the DHPP go another year and run a heartworm test instead. At the clinic I work, a DHPP and heartworm test are only cents difference. As a technician, it is my job to "present the facts" to the owner and let each one decide. I've discussed with one of the veterinarians I work with about compromise, and how do we present the information as unbiasedly as possible. I clearly have a bias, but I try not to let it interfere.
How does your veterinarian present heartworm and vaccine information? Do you run a yearly heartworm test, do you give annual vaccines? Does your dog have risk factors that affect your decisions?
Truthfully, I run a 4DX on both of my dogs every spring. They are on every 3 years for DHPP and Rabies, alternating years. I haven't given a Lyme vaccine in years and the 4DX hasn't shown Lyme positive for either one. Though, the Lyme vaccine is giving me a lot of headache this year. I just cannot decide!