Efficacy of avian influenza vaccine in poultry: a meta-analysis.

Vaccination is an effective method for controlling avian influenza (AI), especially in countries with endemic infection. This study conducted a Bayesian meta-analysis to evaluate the efficacy of AI vaccines in chickens. We included both inactivated and recombinant fowlpox virus expressing H5 (rFPV-H5) vaccine studies that used specific-pathogen-free chickens where outcomes against the H5N1 or H5N2 AI viruses were measured. Vaccine efficacy was evaluated by protection from mortality, protection from morbidity, reductions in virus isolation from the respiratory tract, and reductions in virus isolation from the cloaca. The efficacies for homologous inactivated vaccines by those four outcomes were 92% (95% confidence interval 90%-95%), 94% (91%-96%), 54% (50%-58%), and 88% (84%-91%), respectively. Corresponding figures for heterologous inactivated vaccines were 68% (63%-73%), 78% (74%-81%), 24% (16%-31%), and 71% (64%-77%); and efficacies for rFPV-H5 vaccine were 97% (94%-99%), 93% (90%-94%), 21% (14%-27%), and 78% (72%-84%), respectively. Although those vaccines protect chickens from morbidity and mortality, virus shedding would be an important biosecurity issue for further AI endemic control.