Vaccination and surveillance for high pathogenicity avian influenza in poultry-current situation and perspectives.

The International Alliance for Biological Standardization (IABS), in collaboration with the World Organization for Animal Health (WOAH) convened a hybrid meeting on 22-23 October 2024 at the WOAH Headquarters (HQ) in Paris, France to discuss the global state of vaccination and surveillance for high pathogenicity avian influenza (HPAI) in poultry. The primary objective of the meeting was to advance vaccination acceptance to both control virus spread and reduce disease. Vaccination is increasingly recognized as a tool to complement biosecurity, movement controls and stamping-out of infected flocks. However, concerns persist regarding the risk of undetected, sustained transmission (silent infection) in vaccinated flocks as a result of inadequate surveillance. This has contributed to both vaccination hesitancy and trade barriers. The meeting aimed to assess the current state of the art regarding HPAI surveillance programs in vaccinated populations and their effectiveness. Representatives of multiple stakeholders were invited to share their experiences and perspectives on the use of vaccination and accompanying surveillance to control the growing H5N1 panzootic and its global impact. Several conclusions and recommendations emerged as essential to advancing the acceptance of vaccination strategies. These included (1) the utility of quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) as a sensitive, specific and economical tool to detect virus in vaccinated populations, (2) regular testing of dead birds within a flock as a highly effective method for early detection of outbreaks in vaccinated flocks and demonstrating freedom from infection and, (3) the importance of collecting information on circulating field strains in the selection of candidate vaccine antigens to ensure adequate efficacy. Testing sentinel birds was deemed less effective for surveillance and serological testing of vaccinated birds was considered more useful for assessing immunity levels than for determining the infection status of a flock. There was broad agreement on the need to standardize surveillance outcomes in terms of accepted confidence levels to promote safe and fair trade. However, it was acknowledged that context and pragmatic considerations will shape the development of situation specific plans, which must be statistically valid, scientifically sound, economically feasible and operationally sustainable for both governments and industry. Concomitantly, it was recommended that trade policies tied to vaccination and surveillance should be based solely on science and risks. To this end, enforcement of existing international rules and resolution of disputes are considered a shared responsibility. Peer reviewed publications were proposed as a central mechanism for developing the stronger guidelines needed to facilitate fair trade agreements and enable implementation of global vaccination programs. Rapid dissemination of information, consistent messaging and exchange of virus isolates were also seen as critical for coordinating an effective global response to controlling HPAI.