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Review
. 2023 Nov 1:4:100072.
doi: 10.1016/j.crimmu.2023.100072. eCollection 2023.

The efficacy, safety, and immunogenicity of plague vaccines: A systematic literature review

Louise Hartley  1 , Sydney Harold  1 , Emma Hawe  1
Affiliations
Review

The efficacy, safety, and immunogenicity of plague vaccines: A systematic literature review

Louise Hartley et al. Curr Res Immunol. .

Abstract

Plague remains endemic in many parts of the world, and despite efforts, no preventative vaccine is available. We performed a systemic review of available randomised controlled trials (RCTs) of live, attenuated, or killed plague vaccines vs. placebo, no intervention, or other plague vaccine to evaluate their efficacy, safety, and immunogenicity. Data sources included MEDLINE, Embase, and the Cochrane Library; clinical trial registers; and reference lists of included studies. Primary outcomes were efficacy, safety, and immunogenicity. Risk of bias was assessed using the Cochrane Collaborations tool. Only 2 RCTs, both on subunit vaccines, were included out of the 75 screened articles. The 2 trials included 240 participants with a follow-up of 3 months and 60 participants with a follow-up of 13 months, respectively. Safety evidence was limited, but both vaccines were well tolerated, with only mild to moderate adverse events. Both vaccines were immunogenic in a dose-dependent manner. However, given the limited data identified in this systematic review, we are unable to quantify the efficacy of vaccines to prevent plague, as well as their long-term safety and immunogenicity. More trials of plague vaccines are needed to generate additional evidence of their long-term effects.

Keywords: Bubonic plague; Plague vaccine; Pneumonic plague; Yersinia pestis.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf. LH, SH, and EH have no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities to declare that could appear to have influenced the submitted work.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
PRISMA Flow Diagram of Study Inclusion and Exclusion PRISMA = Preferred Reporting Items for Systematic reviews and Meta-Analyses; RCT = randomised controlled trial.
Fig. 2
Fig. 2
Risk of bias summary.
Fig. 3
Fig. 3
Risk of bias graph.
See this image and copyright information in PMC

References

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