Vaccinating Meat Chickens against Campylobacter and Salmonella: A Systematic Review and Meta-Analysis

Foodborne enteritis is a major disease burden globally. Two of the most common causative bacterial enteropathogens in humans are Campylobacter and Salmonella species which are strongly associated with the consumption of raw or contaminated chicken. The poultry industry has approached this issue by use of a multi-hurdle method across the production chain to reduce or eliminate this risk. The use of poultry vaccines is one of these control methods. A systematic review and meta-analysis of vaccination effects against caecal Campylobacter and Salmonella were performed on primary research published between 2009 and 2022. Screening was conducted by three reviewers with one reviewer performing subsequent data extraction and one reviewer performing the risk of bias assessment. The confidence in cumulative evidence was evaluated based on the GRADE method. Meta-analyses were performed using standardised mean differences (SMDs) with additional analyses and random effects regression models on intervention effects grouped by the vaccine type. A total of 13 Campylobacter and 19 Salmonella studies satisfied the eligibility criteria for this review. Many studies included multi-arm interventions, resulting in a total of 25 Campylobacter and 34 Salmonella comparators which were synthesised. The analyses revealed a large reduction in pathogen levels; however, many effects required statistical adjustment due to unit of analysis errors. There was a moderate level of confidence in the reduction of Campylobacter by 0.93 SMD units (95% CI: −1.275 to −0.585; p value < 0.001) and a very low level of confidence in the reduction of Salmonella by 1.10 SMD units (95% CI: −1.419 to −0.776; p value < 0.001). The Chi(2) test for heterogeneity (p value 0.001 and <0.001 for Campylobacter and Salmonella, respectively) and the I(2) statistic (52.4% and 77.5% for Campylobacter and Salmonella, respectively) indicated high levels of heterogeneity in the SMDs across the comparators. The certainty of gathered evidence was also affected by a high risk of study bias mostly due to a lack of detailed reporting and, additionally for Salmonella, the presence of publication bias. Further research is recommended to source areas of heterogeneity, and a conscious effort to follow reporting guidelines and consider units of analysis can improve the strength of evidence gathered to provide recommendations to the industry.