Plague is a rare disease now, but can be life threatening. It is transmitted by fleas and related to rat infestation. There are different forms of the disease, but they can all lead to blood poisoning and to death, although antibiotics are effective against the bacterium that causes it. Vaccines are available for use in laboratory staff working on the disease; however when the authors searched the literature they found no studies of sufficient quality to be included in this review. We therefore cannot make confident decisions about the effectiveness or tolerability of any plague vaccines.
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Plague is endemic in China, Mongolia, Burma, Vietnam, Indonesia, India, large parts of Southern Africa, the United States and South America. There are three types of vaccines (live attenuated, killed and F1 fraction) with varying means of administration.
Objectives
The objective of this review was to assess the effects of vaccines to prevent plague.
Search strategy
We searched MEDLINE (1966 to February 2011), EMBASE (1985 to February 2011), CENTRAL (The Cochrane Library 2011, Issue 2) and reference lists of articles. We handsearched the journal 'Vaccine' (up to 1997) and contacted experts in the field.
Selection criteria
Randomized trials comparing live and killed plague vaccines against no intervention, placebo, other plague vaccines or vaccines against other disease (control vaccines).
Data collection and analysis
Three reviewers assessed the eligibility of trials.
Main results
No trials were included.
Authors' conclusions
There is not enough evidence to evaluate the effectiveness of any plague vaccine, or the relative effectiveness between vaccines and their tolerability. Circumstantial data from observational studies suggest that killed types may be more effective and have fewer adverse effects than attenuated types of vaccine. No evidence appears to exist on the long-term effects of any plague vaccine.
