This online workshop series is part of a program of work to identify and address constraints to using emergency vaccination in Europe and its neighbourhood. During the first workshop, held on 10 March 2022, participants used FMD outbreak scenarios to develop specific criteria that would influence a decision to implement emergency vaccination for FMD

1. Aproach to FMD control – a role for
vaccination ?
Australia
Emergency Vaccination Workshop 2. 14 June 2022
Graeme Garner
European Commission for the Control of Foot-and-Mouth Disease

2. Introduction
● Background
● Context and drivers
● Findings from modelling studies
● Australia’s approach and vaccination policy
● Conclusions
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3. Background
● Vaccination increasinglybeing recognised as an
important tool to assist in eradicating FMD
● Modelling studies: vaccination, if used early can
reduce size and duration of outbreaks under some circumstances
● Can avoid the need for large scale culling of at-risk animals
● Reduce environmental problems - disposingof large numbersof culled animals
● However, vaccination will make achieving recognition of free status more difficult
○ For exporting countries implicationsof vaccinationrequire careful consideration
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4. Australia – context and considerations
● Major exporter of livestock, livestock products, and genetic material
● Large country, large animal populations, long distances, low human population
● Reduction in animal health services – resourcinga responsewill be a key issue in
Australia
● Social attitudes – opposition to destruction of large numbersof ‘healthy’ animals
● Disposingof large numbers of culled animals has emerged as a significant issue
● Preparednessplanning - key priorityfor government and industry
● Modelling studies (regional, national and international) have been an important
component
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5. Australia’s approach to FMD
● Australiawill maintain a flexible policy to FMD control - use vaccination if
appropriate for a specific outbreak situation
● Move beyond the simple question of whether vaccination should be used or not
o Understand when vaccinationmay (and may not) offer benefits)
● Addressoperational issues:
o How to use vaccine
o Timing (when to use)
o What species to vaccinate
o Setting vaccinationpriorities
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6. Modelling studies
● Vaccination can be effective in reducingthe size and duration of outbreaks:
○ where FMD is likelyto spread rapidly(larger outbreaks)
○ when resources to control the disease are constrained
○ if used early in an outbreak
○ suppressive ring vaccinationgenerally outperforms protective vaccination
● However no ‘one size fits all’. Factors influencingsize of an outbreak:
○ how, where and when FMD is introduced
○ time to first detection
○ adequacyof resources for control
2016)
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7. Identifying higher risk areas for FMD establishment and spread
(FMD Ready Project 2020)
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Establishment Spread

8. ● Best estimates of effectiveness of surveillance system – size of outbreak when
reported
● Potential for FMD to establish and spread quite variable in different parts of
Australia
○ Lower in northern/central Australia), higher in south eastern Australia)
● First report ~ 3 week after introduction
○ could expected >10 infected premises (potentiallya lot more)
○ More pessimistic assessment: 5 or more weeks with 30-40 premises infected in
multiplestates
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Time to detection - GSEWG

9. Importance of resources
● Australia’s capacity to deal with a medium-large outbreak of FMD reviewed
● Baseline (realistic) resources, probability of eradication using SO only (Vic scenario):
○ 16% within 3 months, 60% probability within 6 months
● Additional 60 personnel in first 3 weeks:
○ 68% within 3 months, 100% within 6 months
● Targeted vaccination in high risk areas:
○ 74% within 3 months, 100% in 6 months
● Highlighted importance of:
○ careful resource management
○ potential importance of vaccination
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10. Predicting outbreak size?
● Joint Australia – New Zealand modellingstudy
● Number of IPs, number of pending culls, infected area,
EDR, cattle density - correlated with final outbreak size
● Predictability improved at later time points in the outbreak
● Relatively simple metrics available early in a control program can be used to
indicate the likelymagnitude of an FMD outbreak under Australianand New
Zealand conditions
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11. FMD Ready Project (2016-2020)
● Evaluate vaccination for a range of incursionscenarios
○ 13 incursion scenarios, 9 control strategies (7 vacc)
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12. Outbreak size and duration
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13. Vaccine strategies
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14. Results
● smaller outbreaks can be effectively managed by stamping out
● the size and duration of larger outbreaks can be significantly reduced when
vaccinationis used
● different vaccinationstrategies produced similarreductions in the size and
durationof an outbreak, but the number of animalsvaccinatedvaried
● selective, targeted vaccinationstrategies could achieve control whilst
significantlyreducing the number of animalsvaccinated
● targeting vaccinationto (a) higher risk regions based on cattle density or (b)
vaccinatingcattle only appearto offer significant advantages
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15. FMD policy
● To eradicate an outbreak as rapidly as possible, preferred option being eradication by stamping-out
● But, Australia will
○ consider the potentialrole of vaccination from the day an incursion of FMD is detected
○ prepare as though vaccination will be used, includingactivatingits FMD vaccine bank
○ make use of lay vaccinators,possiblylivestockowners themselves,to deliver vaccine duringan
outbreakif required
● Vaccination? If authoritiesconsider it would be beneficial in containing and managing the outbreak
● The decision to vaccinate and how to apply vaccination is complex and depends on epidemiological,
logistical, and socio-economic factors.
Decisions on FMD control likely to be controversial and will have to be made in the face of uncertainty.
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16. Decision-making - 3 components
1. Initial assessment
2. Vaccination strategy
3. Vaccinated animal management strategy
● Advice on vaccination will be provided by FMD Vaccination Expert Advisory
Group (VEAG)
● Decision criteria and a decision tree have been developed to assist decision-
making
○ Available at : https://animalhealthaustralia.com.au/ausvetplan/.
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17. Decision making I
1. Initial assessment– a role for vaccination?
● Can disease be controlled with available resources?
● Compare the following scenarios:
○ FMD appearsto have been introduced relativelyrecently, few infected
properties, within a single industry compartment.
○ Multi-focaloutbreak in a high-density livestock production area where
there is already evidence of spread across and between different industry
sectors Resourcing problems for surveillance and stamping-out anticipated
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18. Decision-making II
2. What approach to use?
○ strategy (protective, suppressive, mass)
○ species
○ prioritisation
● Will depend on range of
○ demographic,
○ logistical, and
○ other Issues
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19. Decision-making III
3. Managing vaccinated animals?
○ live out their normal commercial lives
○ remove them from the population
● There are technical considerations(e.g. identification, movement controls,
surveillance)but ultimately the decision is a socioeconomicone
○ To minimise the long-term impacts essential to regain FMD-free status and
re-establish internaland export markets
○ Under current conditions,FMD-vaccinated animalswould be expected to
cause market access difficulties
○ May change in the future.
● Essential to be flexible and keep options open
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20. Conclusions
● Key factors that will affect the size of an FMD outbreak are
○ Time until FMD is recognised
○ Rates of spread that will apply
○ Availabilityof resources to implement control measures
● While each outbreak needs to be consideredindividually, some lessons emerge.
○ Under extensive conditionswith relativelylow rates of spread, emergency
vaccinationdoes not appearto offer any advantagesfor control
○ In situations where disease is likelyto spread rapidly and resources may be
limited, emergency vaccinationcan be a very effective tool for containingan
outbreak
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21. Conclusions cont’d
● Relativelysimple metrics availableearly in a control program can be used to
indicatethe likelymagnitude of an outbreak
● A medium to large outbreak of FMD will stretch resources to the limit. Vaccination
may be an essential component of a response
● If vaccinationis used, vaccinatedanimals will have to be managed to minimise
trade effects
● Selective, targeted vaccinationstrategies can achieve effective FMD control whilst
significantlyreducing the number of animalsvaccinated
● Vaccinationis only likely to be effective if you have a clear picture of when, where
and how to use it and it can be delivered in a timely fashion.
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22. fao.eufmd.org eufmdlearning.works eufmdvirtual.com #eufmd
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