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Country, territory, zone or compartment (keep as appropriate)
Disease history (previous outbreaks in poultry or cases in wild birds of HPAI/LPAI)
Description of the reasons for the decision on the introduction of vaccination
Risk assessment based on:
Avian influenza outbreak within that third country, territory, zone or compartment (keep as appropriate)
Avian influenza outbreak in a nearby country
Other risk factors such as certain areas, type of poultry husbandry or categories of poultry or other captive birds
Geographical area where vaccination is carried out
Number of establishments in vaccination area
Number of establishments where vaccination is carried out, if different from number in point 6
Species and categories of poultry or other captive birds in vaccination territory, zone or compartment
Approximate number of poultry or other captive birds in the establishments referred to in point 7
Summary of the vaccine characteristics
Authorisation, handling, manufacture, storage, supply, distribution and sale of avian influenza vaccines on national territory
Implementation of a DIVA strategy
Envisaged duration of vaccination campaign
Provisions and restrictions on the movements of vaccinated poultry and poultry products derived from vaccinated poultry or vaccinated other captive birds
Clinical and laboratory tests carried out in the establishments vaccinated and/or located in the vaccination area (e.g. efficacy and pre-movement testing etc.)
Means of record keeping (e.g. for the detailed information referred to point 15) and registration of holdings where vaccination is carried out.
Where vaccination is carried out in a third country, territory, zone or compartment all commercial establishments that are vaccinated against avian influenza must be required to undergo laboratory testing and the following information, in addition to the information referred to in Part I.A to Annex IV, shall be submitted:
Number of vaccinated establishments in area per category
Number of vaccinated establishments to be sampled per poultry category
Use of sentinel birds (indicate species and number of sentinel birds used per shed)
Number of samples taken per establishment and/or shed
Data on vaccine efficacy.
Please give as much detailed information as necessary to allow proper assessment of the programme.