1
|
Amdany H, Koech B. Best practice implementation on reporting of coronavirus disease 2019 vaccine adverse events following immunization in Uasin Gishu County, Kenya. JBI Evid Implement 2023; 21:146-155. [PMID: 36545897 DOI: 10.1097/xeb.0000000000000362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This project's aim was to implement vaccine safety surveillance best practices to improve reporting of adverse events following immunization (AEFI) during coronavirus disease 2019 (COVID-19) vaccination roll out in Uasin Gishu County. INTRODUCTION Weak vaccine safety surveillance systems in developing countries has contributed to underreporting of AEFIs undermining public confidence in immunization efforts, contributing to low uptake of vaccines critical in the fight against communicable diseases. METHODS The JBI Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit tool for promoting change in healthcare practice was utilized. Preimplementation and postimplementation audit cycles carried out utilized six best practice recommendations. Context-specific strategies and resources were used to address the gaps identified. RESULTS Less than half of the AEFIs reported were in accordance with the local policy recommendation, and most of the AEFIs reported were submitted in a timely manner in the baseline and follow-up cycle. Slight improvement was recorded in the number of health facilities with AEFIs reporting forms. An improvement of 33.7% was recorded in the number of health workers providing COVID-19 vaccination services who had received education and practical training on vaccine pharmacovigilance. CONCLUSION Underreporting and delayed submission of COVID-19 vaccine AEFI was evident among the healthcare providers offering COVID-19 vaccination services, the majority of healthcare providers had received training on vaccine pharmacovigilance, and AEFI hard copy reporting forms were not adequate in the health facilities. Public education on vaccine safety before administration of vaccine needs emphasis in order to improve reporting of AEFI.
Collapse
|
2
|
Mittal S, Rawat C, Gupta A, Solanki HK, Singh RK. Adverse Events Following Immunization Among Children Under Two Years of Age: A Prospective Observational Study From North India. Cureus 2023; 15:e38356. [PMID: 37266060 PMCID: PMC10229756 DOI: 10.7759/cureus.38356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Vaccination is one of the most cost-effective child survival health interventions. A single serious adverse event following immunization (AEFI) or a cluster of events may lead to a loss of public confidence in the program and a major setback to immunization coverage. This study was conducted to assess the incidence of AEFIs in children less than two years of age. MATERIAL AND METHODS A prospective community-based observational study was conducted in the North Indian state of Uttarakhand from October 2017 to February 2018. A total of 255 children who attended the selected sub-centres for immunization were finally included in the study. Follow-up home visits on the 8th and 30th day of vaccination were carried out to identify any occurrences of AEFIs. RESULTS Among 255 children, 212 AEFIs from 152 vaccinated subjects were reported. The majority of the AEFIs were reported in the age group 0-1 years. The incidence of AEFIs was 33.0 per 100 doses of vaccines administered. The most common AEFI reported was fever (101, 47.6%), followed by swelling (53, 25.0%). Among the vaccines, Pentavalent + oral polio vaccine (OPV) (48.8 per 100 doses) was majorly responsible for AEFIs, followed by diphtheria pertussis tetanus (DPT) + measles and rubella (MR) + OPV (46.6 per 100 doses). CONCLUSION Our findings revealed that although the incidence of AEFI reported was high, all of them were minor and no serious AEFIs were identified. The awareness among health professionals and the public regarding the reporting of AEFIs should be continued to increase the safety profile of vaccines.
Collapse
Affiliation(s)
- Sneha Mittal
- Department of Community Medicine, Soban Singh Jeena Government Institute of Medical Science and Research, Almora, IND
| | - Cms Rawat
- Department of Community Medicine, Veer Chandra Singh Garhwali Government Medical Science and Research Institute, Srinagar, IND
| | - Amit Gupta
- Department of Pharmacology, Soban Singh Jeena Government Institute of Medical Science and Research, Almora, IND
| | - Hariom K Solanki
- Department of Community Medicine, Government Institute of Medical Sciences, Greater Noida, Greater Noida, IND
| | - R K Singh
- Community Medicine, Pandit Deendayal Upadhyaya Medical College, Churu, IND
| |
Collapse
|
3
|
Pagar VS, Chavan SS, Patil SP, Borde A, Kinge AD, Khargekar N. Epidemiological study of adverse events following immunization in under 5 year children. J Family Med Prim Care 2021; 10:2482-2487. [PMID: 34568123 PMCID: PMC8415665 DOI: 10.4103/jfmpc.jfmpc_2328_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/02/2020] [Accepted: 03/17/2021] [Indexed: 11/18/2022] Open
Abstract
Background: The present study was conducted to study the socioeconomic and the demographic profile of children reporting with adverse events following immunization (AEFI) along with the determinants associated with AEFIs, based on investigation of each case and to assess the proportion of programmatic errors linked with AEFI cases. Materials and Methods: Record-based cross–sectional study conducted among sample of 118 cases of AEFI were reported. The case reports of all AEFI cases were procured and analyzed to identify factors associated with reported AEFI. The questionnaires related with preliminary investigation reports (PIRs) including forensic evidence of death cases were analyzed. Percentage analysis of data was done by proportions, measures of central tendencies, and Chi-square test. Results: Most of the cases reported were between 0 and 3 months of age constituting 39%. AEFI was seen more in male child than female. more than half of cases of AEFI were recorded following immunization with OPV/DPT/HBV together (66.94%). Most common AEFI reported were convulsion (68.64 %) and fever (58.47%) followed by local swelling at site of injection (11.86%). More than half of the cases of AEFI occurred within 12 hours of immunization (61.88%). Birth weight of most cases of AEFI were in the range between 2 and 2.4 kg (44.06%), followed by range between 2.5 and 2.9 kg (32.20%), the mean of birth weight was 2.51 kg. Conclusion: Convulsion was the most commonly reported AEFI, majority of AEFI occur within 12 h of immunization. Most of the AEFI were recorded following immunization with OPV/DPT/HBV together.
Collapse
Affiliation(s)
- Vikrant S Pagar
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Sushant S Chavan
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Sarika P Patil
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Anant Borde
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Amol D Kinge
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Naveen Khargekar
- Department of Preventive Oncology, Homi Bhabha Cancer Hospital, Varanasi, India
| |
Collapse
|
4
|
van den Boogaard J, de Gier B, de Oliveira Bressane Lima P, Desai S, de Melker HE, Hahné SJM, Veldhuijzen IK. Immunogenicity, duration of protection, effectiveness and safety of rubella containing vaccines: A systematic literature review and meta-analysis. Vaccine 2021; 39:889-900. [PMID: 33454135 DOI: 10.1016/j.vaccine.2020.12.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Rubella containing vaccines (RCV) prevent rubella virus infection and subsequent congenital rubella syndrome (CRS). To update the evidence on immunogenicity, duration of protection, effectiveness and safety of RCV, we conducted a systematic literature review. METHODS We searched EMBASE and SCOPUS, using keywords for rubella vaccine in combination with immunogenicity (seroconversion and seropositivity), duration of protection, efficacy/effectiveness, and safety. Original research papers involving at least one dose of RCV (at any age), published between 1-1-2010 and 17-5-2019 were included. Where appropriate, meta-analyses were performed. Quality of included studies was assessed using GRADE methodology. RESULTS We included 36 papers (32 randomized controlled trials (RCTs) and 4 observational studies) on immunogenicity (RA27/3 strain) in children and adolescent girls, 14 papers (5 RCTs and 9 observational studies) on duration of protection, one paper on vaccine effectiveness (VE) (BRDII strain), and 74 studies on safety, including three on safety in pregnancy. Meta-analysis of immunogenicity data showed 99% seroconversion (95% CI: 98-99%) after a single dose of RCV in children, independent of co-administration with other vaccines. Seroconversion after RCV1 below 9 months of age (BRDII strain, at 8 months) was 93% (95% CI: 92-95%). For duration of protection, the included studies showed a seropositivity of 88%-100% measured 1-20 years after one or two RCV doses. The single study on VE of BRDII strain, reported 100% VE after one and two doses. Among 34,332 individuals participating in the RCTs, 140 severe adverse events (SAEs) were reported as possibly related to RCV. Among the case reports on SAEs, the association with RCV was confirmed in one report (on fulminant encephalitis). Among 3,000 pregnant women who were inadvertently vaccinated, no SAEs were reported. CONCLUSIONS One and two doses of RCV are highly immunogenic for a long period of time, effective in preventing rubella and CRS, and safe.
Collapse
Affiliation(s)
- Jossy van den Boogaard
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Brechje de Gier
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Priscila de Oliveira Bressane Lima
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Shalini Desai
- World Health Organization, Department of Immunization, Vaccines and Biologicals, Geneva, Switzerland
| | - Hester E de Melker
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Susan J M Hahné
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| | - Irene K Veldhuijzen
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (Cib), Bilthoven, the Netherlands
| |
Collapse
|
5
|
Khazaei Z, Moradi G, Zahraei SM, Gouya MM, Goodarzi E, Yaghini F, Roshani D. The Comparison of the Adverse Events of Pentavalent Vaccine and DPT Vaccine in 2-6 Months Infants in Iran: A National Study. Ann Glob Health 2020; 86:11. [PMID: 32064229 PMCID: PMC7006586 DOI: 10.5334/aogh.2449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Vaccination is the most remarkable intervention in public health and is an effective strategy in controlling infectious diseases among infants. Objectives The aim of this study was to compare the adverse events of Pentavalent vaccine and DPT vaccine in two- to six-month-old infants in Iran. Methods This is an analytical cross-sectional study in which healthy infants aged two to six months, having received DPT vaccine in 2013 and Pentavalent vaccine in 2015, were studied for any experienced adverse events related to these vaccines. Percentage, mean, standard deviation and chi-square tests were used to describe and analyze the data (p < 0.05). Findings The results showed that 10,464 and 17,561 adverse events, which were associated with DPT vaccine and Pentavalent vaccine respectively, were recorded in the infants who received these vaccines throughout Iran. Mazandaran, Qazvin and Golestan provinces reported the highest number of adverse events, respectively (15.74%, 11.25%, and 9.12%). Moreover, Pentavalent vaccine seemed to have more recorded adverse events compared to DPT, high fever had the highest record rate for DPT vaccine (47.4%) and mild localized complications was the highest for Pentavalent vaccines (31.68%). There was a significant relationship between the kind of vaccine and the type of reaction, adverse event categorization and the country that produced the vaccine (p < 0.05). Conclusion Severe localized adverse events including high fever, vomiting, diarrhea and restlessness seemed to be less in Pentavalent vaccine compared to DPT vaccine. Therefore, substituting Pentavalent vaccine for DPT vaccine in infants seems to reduce the adverse events among them.
Collapse
Affiliation(s)
- Zaher Khazaei
- Department of Public Health, School of Medicine, Dezful University of Medical Sciences, Dezful, IR
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, IR
| | - Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, IR
| | - Mohammad Mehdi Gouya
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, IR
| | - Elham Goodarzi
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, IR
| | - Fateme Yaghini
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, IR
| | - Daem Roshani
- Department of Epidemiology and Biostatistics, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, IR
| |
Collapse
|
6
|
Masuka JT, Khoza S. Adverse events following immunisation (AEFI) reports from the Zimbabwe expanded programme on immunisation (ZEPI): an analysis of spontaneous reports in Vigibase® from 1997 to 2017. BMC Public Health 2019; 19:1166. [PMID: 31455314 PMCID: PMC6712865 DOI: 10.1186/s12889-019-7482-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/13/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Vaccine safety surveillance is an essential requirement in vaccination programmes. It supports signal identification, hypothesis generation, and the identification and rectification of gaps in vaccine pharmacovigilance systems. The objectives of this study were to determine the characteristics and trends of adverse events following immunisation (AEFI) and to assess the performance of the Zimbabwe Expanded Immunisation Programme safety surveillance system. METHODS We carried out a descriptive study of passively collected vaccine-related Individual Case Safety Report (ICSR) data submitted to the World Health Organization global adverse drug reaction database (VigiBase®) from Zimbabwe during the period 1997 to 2017. We extracted AEFI/ICSR data using VigiLyze® for analysis with respect to the demographic distribution, AEFI characteristics, reporting trends over time, ICSR timeliness and case completeness. RESULTS A total of 272 vaccine-related ICSRs were included in the analyses with a median completeness score of 0.90 interquartile range, IQR (0.63; 0.90). The overall annual reporting rate was 0.58 per 100,000 vaccine doses and the AEFI reporting ratio ranged between 0 and 30.2 AEFI reports per 100,000 surviving infants. The majority of ICSRs were male (55.3%; p value = 0.641) and the median age was 12 (0-168) months. The majority of ICSRs were reported in children who had received measles (n = 133; 48.9%) and OPV/DTP-Hib-HepB (n = 107; 39.3%) vaccines. Of the 387 observed AEFIs, 301 (77.8%) were systemic events and 86 (22.2%) were local reactions. Systemic events were more frequently reported with doses containing the measles antigen (n = 190; 49.1%) while local events were associated with the multiple antigen OPV/DTP-Hib-HepB (n = 62; 16.0%). The multiple antigen OPV/DTP-Hib-HepB was associated with higher rates for injection site abscess (n = 57), pyrexia (n = 27), diarrhea (n = 15), vomiting (n = 12), and seizures (n = 6). The measles antigen was associated with higher rates for rash (n = 44), ocular disorders (n = 26), pyrexia (n = 26), urticaria (n = 22), diarrhea (n = 8), and vomiting (n = 12). CONCLUSIONS Most of the ICSRs were associated with measles and OPV/DTP-Hib-HepB vaccines. Zimbabwe's vaccine safety surveillance system is still developing and is not yet fully functional. However, the current system provides a reference point for the monitoring of the ongoing AEFI reporting trends and characteristics.
Collapse
Affiliation(s)
- Josiah Tatenda Masuka
- Harare Central Hospital, PO Box ST14, Southerton, Harare, Zimbabwe.
- Department of Dermatology, Nelson R Mandela School of Medicine, Private Bag X7, Congella, Durban, 4013, South Africa.
| | - Star Khoza
- Department of Clinical Pharmacology, College of Health Sciences, University of Zimbabwe, PO Box A178, Avondale, Harare, Zimbabwe
- Discipline of Pharmacology and Clinical Pharmacy, School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa
| |
Collapse
|
7
|
Gentile A, Bricks L, Ávila-Agüero ML, Kfouri RA, Torres JP, Ulloa-Gutierrez R, Glover RE, Sarti E. Pertussis in Latin America and the Hispanic Caribbean: a systematic review. Expert Rev Vaccines 2019; 18:829-845. [PMID: 31317794 DOI: 10.1080/14760584.2019.1643241] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: Pertussis in Latin America continues to cause periodic epidemics with substantial morbidity particularly among young children. The disease has persisted despite long-standing vaccination programs in the region. Areas covered: We conducted a systematic review to characterize the recent epidemiology of pertussis in Latin America and Hispanic Caribbean. We undertook a holistic approach and attempted to include all available data concerning pertussis that may explain the changing dynamics of the disease. Expert opinion: There are wide disparities in the reported annual incidence rates of pertussis both within and between countries in the region. General trends in pertussis incidence are difficult to ascertain due to the heterogeneity in the epidemiological data. Available data suggests that the disease burden has changed over the years such that now it predominantly affects those <1 year. Coverage with three doses of the pertussis vaccine has been highly variable, and very few countries have consistently achieved ≥90% coverage annually since 2000. There remain inequalities in vaccination coverage in some regions/localities and specific groups, which sustains the risk of pertussis dissemination. The WHO considers that maternal pertussis immunization provides protection to infants too young to be vaccinated; >10 Latin American countries currently recommend vaccination of pregnant women.
Collapse
Affiliation(s)
- Angela Gentile
- a Department of Epidemiology, "R. Gutiérrez" Children's Hospital , Buenos Aires , Argentina
| | - Lucia Bricks
- b LATAM PPH, Sanofi Pasteur , São Paulo , Brazil
| | - María L Ávila-Agüero
- c Servicio de Infectología Pediátrica, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense del Seguro Social (CCSS) , San José , Costa Rica.,d Center for Infectious Disease Modeling and Analysis (CIDMA), Yale University , New Haven , CT , USA
| | - Renato Avila Kfouri
- e Santa Joana Immunization Center, São Paulo and Brazilian Society of Immunization , São Paulo , Brazil
| | - Juan Pablo Torres
- f Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Hospital Luis Calvo Mackenna, Universidad de Chile , Santiago , Chile
| | - Rolando Ulloa-Gutierrez
- c Servicio de Infectología Pediátrica, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense del Seguro Social (CCSS) , San José , Costa Rica
| | | | - Elsa Sarti
- h LATAM, Sanofi Pasteur, Coyoacán, CDMX , São Paulo , Mexico
| |
Collapse
|
8
|
Sow C, Sanou C, Medah C, Schlumberger M, Mireux F, Ouédraogo I, Ouédraogo SM, Betsem E. Challenges of cold chain quality for routine EPI in south-west Burkina-Faso: An assessment using automated temperature recording devices. Vaccine 2018; 36:3747-3755. [PMID: 29779921 DOI: 10.1016/j.vaccine.2018.05.062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 05/12/2018] [Accepted: 05/14/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Abnormal temperatures are a major issue for vaccines within the Expanded Program of Immunization in tropical climates. Prolonged exposure to temperatures outside the standard +2 °C/+8 °C range can impact vaccine potency. METHODS The current study used automatic temperature recording devices (Testostore 171-1©) to monitor cold chain in remote areas of Western Burkina Faso. A series of 25 randomly selected health centers representing 33% of the existing 176 EPI facilities in Western Burkina Faso were prospectively assessed for eight months in 2015. Automatic measurements were compared to routine temperature loggers and vaccine vial monitors (VVM). RESULTS The median age for all refrigerators was 9 years with 10/25 (42%) older than 10 years. Adverse temperatures were recorded in 20/24 (83%) refrigerators and ranged from -18.5 °C to +34.2 °C with 12,958/128,905 (10%) abnormal hourly records below +2 °C and 7357/128,905 (5.7%) above +8 °C. Time of day significantly affected the rate of temperature excursions, with higher rates from 00 am to 06 am (p < 0.001) for low temperatures and 10-12 am (p < 0.001) and 13-16 pm (p < 0.001) for high temperatures. Abnormal temperatures lasted from 1 h to 24 h below +2 °C and 13-24 h above +8 °C. Standard manual registers reported only 182/2761 (7%) inadequate temperatures and VVM color change detected only 133/2465 (5%) disruptions. Reliability of the refrigerators ranged from 48% to 98.7% with a median of 70%. Risk factors for excursions were old age of the refrigerators, the months of April and May, hours of high activity during the day, and health staff-associated factors such as inappropriate actions or insufficient knowledge. CONCLUSION Important cold chain reliability issues reported in the current study in Western Burkina Faso raise concern about vaccine potency. In the absence of systematic renewal of the cold chain infrastructure or improved staff training and monitoring, antibody response assessment is recommended to study levels of effective immunization coverage.
Collapse
Affiliation(s)
- C Sow
- University of Ouagadougou, UFR SDS, Ouagadougou, Burkina Faso; Laboratoire Mixte International de Vaccinologie (LAMIVAC), Bobo-Dioulasso, Burkina Faso
| | - C Sanou
- Laboratoire Mixte International de Vaccinologie (LAMIVAC), Bobo-Dioulasso, Burkina Faso; Agence de Médecine Préventive (AMP), Bobo-Dioulasso, Burkina Faso
| | - C Medah
- Institut Supérieur des Sciences de la Santé (INSSA), Bobo-Dioulasso, Burkina Faso; Direction Régionale de la Santé des Hauts-Bassins, Burkina Faso
| | - M Schlumberger
- Laboratoire Mixte International de Vaccinologie (LAMIVAC), Bobo-Dioulasso, Burkina Faso
| | - F Mireux
- Laboratoire Mixte International de Vaccinologie (LAMIVAC), Bobo-Dioulasso, Burkina Faso
| | - I Ouédraogo
- Agence de Médecine Préventive (AMP), Bobo-Dioulasso, Burkina Faso
| | - S M Ouédraogo
- Institut Supérieur des Sciences de la Santé (INSSA), Bobo-Dioulasso, Burkina Faso
| | - E Betsem
- Laboratoire Mixte International de Vaccinologie (LAMIVAC), Bobo-Dioulasso, Burkina Faso; Agence de Médecine Préventive (AMP), Bobo-Dioulasso, Burkina Faso.
| |
Collapse
|
9
|
Pacheco FC, Domingues CMAS, Maranhão AGK, Carvalho SMD, Teixeira AMDS, Braz RM, Rebelo RCF, Guilhem DB. [Analysis of the Vaccine Adverse Event Reporting System in Brazil, 2014 to 2016Análisis del Sistema de Información de Vigilancia de Eventos Adversos Posvacunación en Brasil, 2014 a 2016]. Rev Panam Salud Publica 2018; 42:e12. [PMID: 31093041 PMCID: PMC6385780 DOI: 10.26633/rpsp.2018.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 09/09/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the characteristics of vaccine adverse events (VAE) reports in the online VAE Reporting System (VAE-RS) after 2 years of operation. METHOD A descriptive analysis of VAE reports entered into the VAE-RS between July 2014 and June 2016 was performed. RESULTS During the study period, 24 732 VAE were reported. Of 5 570 Brazilian municipalities, 2 571 (46.2%) reported at least one VAE; however, only 1 622 (6.6%) reports had been completed/closed at the end of the study period. Of these, 89.9% referred to mild VAE. Among the completed reports, 19.7% did not provide information on "type of medical care provided," and 98.7% had no information regarding laboratory tests. Systemic neurological symptoms were the most frequent serious VAE among closed reports (59.5% of serious signs/symptoms). Concerning age, the highest VAE reporting coefficients were recorded for children aged ≤ 4 years. CONCLUSION The VAE-RS is useful to monitor immunization safety. However, municipal services must increase adherence to the system and perform the required investigation and reporting of VAE, with timely and adequate completion of the VAE-RS form. Knowledge regarding VAE can be used in the daily routine of surveillance services, improving the safety of immunobiological agents.
Collapse
Affiliation(s)
- Flávia Caselli Pacheco
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Coordenação Geral do Programa Nacional de Imunizações, Brasília (DF), Brasil
| | | | - Ana Goretti Kalume Maranhão
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Coordenação Geral do Programa Nacional de Imunizações, Brasília (DF), Brasil
| | - Sandra Maria Deotti Carvalho
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Coordenação Geral do Programa Nacional de Imunizações, Brasília (DF), Brasil
| | - Antonia Maria da Silva Teixeira
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Coordenação Geral do Programa Nacional de Imunizações, Brasília (DF), Brasil
| | - Rui Moreira Braz
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Coordenação Geral do Programa Nacional de Imunizações, Brasília (DF), Brasil
| | - Renata Cristina Freitas Rebelo
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Coordenação Geral do Programa Nacional de Imunizações, Brasília (DF), Brasil
| | - Dirce Bellezi Guilhem
- Universidade de Brasília, Programa de Pós-Graduação em Ciências da Saúde, Brasília (DF), Brasil
| |
Collapse
|
10
|
Sato APS, Ferreira VLDR, Tauil MDC, Rodrigues LC, Barros MB, Martineli E, Costa ÂA, Inenami M, Waldman EA. Use of electronic immunization registry in the surveillance of adverse events following immunization. Rev Saude Publica 2018; 52:4. [PMID: 29412373 PMCID: PMC5802648 DOI: 10.11606/s1518-8787.2018052000295] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 01/12/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe adverse events following vaccination (AEFV) of children under two years old and analyze trend of this events from 2000 to 2013, in the city of Araraquara (SP), Brazil. METHODS This is a descriptive study conducted with data of the passive surveillance system of AEFV that is available in the electronic immunization registry (EIR) of the computerized medical record of the municipal health service (Juarez System). The study variables were: age, gender, vaccine, dose, clinical manifestations and hospitalization. We estimated rates using AEFV as numerator and administered doses of vaccines as denominator. The surveillance sensitivity was estimated by applying the method proposed by the Centers for Disease Control and Prevention. We used Prais-Winsten regression with a significance level of 5.0%. RESULTS The average annual rate of AEFV was 11.3/10,000 administered doses, however without a trend in the study period (p=0.491). Most cases occurred after the first dose (41.7%) and among children under one year of age (72.6%). Vaccines with pertussis component, yellow fever and measles-mumps-rubella were the most reactogenic. We highlighted the rates of hypotonic-hyporesponsive episodes and convulsion that were 4.1/10,000 and 1.5/10,000 doses of vaccines with pertussis component, respectively, most frequently in the first dose; 60,0% of cases presented symptoms in the first 24 hours after vaccination, however, 18.6% showed after 96 hours. The sensitivity of surveillance was 71.9% and 78.9% for hypotonic-hyporesponsive episodes and convulsion, respectively. CONCLUSIONS The EIR-based AEFV surveillance system proved to be useful and highly sensitive to describe the safety profile of vaccines in a medium-sized city. It was also shown that the significant increase of the vaccines included in the basic vaccination schedule in childhood in the last decade did not alter the high safety standard of the National Immunization Program.
Collapse
Affiliation(s)
- Ana Paula Sayuri Sato
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| | | | - Márcia de Cantuária Tauil
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| | - Laura Cunha Rodrigues
- Faculty of Epidemiology and Population Health. London School of Hygiene and Tropical Medicine. London, UK
| | - Mariana Bernardes Barros
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| | - Edmar Martineli
- Universidade de São Paulo. Centro de Tecnologia da Informação de São Carlos. São Carlos, SP, Brasil
| | - Ângela Aparecida Costa
- Universidade de São Paulo. Faculdade de Saúde Pública. Serviço Especial de Saúde de Araraquara. Araraquara, SP, Brasil
| | - Marta Inenami
- Universidade de São Paulo. Faculdade de Saúde Pública. Serviço Especial de Saúde de Araraquara. Araraquara, SP, Brasil
| | - Eliseu Alves Waldman
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| |
Collapse
|
11
|
Saleh E, Swamy GK, Moody MA, Walter EB. Parental Approach to the Prevention and Management of Fever and Pain Following Childhood Immunizations: A Survey Study. Clin Pediatr (Phila) 2017; 56:435-442. [PMID: 27798399 PMCID: PMC5600183 DOI: 10.1177/0009922816675116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Antipyretic analgesics are commonly used to prevent and treat adverse events following immunizations. Current practice discourages routine use due to possible blunting of vaccine immune responses. We surveyed 150 parents/caregivers of recently vaccinated 6- and 15-month-old children to determine the prevalence of and beliefs regarding antipyretic analgesics use around vaccinations. 11% used them prophylactically, before vaccination. Use in the first 48 hours after vaccination was 64%, primarily to prevent and/or treat fever and pain. Acetaminophen was administered 2.6 times more frequently than ibuprofen. Ibuprofen was used more in the 15-month compared with the 6-month-old children (28% vs 7.4%, respectively, P = .001). The majority of caregivers disagreed with their use for fever (53%) or pain (59%). Antipyretic analgesic use, including prophylaxis, around vaccinations was common in our study population. Effective interventions are needed to target parents/caregivers to eliminate unnecessary antipyretic analgesic use around vaccination time and foster nonmedication alternatives.
Collapse
Affiliation(s)
- Ezzeldin Saleh
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke Clinical Vaccine Unit, Duke University School of Medicine, 2608 Erwin Road, Suite 210, Durham, NC 27705, Telephone: (919) 684-6335
| | - Geeta K Swamy
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Duke Clinical Vaccine Unit, Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC, USA, Telephone: 919-681-5220
| | - M Anthony Moody
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke University School of Medicine, Address: Duke Human Vaccine Institute, Box 103020 DUMC, Durham, NC 27710, Telephone: (919) 668-2551
| | - Emmanuel B. Walter
- Department of Pediatrics, Divisions of Primary Care and Pediatric Infectious Diseases, Duke University School of Medicine, Address: Duke Clinical Vaccine Unit, 2608 Erwin Road, Suite 210, Durham, NC 27705, Telephone: 919-620-5374
| |
Collapse
|
12
|
Knowledge, Perceptions, and Practice of Nurses on Surveillance of Adverse Events following Childhood Immunization in Nairobi, Kenya. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3745298. [PMID: 28078288 PMCID: PMC5204106 DOI: 10.1155/2016/3745298] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/16/2016] [Indexed: 11/17/2022]
Abstract
Background. Although vaccines currently approved for routine childhood immunization are safe and effective, frequent adverse events following immunization often cause illnesses and sometimes loss of public trust in immunization programs. Nurses are essential in this surveillance system. Objective. To determine nurses' knowledge, perception, and practice towards surveillance of postimmunization adverse events within Nairobi County health centers, Kenya. Methods. This is a cross-sectional survey involving nurses (n = 274). Data were collected using self-administered questionnaires. Data analysis was performed using SPSS version 20. Differences in proportions of categorical variables were compared between groups using chi-square tests. Binary logistic regression model was used to compute independent predictors of outcome. Results. 29.2%, 32.1%, and 45.3% of the respondents had good knowledge, good practices, and good perceptions on AEFI surveillance, respectively. Respondents with diploma or degree nursing training level were 1.8 times and 2.5 times more likely to have good knowledge and good perception in AEFI surveillance, respectively. Nurses with previous AEFI training were 9.7 times and 1.8 times more likely to have good AEFI knowledge and practices, respectively. Conclusion. There is a need to train and mentor nurses on AEFI surveillance. Findings of this study will be valuable in informing policy review on childhood immunization programs.
Collapse
|
13
|
Ateudjieu J, Stoll B, Nguefack-Tsague G, Yakum MN, Mengouo MN, Genton B. Incidence and types of adverse events during mass vaccination campaign with the meningococcal a conjugate vaccine (MENAFRIVAC™) in Cameroon. Pharmacoepidemiol Drug Saf 2016; 25:1170-1178. [PMID: 27174237 DOI: 10.1002/pds.4027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 02/10/2016] [Accepted: 04/11/2016] [Indexed: 11/10/2022]
Affiliation(s)
| | - Beat Stoll
- Adamawa Health Region and North West Health Region; Cameroon
| | | | | | | | - Blaise Genton
- Adamawa Health Region and North West Health Region; Cameroon
| |
Collapse
|
14
|
Yang S, Ma X, Ni H, Zhou S, Hu D, Shi H, Chen X, Dong H, Xu G. Safety, immunization coverage and determinants of a new kind of Hepatitis B vaccine firstly applied in Ningbo, China. Hum Vaccin Immunother 2015. [PMID: 26211419 DOI: 10.1080/21645515.2015.1066946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Evaluate safety and immunization coverage of a new kind of recombinant Hepatitis B vaccine (HepB) in Ningbo city, China. Two groups were carried out in 2 of 11 randomly selected countries in Ningbo in 2009. All of the infants born from July 1 to December 31, 2009 were enrolled as subjects and received 3 doses of HepB at 0, 1, 6 month. Control group (N = 3452) received current HepB derived from Saccharomyces Cerevisiae Yeast (HepB made by recombinant DNA techniques in Saccharomyces Cerevisiae Yeast, HepB-SCY; 5 μg/0.5 ml per dose) and experimental group (N = 5104) received the new kind of HepB derived from Hansenula polymorpha Yeast (HepB made by recombinant DNA techniques in Hansenula polymorpha Yeast, HepB-HPY; 10 μg/0.5 ml per dose). 3-dose and timely birth dose (TBD) coverage were available and compared between 2 groups. Standard structured questionnaires were applied to record information from parents and hospitals for selecting determinants of coverage. The data were analyzed using stepwise multiple logistic regression models. After each dose, HepB-related adverse events (AEs) and recta-temperature were recorded for 7 days. 3-dose coverage in control group (89.98%) was higher than that in experimental group (χ2 = 575.1173, P < 0.0001). TBD coverage in control and experimental group were 98.41% and 98.53%, respectively. No statistically significant difference in TBD coverage was found between 2 groups (χ2 = 0.0623, P = 0.8029). A total of 9 local AEs were reported, 4 for control group and 5 for experimental group. The percentages of subjects reporting AEs were similar across the 2 vaccination groups. No serious or immediate reactions were found in this study. From logistic models, receiving 10 μg vaccine (odds ratio [OR]:0.38; 95% confidence interval [95%CI]: 0.34-0.44) and mother migrating from other cities (OR: 0.45; 95%CI: 0.42-0.47) were the determinants for non-acceptance of 3 doses of HepB; infants born from low grade hospitals and native mothers contributed to administrate the TBD.
Collapse
Affiliation(s)
- Sijia Yang
- a Ningbo Municipal Center for Disease Control and Prevention ; Zhejiang , China
| | - Xiao Ma
- a Ningbo Municipal Center for Disease Control and Prevention ; Zhejiang , China
| | - Hongxia Ni
- a Ningbo Municipal Center for Disease Control and Prevention ; Zhejiang , China
| | - Shaoying Zhou
- a Ningbo Municipal Center for Disease Control and Prevention ; Zhejiang , China
| | - Danbiao Hu
- b Ninghai Municipal Center for Disease Control and Prevention ; Zhejiang , China
| | - Honghui Shi
- c Yuyao Municipal Center for Disease Control and Prevention ; Zhejiang , China
| | - Xiaoying Chen
- a Ningbo Municipal Center for Disease Control and Prevention ; Zhejiang , China
| | - Hongjun Dong
- a Ningbo Municipal Center for Disease Control and Prevention ; Zhejiang , China
| | - Guozhang Xu
- a Ningbo Municipal Center for Disease Control and Prevention ; Zhejiang , China
| |
Collapse
|
15
|
Factors associated with the exposure of vaccines to adverse temperature conditions: the case of North West region, Cameroon. BMC Res Notes 2015; 8:277. [PMID: 26122104 PMCID: PMC4485865 DOI: 10.1186/s13104-015-1257-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/22/2015] [Indexed: 02/03/2023] Open
Abstract
Background Adverse temperature recording in vaccine’s cold chain is a major issue worldwide and this condition is known to compromise the
quality of vaccines very rapidly. In Cameroon, with tropical climate, vaccines exposure to abnormal temperatures is very common. This study was conducted to identify factors associated to abnormal temperature recording in cold chain in the North West region. Results A total of 65 vaccinating health facilities were visited for the study from eight health districts. Concerning type of health facility, 48 (73.8%) of the health facilities were governmental facilities. About 50 (76.0%) of the facilities had a functional thermometer. Among the 50 health facilities with functional thermometer, abnormal temperatures were registered in 10 (20%) health facilities during data collection and 12 (24%) in the 2 months preceding collection. Factor significantly associated with abnormal temperature recording was the absence of an alternative power source (OR = 6.5, p = 0.03). Conclusion The absence of an alternative source of power was significantly associated with abnormal temperature exposure in the 2 months preceding data collection. To improve on the quality of vaccines administered in North West region, each vaccinating health facility must have at least two sources of power supply.
Collapse
|
16
|
Marcos E, Zhao B, He Y. The Ontology of Vaccine Adverse Events (OVAE) and its usage in representing and analyzing adverse events associated with US-licensed human vaccines. J Biomed Semantics 2013; 4:40. [PMID: 24279920 PMCID: PMC4177204 DOI: 10.1186/2041-1480-4-40] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 11/04/2013] [Indexed: 11/30/2022] Open
Abstract
Background Licensed human vaccines can induce various adverse events (AE) in vaccinated patients. Due to the involvement of the whole immune system and complex immunological reactions after vaccination, it is difficult to identify the relations among vaccines, adverse events, and human populations in different age groups. Many known vaccine adverse events (VAEs) have been recorded in the package inserts of US-licensed commercial vaccine products. To better represent and analyze VAEs, we developed the Ontology of Vaccine Adverse Events (OVAE) as an extension of the Ontology of Adverse Events (OAE) and the Vaccine Ontology (VO). Results Like OAE and VO, OVAE is aligned with the Basic Formal Ontology (BFO). The commercial vaccines and adverse events in OVAE are imported from VO and OAE, respectively. A new population term ‘human vaccinee population’ is generated and used to define VAE occurrence. An OVAE design pattern is developed to link vaccine, adverse event, vaccinee population, age range, and VAE occurrence. OVAE has been used to represent and classify the adverse events recorded in package insert documents of commercial vaccines licensed by the USA Food and Drug Administration (FDA). OVAE currently includes over 1,300 terms, including 87 distinct types of VAEs associated with 63 human vaccines licensed in the USA. For each vaccine, occurrence rates for every VAE in different age groups have been logically represented in OVAE. SPARQL scripts were developed to query and analyze the OVAE knowledge base data. To demonstrate the usage of OVAE, the top 10 vaccines accompanying with the highest numbers of VAEs and the top 10 VAEs most frequently observed among vaccines were identified and analyzed. Asserted and inferred ontology hierarchies classify VAEs in different levels of AE groups. Different VAE occurrences in different age groups were also analyzed. Conclusions The ontology-based data representation and integration using the FDA-approved information from the vaccine package insert documents enables the identification of adverse events from vaccination in relation to predefined parts of the population (age groups) and certain groups of vaccines. The resulting ontology-based VAE knowledge base classifies vaccine-specific VAEs and supports better VAE understanding and future rational AE prevention and treatment.
Collapse
Affiliation(s)
- Erica Marcos
- Unit for Laboratory Animal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
| | | | | |
Collapse
|