Background Vaccine safety surveillance is increasingly becoming a critical area in national immunisation programs. Uganda conducted a Measles-Rubella catch-up and Polio mass vaccination campaign between 16 and 20 October 2019. We conducted a descriptive analysis of the adverse events following immunisation reported following this campaign to inform policy updates. The target age-group for the campaign was children aged 9 months to 14 completed years, while the target age-group for polio campaign was 0-59 months. We conducted active search for the serious adverse event following immunisation that were reported. Results Among the 19,241,348 persons vaccinated during the Measles-Rubella catch-up and Polio mass campaign, 10,612,278 (55%) received MR vaccine alone; while 8,629,070 (45%) received either bivalent oral polio vaccine (bOPV) alone or MR and bOPV for children 9 to 59 months. The mean age of the children was 8.3 years, range 0.5-14years, including 68 (47%) boys, 64 (44%) girls and 13 (9%) missing sex classification. The serious adverse events following immunisation (AEFI) included; toxic epidermal necrolysis 3 (2.1%), Steven Johnson syndrome 2 (1.4%), severe anemia 2 (1.4%), febrile illness 1 (0.7%), sudden respiratory failure 1 (0.7%), bullous impetigo 1 (0.7%) and injection abscess 19 (13%). Conclusion AEFI reporting in Uganda is low, and concerted efforts need to be undertaken to create community awareness about the importance of reporting. Additionally, the health care systems should be strengthened to efficiently investigate all potential signals that led to quality causality assessment of serious and other AEFI of public health concern so as to provide correct information to the community and prevent false association of vaccines and or vaccination to incorrect signals, and build a resilient immunisation program that is trusted by the community.
Toward 2019, Uganda experienced an extensive outbreak of measles and rubella. The Uganda National Expanded Programme on Immunization implemented a mass measles-rubella vaccination campaign aimed at halting the ongoing transmission. This study determined the changes in the disease burden thereafter. We conducted a retrospective cross-sectional study on measles-rubella positivity and its associated factors in Uganda using 1697 case-based surveillance data for 2019 and 2020 stratified into two dispensations: prevaccination and postvaccination campaigns. Statistical tests employed in STATA 15 included chi-square, Fisher’s exact, and binomial tests. Measles positivity rates in the period before and after the mass immunization campaign were 41.88% (95% CI: 39.30–44.51) and 37.96% (95% CI: 32.81–43.40), respectively. For rubella, the positivity rate in the precampaign season was 21.73% (95% CI: 19.61–23.99) and in the postvaccination season was 6.65% (95% CI: 4.36–10.00). Binomial tests indicated that postcampaign positivity rates were significantly lower than the precampaign rate for measles ( p = 0.003 ) and rubella ( p < 0.001 ). Generally, age (χ2 = 58.94, p = 0.001 /χ2 = 51.91, p < 0.001 ) and vaccination status (χ2 = 60.48, p = 0.001 /χ2 = 16.90, p = 0.001 ) were associated with the measles positivity rate in both pre/postcampaign periods. Rubella positivity rate was associated with vaccination status (χ2 = 32.97, p < 0.001 / p = 0.001 ) in both periods and age in the precampaign season ( p < 0.001 ). The measles-rubella mass campaign lessened rubella burden remarkably, but barely adequate change was observed in the extent of spread of measles. Children aged less than 9 months are at higher chances of testing positive amidst low vaccination levels among the eligible. The immunization programme must attain and maintain routine immunization coverage at 95% or more and roll out a second-dose measles-rubella vaccination to sustain the reduced disease burden.
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