Implementation of data triangulation and dashboard development for COVID-19 vaccine adverse event following immunisation (AEFI) data in Nigeria

Abstract

Nigeria began administering COVID-19 vaccines on 5 March 2021 and is working towards the WHO’s African regional goal to fully vaccinate 70% of their eligible population by December 2022. Nigeria’s COVID-19 vaccination information system includes a surveillance system for COVID-19 adverse events following immunisation (AEFI), but as of April 2021, AEFI data were being collected and managed by multiple groups and lacked routine analysis and use for action. To fill this gap in COVID-19 vaccine safety monitoring, between April 2021 and June 2022, the US Centers for Disease Control and Prevention, in collaboration with other implementing partners led by the Institute of Human Virology Nigeria, supported the Government of Nigeria to triangulate existing COVID-19 AEFI data. This paper describes the process of implementing published draft guidelines for data triangulation for COVID-19 AEFI data in Nigeria. Here, we focus on the process of implementing data triangulation rather than analysing the results and impacts of triangulation. Work began by mapping the flow of COVID-19 AEFI data, engaging stakeholders and building a data management system to intake and store all shared data. These datasets were used to create an online dashboard with key indicators selected based on existing WHO guidelines and national guidance. The dashboard went through an iterative review before dissemination to stakeholders. This case study highlights a successful example of implementing data triangulation for rapid use of AEFI data for decision-making and emphasises the importance of stakeholder engagement and strong data governance structures to make data triangulation successful.

Collaboration within the global vaccine safety surveillance ecosystem during the COVID-19 pandemic: lessons learnt and key recommendations from the COVAX Vaccine Safety Working Group

“…Training for both the public and healthcare professionals on the processes followed by the NRAs in ensuring the safety and effectiveness of the COVID-19 vaccines was implemented. Digital innovations, such as the MedSafety app, facilitated reporting of potential AEFIs in Ghana,38 and AEFI data triangulation and dashboard development supported public health decision-making in Nigeria 39. Regulators engaged in new regional collaborations for work sharing, most notably the African Union Smart Safety Surveillance (AU-3S) Project, involving Ghana, Nigeria, Ethiopia and South Africa 40.…”

“…Digital innovations, such as the MedSafety app, facilitated reporting of potential AEFIs in Ghana, 38 and AEFI data triangulation and dashboard development supported public health decision-making in Nigeria. 39 Regulators engaged in new regional collaborations for work sharing, most notably the African Union Smart Safety Surveillance (AU-3S) Project, involving Ghana, Nigeria, Ethiopia and South Africa. 40 Signal detection on potential AEFIs from collaborating countries has been performed on a weekly basis, and summary review reports have been shared; such cooperation has allowed for the close monitoring of AEFIs that have been flagged elsewhere.…”

Landscape review of active vaccine safety surveillance activities for COVID-19 vaccines globally

“…National regulatory authorities engaged in new regional collaborations for work-sharing and signal management, most notably in Africa’s African Union Smart Safety Surveillance (AU-3S) [22] . Digital innovations were applied, such as mobile phone applications for AEFI spontaneously reported by patients and health care providers [23] , as well as data triangulation from multiple sources into a single data management system to support decision making [24] . The consequence of these advancements in the capacity for signal detection by passive surveillance, will be the need for continuous improvement, including investments in sustainable infrastructures for further hypothesis-generating or testing by robust well-designed safety activities.…”