Low reporting of adverse events following immunization, during a Measles-Rubella catchup and Polio mass vaccination campaign in Uganda; 2019

Abstract

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.

Interventions to Vaccinate Zero-Dose Children: A Narrative Review and Synthesis

“…One effective health monitoring system is an urban immunization dashboard in India that is reaching unvaccinated children by leveraging the existing health management information systems [ 19 ]. Another similar initiative in Uganda exists where health information systems are used to identify adverse events post-vaccination and respond promptly, hence reducing the likelihood of misinformation and improving parents’ trust in vaccines [ 31 ]. In Afghanistan and Pakistan, permanent transit teams and cross-border vaccination centers were established and supplemented by geographic information systems (GIS) monitoring to improve data management and quality [ 17 ].…”