Adverse Events Following Immunization (AEFI) Surveillance System Evaluation, 2016-2020 Kumasi Metropolis

Abstract

Even though the process of vaccine licensure is rigorous, vaccines meant to protect individuals and populations may result in Adverse Events Following Immunization (AEFIs). An AEFI, is any untoward medical occurrence that follows immunization and which does not necessarily have a causal relationship with the usage of the vaccine. The AEFIs have the potential to derail a vaccination programme if not handled professionally. The WHO makes it mandatory for the Expanded Programme on Immunization to work with the Food and Drugs Authority to implement a robust AEFI surveillance system. This is to detect, correct, and prevent AEFIs caused by errors in vaccine preparation, handling, storage, or administration and to allay fears due to false alarms. This study aimed to evaluate the AEFI surveillance system of the Kumasi Metropolis to determine whether it was meeting its objective, describe its attributes, and assess its usefulness from 2016 to 2020.  A descriptive cross-sectional design was used, based on the updated CDC guidelines for evaluating public health surveillance systems. A semi-structured questionnaire was used to collect data from health workers and caregivers within the Kumasi metropolis. Purposive sampling was adopted. Records were also reviewed. Excel pivot tables were used for analysis. In all, 21 health staff and 16 caregivers were interviewed. Knowledge among health workers and willingness to contribute to the system was high. All staff interviewed knew AEFI. The AEFI reporting forms were available. Between 2016 and 2020, 15 AEFI cases had been reported with no feedback officially received from the Technical Advisory Committee. More than 93% (15/16) of caregivers confirmed experiencing non-serious AEFIs in their children but never reported them. Knowledge among health workers was high, though the system was not meeting most of its objectives. The system was acceptable among health workers, unlike among caregivers. It was not sensitive enough, though stable, flexible, and representative.  Since the system failed to meet its objectives, it was not fully useful. We recommend that the Technical Advisory Committee sends prompt feedback on AEFIs. The case definition could also be reviewed to target AEFIs that may be of concern to caregivers only. Caregivers should be continuously educated on AEFIs.