AEFI Case Studies

This 16-slide presentation from the United Nations Children's Fund (UNICEF) includes a number of case studies exploring responses to adverse events following immunisation (AEFI).

1. Case Study I - Vitamin A Campaign, Assam - As author Kiran Negi reports, the Government of Assam with UNICEF supported the launch of a statewide Vitamin A campaign on November 11 2001. During the week following the campaign, the media reported alleged side effects and resultant deaths of children. According to Negi, the media inflated the figures, and some articles (mis)described the programme as a polio campaign. This "[c]aused mass hysteria in the public with parents rushing children to the hospital". It was picked up by international media. In response, the Government of Assam (GoA) ordered an inquiry into the deaths, sent samples to the National Testing Laboratory (the drugs met all standards), and set up a high-level committee to review the situation and make recommendations on further Vitamin A strategies. UNICEF issued a press release, sent a fact-finding team, prepared and presented a report to GoA, and sent samples to Australia (the drugs met all standards). Various impacts are described here: for instance, Vitamin A coverage very low in the state of Assam. In February 2004, UNICEF conducted a media workshop in Guwahati, Assam on the polio eradication campaign with GoA and the World Health Organization (WHO) and appealed to the media to move on in the interest of the children of Assam.
2. Case Study II - Polio NID/SID, West Bengal - This case study looks at key perceptions of the community that the media reflects regarding polio National Immunization Days (NIDs)/Supplementary Immunization Days (SIDs). An example misconception: "Causes infertility - it is a ploy on the part of the Govt. to make the children infertile, and hence is so adamant on giving Polio drops again & again." UNICEF, for one, has responded through: regular media monitoring to track the stories on polio, addressing misconceptions with the media on a one-one-one basis, conducting media workshops, facilitating connections between the government and the media, sharing media feedback with the government, and partnering with WHO in all media activities. One lesson here: "A boycott in one area also sometimes motivates other areas to use Polio as a bargaining tool."
3. Case Study III - Intake of Iron tablets, West Bengal - As reported here, on July 22 2004, in the Nalanda Vidyapith School, Balurghat, Dakhin, Dinajpur, iron/folic acid tablets were distributed to adolescent girls under a government anaemia control programme supported by UNICEF. When 3 girls reported nausea and vomiting, "[h]ysteria broke out and other girls too started to complain." As part of the Government/UNICEF response, communication-centred actions included: setting up a committee to examine the causes, meeting with the parents of the girls after school hours to reassure them, calling a media briefing and address the issue the following day, holding a media briefing, and asking the media to not sensationalise the news to protect against any adverse impact to the programme.

Suggestions gleaned from the above include: partner with the media, involve physicians, keep the government informed and involved, and think long term.