Overview of AEFI Surveillance and Response Guidelines

This 20-slide presentation from the United Nations Children's Fund (UNICEF) aims to provide an overview and arrive at a common understanding of the current adverse events following immunisation (AEFI) guidelines and programmatic responses in South Asia.

Following an illustration of historical perspectives on AEFI and the current context, Dr. Bentsi-Enchill explains what AEFI exactly means and then distinguishes an adverse event (no causal connection between the medical incident and the undesirable outcome) from an adverse reaction (undesirable outcome caused by vaccine (or drug) when there is evidence supporting a causal relationship). There are 5 types of AEFI delineated here: vaccine reaction, programme error, injection reaction, coincidental, and unknown.

In this context, AEFI surveillance aims to: detect serious or potentially serious AEFI, ensure rapid notification and effective evaluation of information, and enable prompt and effective response in order to minimise negative impacts on health and immunisation programmes. Dr. Bentsi-Enchill outlines core elements of AEFI surveillance, including communication within the health community (e.g., provision of training and tools to handle ongoing questions from vaccinees/parents, technical information on AEFI, vaccine information, and support to handle crises (communication strategy, spokespersons, multiple stakeholders) and communication with public/community (e.g., anticipating crises, having a plan, staying well-informed, and verifying facts). Dr. Bentsi-Enchill lists some models for AEFI surveillance, and then looks at challenges and opportunities facing country and global programmes. A few recent examples of AEFI - in Bangladesh, Myanmar, and Nepal - are provided as illustrations.

Strategies listed here to support/strengthen AEFI surveillance include: advocacy for commitment, leadership, and resources at national level; assessment of AEFI surveillance; development of action plans, including a communication strategy; development of norms (guidelines, reporting forms); reference material and technical documents (background information on AEFI, with attention to accessibility (e.g., print and online, language needs); training; and technical support.

Links are provided to organisations addressing safety concerns at the global level.

Dr. Bentsi-Enchill concludes by stressing that lack of correct and timely response to rumours and crises creates the potential for wrong information or miscommunication.

For more information, contact:

Dr. Adwoa Bentsi-Enchill

WHO

bentsienchilla@who.int