IPROC iproc Iproceedings 2369-6893 JMIR Publications Toronto, Canada v8i1e36635 10.2196/36635 Abstract Abstract Surveillance System Evaluation for COVID-19 Vaccine–Associated Adverse Events Following Immunization (AEFI), Sindh Pakistan (2021) Khader Yousef Qureshi Samreen Ashraf MBBS, Diploma Family Health 1
Department of Health Government of Sindh Provincial Disease Surveillance and Response Unit at Directorate General Health Services Sindh Hyderabad Pakistan 92 3213021631 qsamreen@yahoo.com
Masood Naveed MBBS, MSPH 2 Syed Asif MBBS, MPH, PhD 3 Hussain Mudassar MBBS, MSPH, MSc 4 Hussain Kashif MBBS 4 Bhurt Saeed Ahmed MBBS, MSc 5 Gadehi Muhammad Ali MBBS, MPH 5 Memon Fahad MBBS, MPH 5 Bahoto Muhammad Juman MBBS, DCH, MBeth, MScHPM 4 Department of Health Government of Sindh Hyderabad Pakistan Department of Health, Government of Sindh Hyderabad Pakistan Department of Health, Government of Pakistan Karachi Pakistan Department of Health, Government of Pakistan Hyderabad Pakistan Health Department, Government of Pakistan Hyderabad Pakistan Corresponding Author: Samreen Ashraf Qureshi qsamreen@yahoo.com Jan-Dec 2022 18 2 2022 8 1 e36635 19 1 2022 19 1 2022 ©Samreen Ashraf Qureshi, Naveed Masood, Asif Syed, Mudassar Hussain, Kashif Hussain, Saeed Ahmed Bhurt, Muhammad Ali Gadehi, Fahad Memon, Muhammad Juman Bahoto. Originally published in Iproceedings (https://www.iproc.org), 18.02.2022. 2022

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.

 Background

In February 2021, a mass vaccination campaign commenced in Sindh Province in response to the COVID-19 epidemic. An adverse-events-following-immunization surveillance system (AEFI-SS) was established to monitor the adverse events following vaccination.

 Objective

We evaluated the AEFI-SS with the aim to identify its strengths and weaknesses and suggest recommendations.

 Methods

In May-June 2021, a descriptive evaluation study was conducted in Sindh Province, Pakistan. The Centers for Disease Control and Prevention’s (CDC) updated guidelines for evaluation of SS-2001 were followed to measure the qualitative, quantitative, and utility attributes of the AEFI-SS. Key stakeholders were identified based on their involvement in the AEFI-SS and were interviewed. Case investigation proformas for the AEFI were randomly reviewed for data quality, timeliness, and completeness. Sensitivity was calculated. Each attribute was rated as good, fair, or poor based on a scoring legend.

 Results

The SS was useful in effectively identifying 7147 cases of AEFIs. Timeliness of all AEFI cases was good and was found to be 100%, as all cases were reported within 24 hours. The World Health Organization (WHO)-approved case definition was used for the identification of AEFI cases and had a simple flow of information. The AEFI-SS was good in data quality and completeness (100%), and data collection tools were filled by trained medical officers. Sensitivity was 100%, and the predictive value positive (PVP) was not calculated due to the absence of a laboratory component. Good representativeness (>80%) of the population was covered by 1004 vaccination centers. The system was found to be stable as resources of the health department government of Sindh were being used. The AEFI-SS was paper based and deficient in a feedback mechanism.

 Conclusions

Sindh Province has an appropriate surveillance mechanism for AEFI detection and management for the ongoing COVID-19 vaccination SS. The representativeness can be increased by involvement of the private health sector. Establishment of a feedback mechanism and digital data transformation and integration of the AEFI system with the Expanded Program on Immunization (EPI) are recommended.

 surveillance system evaluation COVID-19 vaccine–associated AEFI