AEFI Dhamija
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AEFI Dhamija

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AEFI Dhamija AEFI Dhamija Presentation Transcript

  • Adverse EventsFollowing Immunization: Updates and Issues Dr. Navneet Kumar Dhamija Asstt. Commissioner – Immunization Ministry of Health & FW, Govt. of IndiaMobiles : 8826772555, 9911220066Office : 23062993, 23062126, 23062728E-mail : ImmunizationAC@gmail.com
  • Concepts• Background• AEFI surveillance• National Guidelines• Case investigation• Recording and Reporting• AEFI committees
  • Adverse Event Following ImmunizationA medical incident that takes placeafter an immunization, causes concernand is believed to be caused byimmunization
  • Serious AEFI:WHO standard definition for drug and vaccineadverse events is : “Any untoward medical occurrence that results in death, hospitalization or prolongation of hospitalization,persistent or significant disability/incapacity, or is lifethreatening”Additional AEFIs that need systematic causalityassessment- AEFIs that may be caused by a programme error, e.g., a cluster of bacterial abscesses;- Serious unexplained AEFI occurring within 30 days after vaccination and not listed in product label;- Events causing significant parental or community concern.
  • Pre-vaccine Increasing Confidence: Disease Eradication Coverage Loss Return (vaccination stops?)“Incidence” Vaccine Outbreak Coverage Adverse Events: real/perceived ? Eradication Maturity of immunization programme Impact of AEFI on immunization programs
  • Reported Serious AEFI Cases (1999 – 2011) 395 400 350 301 300 199 AEFI state 250 workshops 200 170 150 100 80 48 82 50 29 32 3 9 9 0 0 r) 99 00 01 02 03 05 07 08 09 10 04 06 Ap 19 20 20 20 20 20 20 20 20 20 20 20 n- Ja ( 11 20*data does not include serious AEFI cases reported in Japanese Encephalitis campaigns conducted in endemic states Data as on 20th April 2011
  • AEFI Surveillance AEFIs identified by existing surveillanceUnreported, undetected AEFIs
  • Members of National AEFI Committee • National Immunization Program Manager (Asstt.Commissioner-Imm.) – Member Secretary • An Eminent Epidemiologist/Public Health Specialist / Pediatrician – Nominated as Chairman by MoHFW, GoI • Senior Scientist from DHR / ICMR, Govt. of India • Director – National Centre for Disease Control • Sr. Officer from National Drug Authority ( DCGI ) • Pediatrician of Medical College • Microbiologist of Medical College
  • Members of National AEFI Committee... • Pathologist of Medical College • Pharmacologist / Toxicologist of Medical College • Neurologist of Medical College • Forensic Medicine expert of Medical College • National Level Cold Chain Officer • Representative of IDSP • Members from professional bodies like IAP/IMA • Representatives from partner agencies can be on panel as ex-officio members and should be invited , when required
  • Sub-committees ofNational AEFI Committee...• Causality assessment sub committee• Operational group sub committee• Investigation sub committee• Media management sub committee
  • Members of State AEFI Committee • SEPIO – Member Secretary • Epidemiologist/Public Health Specialist • Representative from Drug Authority • Pediatrician ( preferably of Medical College ) • Microbiologist ( preferably of Medical College ) • Pathologist ( preferably of Medical College ) • Neurologist ( preferably of Medical College ) • Forensic Medicine expert ( preferably of Medical College )
  • Members of State AEFI Committee.... • State Cold Chain Officer • Representative of IDSP • Representative from local bodies like corporation • Members from professional bodies like IAP/IMA • Representatives from partner agencies can be on panel as ex-officio members and should be invited , when required • DIO and other Distt. AEFI Committee members where AEFI occurred – as special invitees
  • Members of Distt. AEFI Committee • DIO – Member Secretary • CMO of the district • Epidemiologist/Public Health Specialist • Representative from Drug Authority • Pediatrician ( preferably of Medical College ) • Microbiologist ( preferably of Medical College ) • Pathologist ( preferably of Medical College ) • Neurologist ( preferably of Medical College ) • Forensic Medicine expert ( preferably of Medical College )
  • Members of Distt. AEFI Committee ……. • Distt. Cold Chain Officer • Representative of IDSP • Representative from local bodies like corporation • Members from professional bodies like IAP/IMA • Representatives from partner agencies can be on panel as ex-officio members and should be invited , when required • Block-IO and other Block-AEFI Committee members where AEFI occurred – as special invitees
  • AEFI Committees Status District Level State Level # # # # # # JAMMU & KAS HMIR # # # # # # # # # # # # # # n = 35 n = 494 HIMACHAL PRADESH # # # # # # # # # # # # PUNJAB # # # # # # # # # # # # # # # # # # # # # # UTTARANCHAL # # # # # # # ## # # # # # # # ## # # # # # HARYANA # # # # # # # # # # # # # # # # # # # # # # # # ARUNACHAL PR. # # ## # # # # # # # # # # # # # # # SIKKIM # # # # # # # # # # # # # # # # # # # # # # # # ## # # RAJASTHAN UTTAR PRADE SH ASSAM # # # # # # # # # # # # # # # # # # # # # # # # # # # # ## # # ## # # # # NAG ALAND # # # # # # # # # # # # # # # # # # # # BIHAR # MEG HALAYA # # # # # # # # # # # # # # # # # # # # # # # # # ## # # # # # # # MANIPUR # # # # # # # # # # # # # # # # # # # # # # # # # # # TRIPURA # # # # # # # # # # # JHARKHAND # # # # # # # # # #GUJARAT MADHYA PRADESH MIZORAM # ## # # # # # # WEST BENGAL # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # CHHATTISGARH # # # # # # # # # # # # # ORIS SA # # # # # # # # # D&N HAVELI # # # # # # # # # ## # # MAHARASHTRA # # # # # # # # # # # # # # # # # BI A R D # # # # # # # # # GULBA R A G # # ANDHRA PRADESH BI APU R J # # # # # # # BELG M AU BAGALK OT # # # # R C HU AI R # # # GOA ## DH W # AR AD G AG AD # KOPPA L # # KARNATAKA BELLARY # # HAVER I # # UTTAR KAN NAD # DAVAN AG E ER # SHI O A M G C TRAD R A HI U G # # # U UP I D ## CH CKABA LLAPUR I # TUM U K R C KM LU HI AG R KOLAR # # # # # # A&N ISLANDS BAN ALO E ( ) G R R H # ASSA N BANG ALO E ( U R ) # # # # # DAKSH I KAN N N AD R A NAG R AM A A M D YA AN # # KO G ( C O R ) DA U O G # # # PONDICHERRY # # MYSO RE C AM AR H AJN AGAR # # # # # # ## # # # TAMIL NADU # # # # # # # # # #LAK SHADW EEP KERALA # # # # # # # # # # # # # # # # # # # # # #
  • State AEFI Committees• Status….. Capacity building workshops State workshops conducted (1 ½ day training JAMMU & KASHMIR HIMACHAL PRADESH package developed) PUNJAB UTTARANCHAL HARYANA DELHI ARUNACHAL PR. SIKKIM• Workshops supported with NRHM funds. RAJASTHAN UTTAR PRADESH BIHAR ASSAM NAGALAND MEGHALAYA MANIPUR WEST BENGAL TRIPURA GUJARAT Technical assistance by Partners. MADHYA PRADESH JHARKHAND MIZORAM CHHATTISGARH ORISSA D&N HAVELI• >1100 officials sensitized (state & district AEFI MAHARASHTRA ANDHRA PRADESH committee). GOA KARNATAKA A&N ISLANDS• Data base regularly updated at National level. PONDICHERRY TAMIL NADU LAKSHADWEEPKERALA Includes data of > 970 serious cases (1998-2010).• National Causality assessment training conducted 2009.• Trends show improvement in reporting of serious AEFIs.
  • Timeliness of First Information N=199 N=294 N=87 5% 3%38% 38% 32% 34% 61% 65% 24% 2008 Within 24 hours 2009 2010 1-7 days No data Based on FIR ( Date of notification; Date of completing FIR )
  • Revised AEFISurveillance and Response Operational Guidelines Released in September 2010 By Ministry of Health and FW, Government of India, New Delhi
  • DIFFICULTIES ARE INTENDED TO MAKE US BETTER, NOT BITTERImmunization Division & National AEFI Committee
  • Immunization Division & National AEFI Committee