Two types of reporting. Routine monthly for the Minor AEFIs and Immediate reporting for the Serious AEFIs.
Common, minor reactions These occur within a day or two of immunization (except for measles/MMR - 6 to 12 days after immunization) and they only last one to a few days. Local reactions include pain, swelling and/or redness at the injection site and can be expected in about 10% of vaccinees, except for those injected with DTP, or tetanus boosters, where up to half can be affected. BCG causes a specific local reaction that starts as a papule (lump) two or more weeks after immunization that then becomes ulcerated and heals after several months, leaving a scar. Individuals with dormant tuberculosis infection often have an accelerated response to BCG. Keloid (thickened scar tissue) from the BCG lesion is more common among Asian and African populations. Systemic reactions include fever and occur in about 10% or less of vaccinees, except for DTP where it is again about half. Other common systemic reactions (e.g., irritability, malaise, ‘off-colour’, anorexia) can also occur after DTP. For measles/MMR and OPV the systemic reactions arise from vaccine virus infection. Measles’ vaccine causes fever, rash and/or conjunctivitis, and affects 5-15% of vaccinees. It is very mild compared to ‘wild’ measles, but for severely immunocompromised individuals, it can be severe, even fatal. Vaccine reactions for mumps (swollen parotid gland) and rubella (arthralgia and swollen lymph nodes) affect less than 1% of children. Rubella vaccine causes symptoms more often in adults, with 15% suffering from arthralgia. Systemic reactions from OPV affect less than 1% of vaccinees with diarrhoea, headache, and/or muscle pain.
Rate of local reactions likely to increase with booster doses,
up to 50-85%
** Symptoms include diarrhoea, headache, and/or muscle pains
Vaccine Local reaction (pain, swelling, redness) Fever > 38 o C Irritability, malaise & non specific symptoms BCG Common -- -- Hib 5% - 15% 2% - 10% -- Hepatitis B Adult up to 15% Children up to 5% 1% - 6% -- Measles/MMR Up to 10% 5% - 15% Up to 5% (rash) Polio (OPV) -- Less than 1% Less than 1% * Tetanus/DT/Td Up to 10% ** Up to 10% Up to 25% Pertussis (DPT - whole cell) c Up to 50% Up to 50% Up to 60%
AEFI Monthly Reporting - Data Flow Depending on location * Monthly reports to be sent to the respective district OR state HQ through the Asst Health Officer (EPI)/ Corporation Immunization Officer I/C Sub Centre National State HQ District HQ PHC/ Block Urban Centres*
Serious AEFIs: Case investigation; Reporting formats and channels 1. FIR 2. PIR 3. DIR
All serious AEFI cases need to be investigated by Distt. AEFI committee
Standard reporting formats to be used for collecting information;
Lab samples need to be sent as per guidelines
Complete PIR and DIR on time
State committee to do causality assessment
Serious AEFI Cases (formats and timelines) DIO 24 hours Type of Report Responsible Time line FIR First Information Report MO 24 hours PIR Preliminary Investigation Report DIO 7 days DIR Detailed Investigation Report AEFI investigation team 90 days