Surveillance of adverse events following immunisation: the model of SAEFVIC, Victoria

Abstract

State-based adverse events following immunisation (AEFI) reporting systems in Australia demonstrate marked regional differences in surveillance methodologies and reporting rates. To improve AEFI services in Victoria, Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC) was established in 2007. SAEFVIC comprises a central reporting enhanced passive surveillance system integrated with clinical services. AEFI may be reported by phone, fax or on-line. Immunisation nurse specialists follow up all reports, coupled with physician review as required. Supervised re-vaccination in a hospital environment, when appropriate, helps ensure clinical support for vaccinees, families and health-care providers. The Brighton Collaboration, the Australian Immunisation Handbook and in-house case definitions are used to categorise AEFI reports. In the first 3 years (2007-2010) of operation 3,265 reports were received, describing 4,293 AEFI. The number of reports received increased annually over the 3-year period. Seventy-six per cent of AEFI met one of 52 established case definitions and the remainder were recorded verbatim: 22% of reported AEFI were considered severe. Of 1,086 persons reporting an AEFI in 2009, 356 (36%) attended for a clinical consultation and 325 (83%) were revaccinated, of which 114 were day stay or overnight patients. Enhanced passive AEFI surveillance using integrated clinical services has been shown to improve adverse event reporting with reporting rates in Victoria increasing from 2.6 per 100,000 in 2003 to 13.5 per 100,000 per annum in 2009. This report describes the SAEFVIC service model and summarises outcomes and lessons learnt in the first 3 years of operation.