Implementation of data triangulation and dashboard development for COVID-19 vaccine adverse event following immunisation (AEFI) data in Nigeria

Abstract

Nigeria began administering COVID-19 vaccines on 5 March 2021 and is working towards the WHO's African regional goal to fully vaccinate 70% of their eligible population by December 2022. Nigeria's COVID-19 vaccination information system includes a surveillance system for COVID-19 adverse events following immunisation (AEFI), but as of April 2021, AEFI data were being collected and managed by multiple groups and lacked routine analysis and use for action. To fill this gap in COVID-19 vaccine safety monitoring, between April 2021 and June 2022, the US Centers for Disease Control and Prevention, in collaboration with other implementing partners led by the Institute of Human Virology Nigeria, supported the Government of Nigeria to triangulate existing COVID-19 AEFI data. This paper describes the process of implementing published draft guidelines for data triangulation for COVID-19 AEFI data in Nigeria. Here, we focus on the process of implementing data triangulation rather than analysing the results and impacts of triangulation. Work began by mapping the flow of COVID-19 AEFI data, engaging stakeholders and building a data management system to intake and store all shared data. These datasets were used to create an online dashboard with key indicators selected based on existing WHO guidelines and national guidance. The dashboard went through an iterative review before dissemination to stakeholders. This case study highlights a successful example of implementing data triangulation for rapid use of AEFI data for decision-making and emphasises the importance of stakeholder engagement and strong data governance structures to make data triangulation successful.

Keywords: COVID-19; Health systems; Vaccines.

Figure 1

Data flow for COVID-19 adverse events following immunisation (AEFI) data from AEFI event to the COVID-19 AEFI data triangulation dashboard. At time of publication, line list data, call-in data and District Health Information 2 (DHIS2) data are incorporated into the dashboard, while Med Safety app data are not.

Figure 2

Screenshots from the COVID-19 adverse events following immunisation (AEFI) interactive dashboard. (A) The opening page of the dashboard, which begins on The Report Summary page showing key summary statistics for COVID-19 AEFI surveillance. Summary data can be toggled between data sources using the Data Sources button. More in-depth statistics for each data source can be viewed using the page selector on the left-hand bar. (B) Geographical representation of AEFI reports per 100 000 persons vaccinated from the call-in data page, shown as a map. (C) Ten most common AEFI reactions disaggregated by sex, calculated from the line list data. (D) Proportion of AEFIs disaggregated by age group and sex, calculated from the line list data.