Division of Pneumonology, Immunology, Department of Pediatrics, Charité University Medical Center, Augustenburger Platz 1, 13353, Berlin, Germany.
Paediatr Drugs. 2014 Aug;16(4):321-30. doi: 10.1007/s40272-014-0075-3.
Vaccine safety surveillance is highly dependent on accurate reporting of adverse events following immunization (AEFI). An online survey was conducted to assess the utilization of AEFI reporting standards and pathways among pediatricians in Germany, and in Russia where pediatric specialization begins in medical school.
In May 2011, a 31-item online questionnaire was sent to members of the German Professional Association for Pediatricians (BVKJ) and the Union of Pediatricians of Russia (UPR), capturing information on vaccine safety training, awareness of AEFI reporting pathways, and use of standardized case definitions for the ascertainment of AEFI. A convenience sample of 1,632 completed online surveys was analyzed.
Participating pediatricians reported spending approximately 50 min per 8-hour workday on vaccine safety consultations, but only 42 % (56 % UPR, 26 % BVKJ) have ever received any formal vaccine safety training. Two-thirds reported having observed AEFI in their practice, but only one-third utilized standardized case definitions for case ascertainment. Only 35 % of participants named accurate AEFI reporting pathways. Every second pediatrician would report AEFI to institutions that are not primarily in charge of vaccine safety surveillance; the remaining reports would either be lost or delayed. Pediatricians who had received formal vaccine safety training were significantly more likely to apply international safety standards and to report adequately, both at the p < 0.05 level.
Pediatricians play a key role in the post-marketing surveillance of vaccine safety. The lack of training represents a missed opportunity. There may be a role for professional societies to improve vaccine safety training.
疫苗安全监测高度依赖于对疫苗接种后不良反应(AEFI)的准确报告。本研究通过在线调查,评估德国和俄罗斯儿科医生对 AEFI 报告标准和途径的使用情况,俄罗斯的儿科学专业在医学院开始设立。
2011 年 5 月,向德国儿科医生专业协会(BVKJ)和俄罗斯儿科学会(UPR)的成员发送了一份 31 项内容的在线调查问卷,内容包括疫苗安全培训、AEFI 报告途径的认识,以及使用标准化病例定义来确定 AEFI 的情况。分析了方便选取的 1632 份在线调查问卷。
参与调查的儿科医生报告称,他们每天大约要花费 50 分钟用于疫苗安全咨询,但只有 42%(UPR 为 56%,BVKJ 为 26%)接受过任何形式的疫苗安全培训。三分之二的医生报告称在实践中观察到了 AEFI,但只有三分之一的人使用标准化病例定义来确定病例。只有 35%的参与者能够正确指出 AEFI 的报告途径。每两个儿科医生中就有一个会向并非主要负责疫苗安全监测的机构报告 AEFI;其余的报告要么丢失,要么延误。接受过正规疫苗安全培训的儿科医生更有可能应用国际安全标准,并进行充分报告,这在 p<0.05 水平上有显著差异。
儿科医生在疫苗上市后安全性监测中发挥着关键作用。缺乏培训是一个错失的机会。专业协会可能在改善疫苗安全培训方面发挥作用。