Institute for Global Health, University of Siena, Siena, Italy.
Department of Community Medicine, Believers Church Medical College, Thiruvalla, Kerala, India.
Vaccine. 2021 Jul 30;39(33):4678-4684. doi: 10.1016/j.vaccine.2021.06.052. Epub 2021 Jul 6.
The role of health care professionals (HCPs) is central to adverse event following immunisation (AEFI) surveillance. A cross-sectional survey was conducted among paediatricians practising in Kerala, India, to assess their knowledge and reporting behaviour in AEFI surveillance as well as to identify barriers to reporting.
A random sample of 380 paediatricians were contacted of whom, 243 (63.9%) participated in the survey. The understanding scores were distributed as follows: 30.9% very high or high, 40.3% moderate, and 28.8% low. Formal training was significantly associated with higher understanding scores, and increased AEFI detection and reporting. Only 42.0% of respondents had formal training; paediatricians in the public sector had higher access to training than those in the private sector. There were 141 respondents (58.0%) who identified an AEFI in the previous year, of whom 66 (46.8%) reported it. The main barriers to AEFI reporting were: difficulties with reporting process (28.9%); fear of raising public alarm (28.1%); time constraints (22.3%); fear of personal consequences (15.7%); and belief that health authorities rarely take useful action (11.6%).
Training in AEFI surveillance should be prioritised for HCPs with greater emphasis in medical education programmes. Study showed that a user-friendly reporting mechanism and a blame-free culture are crucial to improve AEFI reporting practices.
医疗保健专业人员(HCP)在疫苗接种后不良反应(AEFI)监测中发挥着核心作用。本研究在印度喀拉拉邦开展了一项横断面调查,以评估儿科医生在 AEFI 监测中的知识和报告行为,并确定报告障碍。
联系了喀拉拉邦的 380 名儿科医生,其中 243 名(63.9%)参与了调查。理解评分分布如下:30.9%为非常高或高,40.3%为中等,28.8%为低。正规培训与更高的理解评分、增加 AEFI 的检出和报告显著相关。只有 42.0%的受访者接受过正规培训;公共部门的儿科医生比私人部门的儿科医生更容易获得培训。在过去一年中,有 141 名(58.0%)受访者发现了 AEFI,其中 66 名(46.8%)报告了 AEFI。AEFI 报告的主要障碍是:报告过程困难(28.9%);担心引起公众恐慌(28.1%);时间限制(22.3%);担心个人后果(15.7%);以及认为卫生当局很少采取有效行动(11.6%)。
应优先为 HCP 提供 AEFI 监测培训,在医学教育计划中应更加重视。研究表明,用户友好的报告机制和无责文化对于改进 AEFI 报告实践至关重要。