PIVI partners and stakeholders at the US Centers for Disease Control and Prevention (CDC), the Lao Ministry of Heath, and the World Health Organization (WHO) have just published a paper in the January 2015 issue of the journal Influenza and Other Respiratory Viruses. The paper, “Introducing seasonal influenza vaccine in low-income countries: an adverse events following immunization survey in the Lao People’s Democratic Republic,” provides insight into what PIVI does after the vaccine has been administered.
The paper reports the findings of an evaluation done shortly after vaccine doses were administered in April and May of 2012. Interviews with 2,089 persons who received the influenza vaccine focused on the occurrence of any adverse event following immunization (AEFI). AEFIs could include a number of manifestations (e.g. fever, headache, and/or soreness or swelling around the injection site) and were categorized in four grades ranging from mild to life threatening. The interviews revealed that none of the AEFIs reported were severe or life threatening; most were localized reactions. Additionally, the authors point out that “the majority of AEFIs were reported among persons ≥50 years of age or with chronic disease, and it is likely that some reported events were associated with an existing underlying medical condition and not the vaccine.” The interviews also included questions regarding the participants’ attitudes towards the vaccine. In addition to a high acceptance rate of the vaccine, the results also indicated that many of the participants were quite interested in both being vaccinated again and making the vaccine available for children. Findings such as these demonstrate the vaccine’s safety as well as its public appeal and bode well for PIVI as the partnership continues to encourage contributing partners and country partners to invest in influenza vaccination campaigns.
In order to successfully follow up with persons who have been vaccinated and learn more about the impact of influenza vaccine on a population, the PIVI team at CDC works closely with country partners, including the Ministry of Health, and stakeholders, including the in-country or regional WHO office. In Laos, the collaborative nature of PIVI provided a learning opportunity for the Laos Field Epidemiology Training Program (FETP): CDC epidemiologists on hand for the vaccination campaign kickoff worked closely with the Laos FETP, teaching them how to collect and analyze data for the evaluation. In addition to engaging in the development, implementation, and evaluation of the immunization campaign, the Laos FETP also worked with the CDC to write the just-published paper, giving many of the Laotian partners their first opportunity to author a public health publication. Training opportunities like this help build a country’s public health capacity and provide country partners with a skill set that can be applied to studying other public health issues and disease outbreaks. Finally, while the immunization campaign and evaluation provided great learning and training opportunities for the country partners, the campaign was significantly affected by an important contribution from the Laos Ministry of Health. The paper’s conclusion notes: “the success of this vaccine campaign was in large measure a function of integration with existing National Immunization Program (NIP) systems which are ideally suited to deliver vaccine to populations with limited access to preventive health services in a short period of time. The use of the NIP also contributed to building trust and acceptance of the vaccine among government stakeholders and the local population.” With each partner contributing its expertise and resources, the partnership as a whole was able not only to collect data but also contribute to the development of the skills, relationships, and organizational capacity that help a partner country like Laos better serve and care for its people.