MUMBAI: District-level committees that review adverse events following immunisation (AEFI) have been asked by the health department to add cardiologists and respiratory medicine specialists to their existing experts’ pool. AEFI committees exist at the district, state and national levels to review serious and mild adverse reactions post immunisation.
Till now, they included an epidemiologist, a paediatrician, a microbiologist, a neurologist, a physician, a cold chain officer and representatives from WHO. “It is for the first time that millions of adults, including many with co-morbidities, will be vaccinated. Hence, the Centre had asked states for expansion of AEFI committees,” said Dr Dilip Patil, state immunisation officer, adding the primary mandate would be to address complications arising post vaccination that may not be necessarily linked to it.
Workshops underway to sensitize med officers to vaccination’s adverse effects
The Centre has also asked the states to boost the stocks of kits for management of anaphylaxis, a severe allergic reaction, and for basic treatment of adverse effects. The states have also been asked to identify a medical college as the State AEFI Technical Collaborating Centre.
Dr Patil said that workshops to sensitize medical officers and health workers on AEFI reporting following adult vaccinations are being carried out. Such cases are likely to be discussed during monthly or weekly review meetings.
According to the existing definitions, fever, swelling at the injection site and irritability are all classified as minor adverse effects, whereas pain and swelling which spreads beyond the nearest joint or high-grade fever come in the category of severe adverse effects. Serious AEFIs are those that require hospitalization or lead to death or disability. A senior doctor, though, said mentioning strokes and heart attacks as adverse events was being discussed too. Preliminary figures show an estimated one crore healthcare workers will be vaccinated in the first round, followed by roughly two crore frontline workers. The third category will be of general public aged above 50 years and those below 50 with comorbidities.
Vaccination expert Dr Naveen Thacker, who was a former civil society member of the GAVI, The Vaccine Alliance, called inclusion of more experts a welcome step. “India has a robust AEFI system due to the universal immunisation programme. However, adult vaccination at this scale would be completely new. The role of the specialist could be more of managing any health complications arising after vaccination and not necessarily due to vaccination,” he said. A national committee usually decides on the causality of such cases based on information provided by the local committees.