Prevalence and patterns of adverse events following immunisation among children less than 24 months attending immunisation clinics in Kano, Nigeria

Abstract

Adverse Events Following Immunisation (AEFI) contribute to child morbidity and mortality as they often lead to low uptake of vaccines with consequent persistence of vaccine-preventable diseases. It is essential to assess the prevalence of AEFIs in northern Nigeria, where misconceptions about immunisation exist. This study assessed the prevalence and pattern of AEFI among children less than 24 months after attending immunisation clinics in Kano, Nigeria. Using a mixed-methods design, adapted intervieweradministered questionnaires were assigned to a cross-section of 384 mother-baby pairs who presented to the immunisation clinics of selected primary healthcare centres (PHCs) within metropolitan Kano. This was followed by six sessions of focus group discussion with a sub-sample of the mothers. Logistic regression and the framework approach were used to analyse the data. The prevalence of AEFI was (43.5%, n=164), and most cases (72.4%, n=273) were mild. Fever was the most common type of AEFI reported (66.5%, n=109) and was higher among infants less than three months (44.5%, n=73). Age of the index child was the only significant predictor of AEFI (OR:0.18, 95% CI: 0.10-0.35). Our study shows that AEFI was common among children less than 24 months old in Kano. We recommend sensitisation and health education of caregivers using valuable communication strategies and sufficient training of immunisation service providers on professional ways to deliver these vaccines safely.

Prevalence and patterns of adverse events following childhood immunization and the responses of mothers in Ile-Ife, South West Nigeria: a facility-based cross-sectional survey

“…This study found a generalized/systemic presentation to be the most common site of AEFIs reported by mothers and the pentavalent vaccine to be the vaccine most often believed to be the cause of AEFIs. The finding regarding generalized presentation is consistent with earlier studies [ 13 , 15 – 17 ]. The finding that the pentavalent vaccine was the most frequently cited cause of an AEFI is also not unexpected since it is a combination of 5 vaccines in a single dose and has been reported to be associated with increased incidence of AEFIs and due to the diphtheria, pertussis, and tetanus (DPT) components of the pentavalent vaccine [ 13 , 18 , 19 ].…”

“…The finding regarding generalized presentation is consistent with earlier studies [ 13 , 15 – 17 ]. The finding that the pentavalent vaccine was the most frequently cited cause of an AEFI is also not unexpected since it is a combination of 5 vaccines in a single dose and has been reported to be associated with increased incidence of AEFIs and due to the diphtheria, pertussis, and tetanus (DPT) components of the pentavalent vaccine [ 13 , 18 , 19 ]. We found fever to be the most common AEFI observed by mothers following the vaccination of their children.…”

“…In this study, about 37.9% of children were reported by mothers to have experienced an AEFI in some form. This rate was consistently lower than the rates reported in North Central [ 12 ], North West [ 13 ], and South South [ 14 ] Nigeria, although it was slightly higher than the rate reported in an earlier study in North West Nigeria in 2016 [ 15 ]. The consistently different rates across regions, including the rate reported in this study, may be a result of contextual differences in study settings, differences in the education levels of mothers between regions as documented in past studies [ 12 – 15 ], coincidental events that may have been reported as AEFIs by mothers in some of the studies due to a close temporal association with the timing of immunization, different vaccine handling and storage techniques, differences in the manufacturers of vaccines across zones, and, notably, ethnic and genetic differences between children, given that many studies from different zones of the country employed a similar cross-sectional research design.…”

Adverse events following immunization among children during primary immunizations in selected health facility of Himachal Pradesh

“…Drowsiness/sleep disturbance was observed only at 6 weeks and 14 weeks. The current study reports more diverse and higher incidences of AEFIs as compared to previous studies that mainly report fever, redness swelling and excessive crying (9)(10)(11). While most others studies have observed AEFIs at single immunization event, present study reports vaccine related problems during primary immunizations among the children followed through and up to nine months.…”