Active vaccine safety surveillance of seasonal influenza vaccination via a scalable, integrated system in Western Australian pharmacies: a prospective cohort study

Author:

Salter SandraORCID,Singh Gurkamal,Nissen LisaORCID,Trentino KevinORCID,Murray KevinORCID,Lee KennethORCID,Kop Benjamin,Peters Ian,Leeb Alan

Abstract

ObjectivesWe integrated an established participant-centred active vaccine safety surveillance system with a cloud-based pharmacy immunisation-recording program in order to measure adverse events following immunisation (AEFI) reported via the new surveillance system in pharmacies, compared with AEFI reported via an existing surveillance system in non-pharmacy sites (general practice and other clinics).DesignA prospective cohort study.Participants and settingIndividuals >10 years receiving influenza immunisations from 22 pharmacies and 90 non-pharmacy (general practice and other clinic) sites between March and October 2020 in Western Australia. Active vaccine safety surveillance was conducted using short message service and smartphone technology, via an opt-out system.Outcome measuresMultivariable logistic regression was used to assess the primary outcome: differences in proportions of AEFI between participants immunised in pharmacies compared with non-pharmacy sites, adjusting for confounders of age, sex and influenza vaccine brand. A subgroup analysis of participants over 65 years was also performed.ResultsOf 101 440 participants (6992 from pharmacies; 94 448 from non-pharmacy sites), 77 498 (76.4%) responded; 96.1% (n=74 448) within 24 hours. Overall, 4.8% (n=247) pharmacy participants reported any AEFI, compared with 6% (n=4356) non-pharmacy participants (adjusted OR: 0.87; 95% CI: 0.76 to 0.99; p=0.039). Similar proportions of AEFIs were reported in pharmacy (5.8%; n=31) and non-pharmacy participants (6; n=1617) aged over 65 years (adjusted OR: 0.94; 95% CI: 0.65 to 1.35; p=0.725). The most common AEFIs in pharmacy were: pain (2%; n=104), tiredness (1.9%; n=95) and headache (1.7%; n=88); and in non-pharmacy sites: pain (2.3%; n=1660), tiredness (1.9%; n=1362) and swelling (1.5%; n=1121).ConclusionsHigh and rapid response rates demonstrate good participant engagement with active surveillance in both pharmacy and non-pharmacy participants. Significantly fewer AEFIs reported after pharmacist immunisations compared with non-pharmacy immunisations, with no difference in older adults, may suggest different cohorts attend pharmacy versus non-pharmacy immunisers. The integrated pharmacy system is rapidly scalable across Australia with global potential.

Funder

J.M. O'Hara Research Fund

Publisher

BMJ

Subject

General Medicine

Reference38 articles.

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3. Nissen LM , Glass BD , ETL L . Queensland pharmacist immunisation pilot (QPIP) phase 1 pharmacist vaccination-influenza final report. Brisbane: Queensland University of Technology, 2015. https://eprints.qut.edu.au/91903/

4. International Federation of Pharmacy . An overview of current pharmacy impact on immunisation: a global report. Available: https://www.fip.org/files/fip/publications/FIP_report_on_Immunisation.pdf [Accessed 02 Dec 2020].

5. Pharmaceutical Society of Australia . COVID-19 information for pharmacists, 2021. Available: https://www.psa.org.au/coronavirus/#1613955340819-3ab219ba-bdc1 [Accessed 31 Mar 2021].

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