Advances in vaccination safety

AusVaxSafety, which actively monitors the safety of vaccines using SMS-feedback and email from recently vaccinated children and adults, is helping to ensure public confidence in taking up vaccination.

AusVaxSafety is a collaborative initiative led by the National Centre for Immunisation Research & Surveillance (NCIRS) and funded by the Australian Government Department of Health.

Currently established in 130 sentinel immunisation providers across all States and Territories, AusVaxSafety will expand to more than 200 sites in 2017. General practices, hospital and community-based clinics, and Aboriginal Medical Services are participant partners.

The idea for the monitoring system was sparked in 2010, after a number of children suffered fever and febrile convulsions after receiving one brand of the flu vaccine (Fluvax and Fluvax Junior). There have been no safety concerns with the use of other brands of flu vaccine in children.

Despite withdrawing that brand of vaccine, many parents lost confidence in the flu vaccination. Research conducted by Professor Christopher Blyth of the Telethon Kids Institute revealed that in WA, vaccine uptake was substantially reduced in the following two years.

These reactions prompted different groups across the country to develop a way to monitor adverse reactions to vaccinations, particularly in children.

Traditionally, it’s been left up to parents (or patients themselves) to report adverse reactions to a vaccination to their GP. This passive reporting system then relied on GPs to make a report to the Therapeutic Goods Administration (TGA).

In light of the events of 2010, several medical professionals identified the need for a more proactive reporting system that recorded how vaccination was performing across the population in real-time.

Dr Alan Leeb, a GP in Western Australia, set up a system called SmartVax that uses text messaging and clinical data extracted from existing medical practice management software to actively contact patients who have received a vaccination, to enquire whether they had experienced any adverse reactions.

Meanwhile Professor Mike Gold set up another active monitoring system in South Australia, and a similar system called Vaxtracker was established in NSW by Professor David Durrheim.

Recognising the value in monitoring vaccine safety, the Australian Government called for tenders to conduct surveillance of influenza vaccination in children aged under five for the next three years.

NCIRS won the tender. Now, using SmartVax as the main data collection tool in general practice, AusVaxSafety receives and analyses de-identified data from all States and Territories and reports this to the Department of Health and TGA. AusVaxSafety currently monitors the safety of influenza vaccine in all ages (during the influenza season), pertussis vaccines in toddlers and young children, and zoster vaccine in adults.

SmartVax (http://www.smartvax.com.au/) is a software program, designed to actively monitor the safety of all vaccines given in general practice and vaccination clinics via SMS and smartphone technology. When a practice uses SmartVax, an automated text message is sent to patients three days after their vaccination asking whether they experienced a reaction. Patients who respond ‘yes’ are sent a question about the severity of the reaction, and a survey. Many States and Territories offer specialist vaccine adverse events clinics for patients who experience a reaction. Patients who experience a significant reaction can be referred by their GP to specialist vaccine adverse events clinics. For more information, contact the NSW Immunisation Specialist Service (NSWISS http://www.ncirs.edu.au/vaccine-safety/clinical/) on 1800 679 477.

SmartVax is completely free for practices. It is fully automated, and integrates with existing patient management systems. To get your practice involved, contact SmartVax via the website or by emailing info@smartvax.com.au.

According to the NCIRS, “Patients respond extremely well to SmartVax and participation rates are high. As well as informing national vaccine safety monitoring, the use of SmartVax in practices helps GPs with their duty of care following vaccination.”

NCIRS provides reports regularly to the Department of Health, TGA and vaccine safety experts and clinicians throughout Australia. Any safety concerns are reviewed by the NCIRS Expert Leadership Group, and there are mechanisms in place to follow-up safety concerns through more detailed data analysis and clinical follow-up of patients.

The public will soon be able to access AusVaxSafety’s latest surveillance data via the website, www.AusVaxSafety.org.au.