Liberia FETP Alumni Investigate AEFI/AESI Cases in Liberia

Childhood immunization is vital for protecting against serious diseases, but sometimes adverse events following immunization (AEFI) or adverse events of special interest (AESI) can occur. Recently, four cases of AEFI/AESI in Nimba and Bomi Counties, Liberia, prompted a crucial investigation by the Liberia Field Epidemiology Training Program (LFETP) Alumni. This investigation played a significant role in ensuring the safety and effectiveness of childhood immunization programs in Liberia.

Collaborative Efforts for Immunization Safety

Concerned about these AEFIs/AESIs, the LFETP Alumni collaborated with the Ministry of Health’s Expanded Program on Immunization (EPI), the National Public Health Institute of Liberia (NPHIL), the African Field Epidemiology Network (AFENET), and other partners. Together, they launched a comprehensive investigation to understand these events and identify preventive measures.

Group photo of the AEFI investigation team in Bong County L-R: Mr Ben Karhenye (LFETP Alumni), Surveillance Office, EPI, Ms Helena Bridges, AEFI Focal Person, NPHIL, Ms Faith Kamara Whesseh, Emergency Response Coordinator, AFENET Liberia, Mr. Blama Kamara (LFETP Alumnus), District Surveillance Officer, Klay district, Bomi County, WHO, Mr. Augustine Newray, Safety Coordinator, EPI

Dr. Robert Lee Dolo, County Health Officer, Nimba County (in the middle) with Liberia FETP Alumni involved in AEFI investigation in Nimba County

What the Investigation Uncovered

The investigation focused on three key areas:

• Understanding the Cases: The team reviewed medical records and conducted interviews with parents and healthcare workers to gain a detailed understanding of each AEFI case.
• Identifying Patterns: They looked for commonalities across the cases, such as the timing of symptoms, the types of vaccines administered, and any underlying health conditions in the children.
• Strengthening Prevention: The investigation aimed to identify areas for improvement in vaccine storage, injection practices, and AEFI reporting.

Mr. Blama Kamara (LFETP Alumnus), District Surveillance Officer, Klay district, Bomi County sensitizing community members on reporting AEFI and taking their children for vaccination

Faith Kamara Whesseh, Emergency Response Coordinator, AFENET Liberia sensitizing community members on AEFI in Bong County

Community Health Assistant, Klay district, Bomi County, creating awareness on AEFI and encouraging community members to take their children for vaccination.

Liberia FETP Alumni: Mercy Dormeyan Vaye, Joyce Abel, and Isaac Cole conducting interviews with parent and healthcare workers on AEFI cases, Nimba County

Mr Ben Karhenye (LFETP Alumni), Surveillance Office, EPI, and Ms Helena Bridges, AEFI Focal Person, NPHIL, interviewing a vaccinator on AEFI at the health facility, Bong County

Key Findings and Next Steps

The investigation identified four cases of AEFI in children who had received the Pentavalent vaccine. All four children developed fever and swelling or abscesses at the injection site shortly after vaccination.

While the investigation is awaiting a causality assessment report to definitively determine the cause of these AEFIs, it has already highlighted areas for improvement in the overall immunization process. Based on these findings, the team recommends several steps to improve immunization safety in Liberia:

• Enhanced Training for Healthcare Workers: Strengthening training programs for healthcare workers to emphasize proper injection techniques and effective identification and reporting of AEFIs.
• Improved AEFI Surveillance: Implementing robust surveillance systems for earlier detection and management of potential AEFIs.
• Community Education: Raising awareness among caregivers about common vaccine side effects and the importance of reporting any concerns to ensure timely intervention if needed.

Commitment to Safe and Effective Immunization

The LFETP Alumni and their partners remain dedicated to ensuring safe and effective childhood immunization programs in Liberia.

Remember, Vaccination is the Best Defense!

• Vaccination is the most effective way to protect children from serious diseases.
• Most side effects from vaccines are mild and temporary.
• If you have any concerns about your child’s reaction to a vaccine, consult a healthcare professional immediately.
• Reporting AEFIs helps healthcare officials monitor vaccine safety and prevent future complications.

Together, we can ensure that all children in Liberia benefit from the life-saving power of vaccinations.