Adverse events following immunization (AEFI) reports of extended program immunization (EPI) in Indonesia during 1998-2002

Background The incidence of adverse events following immuni- zation (AEFI) increased in correlation with the number of vaccine doses. Meanwhile AEFI reports should be managed properly to maintain the compliance and immunization coverage. Objectives The aims of this study were to investigate the inci- dence and profile of AEFI, its onset, severity, classification, and outcome. Methods This study was a passive surveillance of AEFI reports received by the National Committee on AEFI, Ministry of Health of Indonesia, during 1998 to 2002. Results Two hundreds and four AEFI cases were reported; 4 cases as zero reports, 182 cases as individual reports, and 18 cluster reports. The AEFI incidence was 0.44 per 1 million doses of vac- cines. Vaccine reaction rate was 1 per 2.3 million vaccine doses. The most common vaccines reported as the causes of AEFI were DTP, Polio, and TT. Among 182 reported cases, local or mild AEFI reactions were observed in 45, moderate in 49, and severe in 88. Based on WHO field classification, this study reported that 84 cases belonged to coincidence, 72 to vaccine reactions, 13 to program- matic errors, 7 to injection reactions, and 6 to unclassified reac- tions. Forty-seven patients died, 12 had some sequelae, and 123 completely recovered. Meanwhile, among the death cases, 70% occurred coincidently, 17% due to vaccine reactions, and 6 were unclassified. Conclusions The incidence of AEFI in the extended program im- munization (EPI) in Indonesia during the period of 1998-2002 were 182 cases, thus vaccine reaction rate was 1 per 2.3 million vac- cine doses. The most common vaccine which caused AEFI was DTP. Most AEFI with severe symptoms happened in 4-24 hours after immunization