Analyzing adverse side-effects of A/H1N1 vaccine in Afghanistan

Saturday, 14 February 2015
Exhibit Hall (San Jose Convention Center)
Nawid Musarat, Afghanistan National Public Health Institute, Kabul, Afghanistan
In 2010 there was widespread public mistrust of the Influenza A/H1N1 vaccine in Afghanistan. To encourage vaccination, the Ministry of Public Health undertook a study to analyze the risks involved in vaccination. The purpose of this study was to demonstrate to the Afghan public that the adverse side-effects did not pose any serious health threat. In order to build public confidence in the vaccination campaign, the Ministry of Public Health analyzed the side-effects of vaccination in Afghan healthcare workers. A total of 27,100 health care workers received the A/H1N1 monovalent vaccine in the four provinces of Kabul, Nangarhar, Balkh and Herat. OpenEpi was used to draw a randomized sample of 417 people for participation in this study, which was conducted over 4 weeks in March-April 2010. Interviewers were trained in questionnaire administration and assigned districts in the four regions. 370 people interviewed were included in the final study: 25% were female, 75% male; mean age was 36 years, and range was from 16–65. Standardization of injection procedure was ensured by using best practices of injection safety for vaccination.  53% of those interviewed reported pain at the injection site, 40% reported fever in the first three days after immunization, 39% reported body pain, 33% reported tiredness, 29% reported swelling at the injection site and 28% reported redness at the injection site. More females than males suffered adverse reactions; the rates varied across provinces, ranging from 79% of females in Balkh reporting adverse side-effects to 23% in Kabul.  While the results demonstrated that a high percentage of vaccine recipients experienced adverse side-effects, all were mild, non-life threatening and resolved within a few days. No serious lasting side-effects were reported. The results of this study were shared with over 20 governmental and non-governmental stakeholder institutions, including UNICEF, WHO and relevant Afghan Ministries, and publicized through media interviews and announcements. As a result, reports from Ministry of Public Health vaccination teams showed daily increases in the number of people vaccinated to the point at which Afghanistan suffered from a vaccine shortage.