January 8, 2025
Strengthening Kenya’s Vaccine Safety Reporting System: increased AEFI reporting in Kenya
Dr. Lucy Mecca achieved remarkable success in strengthening Kenya’s vaccine safety reporting system. Vaccine safety systems and adequate reporting of Adverse Events Following Immunization (AEFI) are essential as they allow public health officials to enhance confidence in immunization programs. In just under two years, Dr. Mecca and her team improved reporting structures and increased the number of reported cases of AEFI from just twelve cases in 2019 and eighteen cases in 2020, to 861 cases in 2021. Dr. Lucy and her team have continued to strengthen this system with 3,251 AEFI cases reported in 2023.
In Kenya, vaccine safety monitoring systems were inadequate and failed to meet the World Health Organization’s surveillance targets of at least 10 reports of Adverse Events Following Immunization (AEFI) per 100,000 infants, with only 20 reports annually from a population of about 1.5 million infants. This underperformance resulted in a lack of robust data on vaccine safety and heightened the risk of rumors, misinformation, vaccine-hesitancy, and conspiracy theories, especially with new vaccines.
Improving vaccine reporting is critical as new vaccines are introduced but is a complex challenge because it involves a diverse set of entities including regulators, public health agencies and the WHO. Dr. Mecca used the introduction of the malaria and COVID-19 vaccines as a window of opportunity to bring stakeholders together to strengthen Kenya’s vaccine safety. She used her skills in stakeholder engagement to focus first on strengthening collaboration with the regulator. This allowed her team to revise health worker training programs to include AEFI, develop and disseminate AEFI reporting guidelines, conduct active AEFI surveillance, and establish the National Vaccines Safety Advisory Committee. Dr. Mecca, working with the regulator, also oversaw the introduction of a new online reporting system which allowed patients to submit AEFI directly without relying on health workers to report. This was particularly effective during the COVID-19 vaccine rollout. Additionally, Dr. Mecca’s team integrated a specialized AEFI reporting module into the regulator’s existing online system. This enhancement allowed for more accurate and comprehensive reporting of vaccine-related adverse events, addressing limitations in the previous drug-focused system.
To implement the overhaul of Kenya’s vaccine safety reporting system, Dr. Mecca drew on policy and leadership skills gained through IPPHL, including stakeholder engagement, team collaboration, efficient resource deployment, implementation analysis and process improvement. The policy memo she developed as part of the IPPHL program played a critical role in analyzing the problems affecting AEFI surveillance and helped her to think creatively about accessing resources. She was ultimately able to implement many of her recommendations.