Fellowship completed

November 3, 2020



IMPRINT fellow Dan Kajungu from the Makerere University Centre for Health and Population Research in Uganda completed his project "Innovations for vaccine safety monitoring and improved maternal and neonatal immunisation in rural Uganda (InVxSIM)." The project supported innovations around childhood and maternal vaccine uptake, enhanced vaccine safety surveillance and increased vaccine acceptability in pregnant women and neonates. It was implemented within a health and demographic surveillance site (population-based cohort) in Eastern Uganda. The project highlights are summarised as follows:

1. Community members' preferences or inclinations regarding the introduction of new vaccines were established through community engagements. Sentiments were captured on attitudes, concerns and beliefs concerning the introduction of vaccines targeting pregnant women; improving the acceptability of new health interventions through community engagements; support systems that enable the uptake of new vaccines; common illnesses anddiseases; the use of traditional alongside modern medicine; and adverse eventsreporting strategies.

2. Focus group discussions with pregnant women found that they were knowledgeable, had positive attitudes and were willing to accept new vaccines. However, ignoring vaccine safety concerns may impede maternal immunisation acceptability because of concerns about adverse events following immunisation (AEFI) by pregnant women and spouses.

3. Health facility records were reviewed at a regional referral hospital and a community-based health centre to establish background incidence rates of obstetrics and neonatal outcomes following the Global Alignment of Immunization safety Assessment in pregnancy (GAIA) outcomes definition. This is critical information for assessing the safety of new maternal vaccines.

4. A systematic review was conducted to assess the role of mHealth interventions in generating demand for immunisation and reporting of AEFI. Important factors are inequity in accessibility, uncertainties around technology ownership, and illiteracy. MHealth interventions should be customised to exploit the benefits of maternal and childhood immunisation.

5. An immunisation reminder system using a mobile app that sends messages to caretakers to enhance neonatal vaccines uptake was piloted. Users commended this innovation and suggested the inclusion of adult immunisation and follow-ups for chronic conditions.

6. A collaboration has been established with the national drug authority to facilitate joint capture and analysis of safety data. This will enhance the utilisation of vaccine and medicines safety databases to guide regulatory decisions. Data system linkages offer stakeholders a picture of safety profiles for maternal vaccines and medicines. An immediate plan is to establish pregnancy registries and robust surveillance systems using the experience from this project.

Dan Kajungu further successfully applied for a Pfizer grant to investigate the impact of pneumococcal conjugate vaccine on pneumonia in children under the age of five. This project is ongoing.


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