Enhanced passive surveillance of influenza vaccination in England, 2016-2017- an observational study using an adverse events reporting card

Hum Vaccin Immunother. 2019;15(5):1048-1059. doi: 10.1080/21645515.2019.1565258. Epub 2019 Mar 20.

Abstract

Influenza is a major public health burden, mainly prevented by vaccination. Recommendations on influenza vaccine composition are updated annually and constant benefit-risk monitoring is therefore needed. We conducted near-real-time enhanced passive surveillance (EPS) for the influenza vaccine, Fluarix Tetra, according to European Medicines Agency guidance, in 10 volunteer general practices in England using Fluarix Tetra as their principal influenza vaccine brand, from 1-Sep to 30-Nov-2016. The EPS method used a combination of routinely collected data from electronic health records (EHR) and a customized adverse events reporting card (AERC) distributed to participants vaccinated with Fluarix Tetra. For participants vaccinated with a different influenza vaccine, data were derived exclusively from the EHR. We reported weekly and cumulative incidence of pre-defined adverse events of interest (AEI) occurring within 7 days post-vaccination, adjusted for clustering effect. Of the 97,754 eligible participants, 19,334 (19.8%) received influenza vaccination, of whom 13,861 (71.7%) received Fluarix Tetra. A total of 1,049 participants receiving Fluarix Tetra reported AEIs; 703 (67%) used the AERC (adjusted cumulative incidence rate 4.96% [95% CI: 3.92-6.25]). Analysis by individual pre-specified AEI categories identified no safety signal for Fluarix Tetra. A total of 62 individuals reported an AEI with a known brand of non-GSK influenza vaccine and 54 with an unknown brand (adjusted cumulative incidence rate 2.59% [1.93-3.47] and 1.77% [1.42-2.20], respectively). In conclusion, the study identified no safety signal for Fluarix Tetra and showed that the AERC was a useful tool that complemented routine pharmacovigilance by allowing more comprehensive capture of AEIs.

Keywords: [MeSH]: General practice; adverse drug reaction reporting systems; adverse effects; drug-related side effects and adverse reactions; influenza vaccines; influenza, human; medical record systems, computerized; pharmacovigilance; records as topic.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Adverse Drug Reaction Reporting Systems / instrumentation*
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Data Collection
  • Electronic Health Records
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Influenza Vaccines / administration & dosage*
  • Influenza Vaccines / adverse effects*
  • Influenza, Human / prevention & control*
  • Male
  • Middle Aged
  • Pharmacovigilance
  • Vaccination / statistics & numerical data*
  • Vaccines, Inactivated / administration & dosage
  • Vaccines, Inactivated / adverse effects
  • Young Adult

Substances

  • Influenza Vaccines
  • Vaccines, Inactivated
  • fluarix

Grants and funding

GlaxoSmithKline Biologicals SA was the funding source and was involved in study design and interpretation (NCT02893878). GlaxoSmithKline Biologicals SA paid for all costs associated with the development of this manuscript.