Retrospective study of immunization errors reported in an online Information System

Area of Science:

• Public Health
• Vaccinology
• Patient Safety

Background:

• Immunization errors pose a risk to patient safety and vaccine efficacy.
• Surveillance systems are crucial for identifying and addressing these errors.

Purpose of the Study:

• To analyze immunization errors reported in an online information system.
• To identify common types and incidence rates of immunization errors.

Main Methods:

• Retrospective study using data from the Adverse Event Following Immunization Surveillance Information System.
• Analysis of errors based on demographic characteristics and vaccination process.
• Calculation of frequencies and incidence rates, with statistical tests for significance.

Main Results:

• 501 immunization errors were analyzed, predominantly involving routine doses (92.6%) in children under five (55.7%).
• Most frequent errors included incorrect vaccine indication (26.9%), improper dosing intervals (18.2%), and administration technique errors (14.2%).
• Overall error incidence was 4.05/100,000 doses, with higher rates for human rabies, HPV, and MMR vaccines.

Conclusions:

• Immunization errors are a prevalent issue requiring health system attention.
• Preventive strategies like protocols, checklists, and continuous education are effective.
• Addressing these errors is essential for maintaining vaccine program integrity and public trust.