Vaccine safety issues can lead to crises, erosion of public trust and even collapse of immunization programmes if communication is not properly handled. Safety concerns may have widespread consequences, even outside the country in which they occur. Preparedness and proactive rather than reactive communication are essential for maintaining confidence in vaccines.

A GACVS subgroup on vaccine safety communication continuously reviews and provides advice on strategies for vaccine safety communication. It was asked to prepare a series of case studies of vaccine safety communication,¹² to contribute to a common framework for vaccine safety crisis communication and capacity-building in Member States. During the meeting, the Committee examined communication about immunization errors involving measles-containing vaccines. Such errors have been reported occasionally in the medical literature. For example, at least 15 children died after being vaccinated against measles during a catch-up campaign, all of whom were aged 6–18 months. A published report indicated that the vaccine had been accidently diluted with atracurium, a muscle relaxant used in anaesthesia, with packaging similar to that of the vaccine diluent.¹³ Contamination of multi-doses vaccine vials of measles-containing vaccine is known to have occurred in India in the 1990s.¹⁴ As such events require programme adjustment and frequently disciplinary action, communication channels become blurred and could lead to the mistaken conclusion that the vaccine itself was responsible.

GACVS reviewed case histories from global vaccine safety websites. It also discussed 2 recent events in which children died because of programme errors during immunization with measles-containing vaccines, in routine immunization and during a mass immunization campaign. In the first instance, 2 infants aged 1 year died within minutes of receiving routine MMR during a routine immunization session. In the other instance, at least 15 deaths resulted from contaminated vaccine during a mass immunization campaign in a medically underserved population. As these events reflect real challenges to immunization programmes, the committee discussed the need for (i) a concerted focus on training, supervision and support of national authorities and partners during planning of mass immunization campaigns; (ii) acknowledgement of programme errors and prompt proposal of corrective measures; (iii) preparedness for crisis management; and (iv) high-quality communication about the safety of immunization, both routine and during mass campaigns.

Vaccine safety issues have multiple dimensions. The GACVS case studies should reveal those aspects, including errors that reflect systemic issues. The Committee unanimously acknowledged that vaccine safety communication should address a broad range of scenarios. Further case studies will address both common and unique problems related to vaccine safety and will be used to prepare guidance for various scenarios, in collaboration with communication experts.

¹²See No. 93, 2018, p. 395.

¹³Cousins S. Contaminated vaccine deaths a serious setback for Syria. Lancet. 2014;384:1172.

¹⁴Sood DK et al. Adverse reactions after measles vaccination in India. Natl Med J India. 1995;8(5):208–10.

Full report of GACVS meeting of 5-6 December 2018, published in the WHO Weekly Epidemiological Record on 25 January 2019