Understanding reporting practices and perceptions of barriers in adverse events following immunisation surveillance: A cross–sectional survey of paediatricians in Kerala, India

Purpose: The role of health care professionals (HCPs) is central to adverse event following immunisation (AEFI) surveillance. A cross–sectional survey was conducted among paediatricians practising in Kerala, India, to assess their knowledge and reporting behaviour in AEFI surveillance as well as to identify barriers to reporting. Results: A random sample of 380 paediatricians were contacted of whom, 243 (63.9%) participated in the survey. The understanding scores were distributed as follows: 30.9% very high or high, 40.3% moderate, and 28.8% low. Formal training was significantly associated with higher understanding scores, and increased AEFI detection and reporting. Only 42.0% of respondents had formal training; paediatricians in the public sector had higher access to training than those in the private sector. There were 141 respondents (58.0%) who identified an AEFI in the previous year, of whom 66 (46.8%) reported it. The main barriers to AEFI reporting were: difficulties with reporting process (28.9%); fear of raising public alarm (28.1%); time constraints (22.3%); fear of personal consequences (15.7%); and belief that health authorities rarely take useful action (11.6%). Conclusion: Training in AEFI surveillance should be prioritised for HCPs with greater emphasis in medical education programmes. Study showed that a user–friendly reporting mechanism and a blame–free culture are crucial to improve AEFI reporting practices.