The Outbreak Observatory is conducting a pilot observation in Taipei, Taiwan. We have coordinated with colleagues at the Taiwan CDC to observe their annual seasonal influenza mass vaccination campaign. This post covers events from Thursday, October 19.

Today, Matt and I observed the logistics and operations of mass influenza vaccination programs at a local primary and nursery school in Taiwan, which included measures to prevent, detect, and report adverse events post-vaccination. Those measures were largely similar to what we observed at a senior high school earlier this week.

While the safety of vaccines—including the seasonal influenza vaccine—has been demonstrated and verified through numerous scientific studies, adverse events such as fainting or allergic reactions do occur in rare instances following vaccination. Vaccinations remain an important tool in preventing the transmission of communicable diseases in both adults and children.

Nurses briefing before the start of vaccination operations at an elementary school in New Taipei City.

Nurses briefing before the start of vaccination operations at an elementary school in New Taipei City.

As mentioned in yesterday’s blog post, parents in Taiwan must provide consent in advance, via a paper form, in order for their child to be vaccinated. This form outlines the risk of potential adverse events, such as Guillain-Barré Syndrome and syncope (fainting), and requires parents to answer specific questions about their child’s medical history. These questions, which include whether their child has ever had an allergic or other type of reaction to a vaccine, help to alert local health station and clinic staff to children who may be at an increased risk for adverse events as a result of the influenza vaccination. Additionally, prior to the mass vaccination, Taiwan CDC communicates tips for mitigating adverse events and for reducing anxiety around vaccination, including eating before receiving the vaccine and listening to music or chatting with friends while waiting in line.

When the child arrives at the vaccination station, a physician reviews the parent-completed consent form, and the child’s temperature is taken to ensure that they do not have a fever. The child then receives the vaccine and is monitored for 30 minutes for any adverse events. During each mass vaccination, Taiwan CDC requires a physician to be present in case of an emergency, and epinephrine must be present on site to treat anaphylactic reactions.

In addition to adverse events, unusual events are also documented and reported to the local health bureau. Unusual events include administering the wrong vaccine (e.g., MMR instead of influenza), administering the wrong dose, or immunizing the wrong person (e.g., someone without a consent form). For both types of events—adverse and unusual—a paper form that describes the incident and includes pertinent information (e.g., symptoms, vaccine batch number) must be completed immediately and reported to the local health bureau, which then reports the event to Taiwan CDC. Taiwan CDC also operates a disease reporting and consultation hotline, where individuals can, among other things, report these adverse events. The local health bureau is responsible for following up with individuals who experience adverse or unusual events, which can involve helping them access health care or file paperwork for Taiwan’s Vaccine Injury Compensation Program, if necessary.

Preventing, monitoring, and reporting adverse and unusual events are important components of the Taiwan CDC mass influenza vaccination program. These measures help to promote safety, which, in turn, helps foster trust between those receiving administering the vaccine and those receiving it.