Understanding and experience of adverse event following immunization (AEFI) and its consequences among healthcare providers in Kebbi State, Nigeria: a qualitative study

Semeeh Akinwale Omoleke, Biniam Getachew, Abubakar Isyaku, Abdulrasheed Bello Aliyu, Ashiru Mohammed Mustapha, Shafiu Muhammad Dansanda, Kehinde Kazeem Kanmodi, Hafsat Abubakar, Zahraddeen Ibrahim Lawal, Haruna Abdullahi Kangiwa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: Vaccines used in the national immunization program are relatively safe and effective. However, no vaccine is perfectly safe. Therefore, adverse reactions may occur. This study aimed to investigate the understanding and experience of Adverse Event Following Immunization (AEFI) among healthcare workers and Routine Immunization (RI) officers. Methods: Phenomenological qualitative study was conducted between June and September 2019, using a semi-structured question guide in Kebbi State, Northwest Nigeria. Face-to-face interviews were conducted with 12 RI providers, eight Expanded Program on Immunization (EPI) officers, and eight Disease Surveillance and Notification Officers. Thematic analysis was used to analyze the data. The interviews were transcribed and translated, then manually analyzed thematically. Results: The knowledge level of healthcare providers on AEFI definition and classification varied and was suboptimal. Error during vaccination was the study participants' most frequently mentioned possible cause of AEFI. Persistent crying, fever, fainting, and swelling and tenderness at injection sites were the AEFI experienced by the healthcare providers in their careers. Block rejection, lower immunization uptake, loss of confidence in RI, attack on RI providers, discrimination of RI providers and divorce threats among spouses were the consequences of AEFI. Supportive supervision of the RI sessions, refresher training on safe injection for RI providers, and symptomatic treatment of clients with AEFI would prevent AEFI consequences. Also, educating caregivers, community sensitization, and dialogue would minimize the consequences of AEFI. Conclusions: Evidence of a sub-optimal understanding of AEFI was established in this study. Hence, policymakers should consider regular refresher training on AEFI to ensure all RI providers have an optimal understanding of AEFI. Health education of caregivers and parents during RI sessions and community engagement should be considered to minimise AEFI consequences on the immunization program and the society.

Original languageEnglish
Article number741
JournalBMC Health Services Research
Issue number1
Publication statusPublished - 3 Jun 2022
Externally publishedYes

Bibliographical note

Funding Information:
The authors acknowledge the support provided by the interviewees who are health workers providing immunization services in Kebbi State, Nigeria. The authors appreciate the effort of the Director of Public Health, Kebbi State Ministry of Health, Mr Muhammad Bubuche, for facilitating the ethical clearance for the study.

Publisher Copyright:
© 2022, The Author(s).


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