7.5.5  Detecting and responding to AEFIs

In your immunization activities, you should monitor, investigate, treat, refer and report the following AEFIs:

  • all injection site abscesses
  • all swelling in the armpit, particularly after BCG immunization
  • all hospitalizations following immunization that occur within one month
  • any other severe or unusual medical incident following immunization within one month
  • all deaths that occur within one month of an immunization
  • all medical events believed to be caused by immunization and about which people are concerned.

If you come across a suspected case of AEFI you should treat the affected person within your professional capacity, as described in Study Sessions 2 and 3, and refer him or her urgently to a higher health facility for further investigation and treatment. The patient should be accompanied by a responsible caregiver who has a clearly written referral note from you, explaining all relevant details.

If the AEFI is related to a known programme error, you must take immediate action to correct the cause. Liaise with the parents and community leaders to explain the cause of the AEFI, if it is known. You will learn more about communication in immunization programmes in Study Session 9.

  • A mother brings you an infant who has a large abscess on his arm. The abscess is at the site where you gave him an immunization against BCG ten days previously. What action should you take?

  • Keep the site of the abscess clean. Give amoxicillin syrup three times daily and refer the child urgently to a higher health facility.

All AEFIs, including those reported immediately during the month, should be counted in routine, written, monthly surveillance reports. (You will learn how to do this in Study Session 10.)

7.5.4  How to avoid AEFIs

7.6  Safe waste disposal