540. FluNet: Real-time Influenza Vaccine Surveillance
Session: Poster Abstract Session: Influenza Vaccines
Friday, October 21, 2011
Room: Poster Hall B1
Background: Current vaccine surveillance systems have many strengths, but are not able to rapidly gather information directly from large numbers of patients simultaneously, leading to under-reporting and delayed detection of adverse events (AE). Text messages are a novel scalable approach to patient-centered vaccine AE surveillance which has not yet been used to study vaccine AE reporting in an urban population.

Methods: Pediatric, adult and obstetric patients in 5 community clinics associated with an academic medical center in a low-income community in New York City were given an enrollment card by nurses after receipt of an influenza vaccine. At one pediatric/adult site, a project coordinator was on site to answer further questions.  Enrollment occurred via an interactive telephonic system that automatically captured the cell phone number. Participants were sent interactive text messages at weeks 1, 2, 4 and 6 post enrollment through which they could report post-vaccination symptoms in the preceding week.  Health tips were sent on weeks 3 and 5.   We report frequency, sensitivity, specificity, positive- and negative-predictive values (PPV, NPV) of reporting.  Additionally, 50 participants were surveyed post-intervention.

Results: 1410 cards were distributed, and 226 patients enrolled; 75% pediatric, 6% internal medicine, 8% family medicine and 11% obstetric. Enrollees ranged from 6 months through 79 years. 63% were enrolled by the onsite coordinator. We received 46% (n=406) of expected responses overall; at week 6 we received 36% of expected responses. In 85% of responses, enrollees reported no symptoms, in 12% non-emergent symptoms (fever, soreness, rash, GI and cough/cold), and in 3% emergent symptoms (severe allergy, fever, and breathing problems) were reported. 79% reported number of days of symptoms. Specificity for reporting symptoms resulting in emergency room visits was 99.5%, sensitivity 70%, PPV 63.6%, NPV 99.7%.  82% of patients surveyed were very satisfied with the service and would sign up again.

Conclusion: Text message vaccine adverse event surveillance is feasible and well-liked by patients. Concerted efforts to improve enrollment would be needed.

Subject Category: I. Adult and Pediatric Vaccines

Melissa Stockwell, MD, MPH, Raquel Andres, PhD, Nadira Fernandez, MD, Celibell Vargas, MD, Marc Lara, PharmD and Philip LaRussa, MD, Columbia University, New York, NY


M. Stockwell, None

R. Andres, None

N. Fernandez, None

C. Vargas, None

M. Lara, None

P. LaRussa, None

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