153. Automated Detection and Reporting of Vaccine Adverse Events: ESP-VAERS
Session: Poster Abstract Session: Adult and Pediatric Vaccines
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • VAERSposter_finalSept2013.png (331.0 kB)
  • Background:

    Vaccine adverse event (VAE) reporting during routine practice helps identify rare or unexpected complications of immunizations and can aid in quantifying the risk of known adverse events. We created an electronic health record (EHR) module to facilitate VAE detection and reporting by clinicians.


    EHR Support for Public health (ESPnet) is an open-source public health surveillance platform that automatically detects and reports notifiable diseases and other public health events using EHR data (esphealth.org). We developed a new module, ESP-Vaccine Adverse Event Reporting System (VAERS), to monitor patients’ electronic records for new diagnoses, changes in laboratory values, new allergies, and suggestive medication prescriptions for up to 6 weeks following vaccinations. When ESPnet finds a possible adverse event, it sends the patient’s clinician a secure electronic message describing the event and inviting the clinician to affirm or refute the event, add comments, and submit an automated, pre-populated electronic case report to the national VAERS. Reports of high probability VAEs are submitted automatically even if the clinician does not respond. We implemented ESP-VAERS in December 2012 at MetroHealth, an inpatient and outpatient practice in Ohio with nearly 1 million encounters per year. We queried the national VAERS database to determine MetroHealth’s baseline reporting rates from 1/2009-3/2012 and then assessed changes in reporting rates with ESP-VAERS.


    In the first four months following implementation, 40,048 vaccinations were given. ESP-VAERS sent 739 messages to responsible clinicians describing potential VAEs. The average number of alerts per clinician was 0.4/month (range 0-6). Clinicians responded to 116 (16%) of the messages and confirmed 9 for transmission to VAERS. An additional 5 high probability VAEs were sent automatically. Reported events included seizure, pleural effusion, and lymphocytopenia. ESP-VAERS increased the reporting rate to VAERS 9-fold compared to the 3 years before implementation.


    An open-source EHR-based clinical decision support system improves the detection and reporting of VAEs.

    Meghan Baker, MD, ScD1, David Kaelber, MD, PhD, MPH2,3, Megan Mazza, MPH1, David Bar-Shain, MD2,3, Bob Zambarano, PhD4, Pedro Moro, MD, MPH5, Richard Platt, MD MS1 and Michael Klompas, MD, MPH, FRCPC, FIDSA1, (1)Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, (2)MetroHealth System, Cleveland, OH, (3)Case Western Reserve University, Cleveland, OH, (4)Commonwealth Informatics, Inc., Gloucester, MA, (5)Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA


    M. Baker, None

    D. Kaelber, None

    M. Mazza, None

    D. Bar-Shain, None

    B. Zambarano, None

    P. Moro, None

    R. Platt, None

    M. Klompas, Premier Healthcare Alliance : Two presentations on ventilator-associated pneumonia surveillance , Speaker honorarium

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.