Behind the scenes in public health: Adverse events following immunization (AEFI) signal investigation in British Columbia
Bibliographic record
Abstract
BACKGROUND: In British Columbia, vaccine safety is monitored through a passive surveillance system with voluntary reporting of adverse events following immunization (AEFIs) from immunizers to five regional health authorities and onward to the British Columbia Centre for Disease Control (BCCDC). OBJECTIVE: To review and summarize all documented AEFI cluster or signal investigations carried out by BCCDC between November 2007 and July 2014. METHOD: Documented cluster or signal investigations were reviewed to summarize year, alerting mechanism, event type and vaccine, investigative analysis approach, results, and public health actions. The findings and public health actions of two cluster investigations are described in detail. RESULTS: There were two fatality investigations and thirteen cluster investigations. The two fatalities were found to be due to sudden infant death syndrome and were not vaccine-related. Clusters were predominantly identified through notification from regional medical health officers or public health nurses, and the majority were local injection site reactions (54%), or allergic events (39%). Most investigations did not identify a specific association to a vaccine or a lot of vaccine, and no public health actions were taken. Two recent investigations-reports of hypotonic-hyporesponsive episodes with or without severe vomiting and diarrhea following receipt of a single lot of DPT-IPV/Hib/hepatitis B vaccine, and reports of severe pain past nearest joint following administration of a single lot of influenza vaccine-were thought to be vaccine-related. The former investigation did not find an association to vaccine, while the severe local reactions post-influenza immunization were determined to be a result of improper injection technique. Public health actions included communication to federal/provincial/territorial vaccine safety partners and additional injection technique training. CONCLUSION: This investigative aspect of public health immunization programs is often not in the public eye but is an important component of behind the scenes activities that serve to protect public safety.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".