Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/131575
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Type: Journal article
Title: Efficacy of m-Health for the detection of adverse events following immunization – the stimulated telephone assisted rapid safety surveillance (STARSS) randomised control trial
Author: Gold, M.S.
Lincoln, G.
Cashman, P.
Braunack-Mayer, A.
Stocks, N.
Citation: Vaccine, 2020; 39(2):332-342
Publisher: Elsevier
Issue Date: 2020
ISSN: 0264-410X
1873-2518
Statement of
Responsibility: 
lM.S. Golda, G. Lincolnb, P. Cashmanc, A. Braunack-Mayerd, N. Stocks
Abstract: Introduction: Passive surveillance is recommended globally for the detection of adverse events following immunisation (AEFI) but this has significant challenges. Use of Mobile health for vaccine safety surveillance enables a consumer-centred approach to reporting. The Stimulated Telephone Assisted Rapid Safety Surveillance (STARSS) a randomised control trial (RCT) sought to evaluate the efficacy and acceptability of SMS for AEFI surveillance. Methods: Multi-centre RCT, participants were adult vaccinees or parents of children receiving any vaccine at a trial site. At enrolment randomisation occurred to one of two SMS groups or a control group. Prompts on days 2, 7 and 14 post-immunisation, were sent to the SMS group, to ascertain if a medical event following immunisation (MEFI) had occurred. No SMS’s were sent to the control participants. Those in the SMS who notified an MEFI were pre-randomised to complete a computer assisted telephone interview or a web based report to determine if an AEFI had occurred whilst an AEFI in the controls was determined by a search for passive reports. The primary outcome was the AEFI detection rate in the SMS group compared to controls. Results: We enrolled 6,338 participants, who were equally distributed across groups and who received 11,675 vaccines. The SMS group (4,225) received 12,675 surveillance prompts with 9.8% being non-compliant and not responding. In those that responded 90% indicated that no MEFI had been experienced and 184 had a verified AEFI. 6 control subjects had a reported AEFI. The AEFI detection rate was 13 fold greater in the SMS group when compared with controls (4.3 vs 0.3%). Conclusion: We have demonstrated that the STARSS methodology improves AEFI detection. Our findings should inform the wider use of SMS-based surveillance which is particularly relevant since establishing robust and novel pharmacovigilance systems is critical to monitoring novel vaccines which includes potential COVID vaccines.
Keywords: Adverse events following immunisation; vaccine safety surveillance, pharmacovigilance; m-Health
Rights: © 2020 Published by Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.vaccine.2020.11.056
Grant ID: http://purl.org/au-research/grants/nhmrc/1067703
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