H1N1: After the Vaccine
Everyone's sick of swine flu (pun not intended, I swear), so apologies in advance for striking up yet another conversation about it, but I couldn't help posting when I heard about post-vaccine monitoring.
What? What's that you say? Monitoring? As in data, systems and overall management of what one might call "health information?" Surely this must pique your interest beyond the daily onslaught of who got H1N1, where they live and if you should invest in a surgical mask.
Here's the run down: With the H1N1 vaccine about to be distributed en masse, the Department of Health and Human Services (HHS) wants to know about side effects, pronto. Problem is, when you have a large amount of people being vaccinated in a short amount of time, any subsequent health problem is going to be flagged as a side effect. Can't say I blame them-I have a friend who's a nurse and got the vaccine. Her headache later that day? Vaccine-induced, we surmised.
To separate true potential side effects from those that are, well, a bit of an overreaction, the government is sponsoring several tracking initiatives. Johns Hopkins, for example, plans to send e-mails inquiring vaccine recipients about their post-dose health (do I hear "follow-up?"). The Centers for Disease Control is also encouraging patients to notify the government of any problems via the Vaccine Adverse Event Reporting System.
But perhaps my favorite is an initiative at Harvard Medical School, where researchers are using vaccine registries and insurance databases to identify vaccine patients who headed back to the doctor and the reason for the visit. And here's the kicker-it's in real time. (Yes! All those codes you assigned and electronic submissions you made are finally getting some recognition.)
As the Associated Press notes, those reported numbers are going to need some sort of baseline. How many cases of nausea is normal in a given week, for example? Or worse, heart attacks? The CDC, therefore, is collecting data and crunching numbers ever-so-quickly so they can target side effects that actually pose a risk and avoid adding to the panic that already surrounds H1N1.
It's another case for quality health information-but you knew that already. Coding errors that trickle through to claims databases could affect the reliability of any links between vaccine and side effect. At the same time, a thorough registry could help researchers contact side effect sufferers sooner, so those contemplating vaccination could know the full risks.
Are you involved in H1N1 response at your facility? Do you traditionally report vaccine side effects, and are you gearing up for H1N1-specific reports? Do you foresee any problems with using databases to flag potential side effects?