Evidence map›Paper›PMID 40238055›Full record

ArticleDrug safety2025

Signal Monitoring for Adverse Events Following Immunisation with COVID-19 Vaccines During the SARS-CoV-2 Pandemic: An Evaluation of the South African Surveillance System.

Chenoa Sankar, Stephen Evans, Johanna Catharina Meyer, Hannah May Gunter, Victoria Sekiti, Kerrigan McCarthy

Abstract read
In one paragraph

Article in Drug safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Chenoa SankarDivision of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa. ChenoaS@nicd.ac.za.ORCID http://orcid.org/0009-0007-7869-2026
Stephen EvansLondon School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-1474-2596
Johanna Catharina MeyerDepartment of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa.ORCID http://orcid.org/0000-0003-0462-5713
Hannah May GunterDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID http://orcid.org/0000-0003-3027-0602
Victoria SekitiSouth African Health Products Regulatory Authority, Pretoria, South Africa.
Kerrigan McCarthyDivision of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa.ORCID http://orcid.org/0000-0001-8958-9795

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMonitoring of adverse events following immunisation (AEFI) is recommended for post-licensure surveillance. We investigated whether the South African surveillance system could detect signals of disproportionate reporting and whether these signals aligned with globally identified AEFI and adverse events of special interest (AESI) post-coronavirus disease-2019 (COVID-19) vaccination.

methodsThis retrospective pharmacovigilance study undertook disproportionality analysis of the National Department of Health AEFI database from the start of the COVID-19 vaccine rollout on 17 May 2021 to 31 December 2022. We complemented this with AEFI reports for vaccines not on the routine Expanded Programme on Immunisation schedule, to address potential masking of signals due to the high reporting rate of COVID-19 vaccine AEFI.

resultsDuring the study period, 3846 AEFI were reported for 37,537,009 doses of COVID-19 vaccines (BNT162b2 and Ad26.COV2.S) administered. The overall reporting rate was 10.2 per 100,000 doses, 18.1/100,000 and 7.9/100,000 for Ad26.COV2.S and BNT162b2, respectively. Comparison with other countries suggests underreporting. Disproportionate reporting signals were obtained for three and seven AEFI following BNT162b2 and Ad26.COV2.S vaccines, respectively. An additional three AEFI signals from Ad26.COV2.S emerged in the augmented dataset, indicating masking. All Ad26.COV2.S signals, and one BNT162b2 signal, appear in the vaccines' product information. Among nine AESI evaluated, myocarditis/pericarditis presented as a signal of disproportionate reporting following BNT162b2 vaccination.

conclusionsThis study is one of the first from a lower-middle-income country, using a spontaneous reporting system for signal detection post-COVID-19 vaccination. Signals aligned with those reported globally. The study highlights the need to further investigate underreporting, masking, and system attributes for system strengthening.

Indexed as

Adverse Drug Reaction Reporting SystemsCOVID-19COVID-19 VaccinesAdolescentAdultBNT162 VaccineChildChild, PreschoolFemaleHumansInfantMaleMiddle AgedPharmacovigilanceRetrospective StudiesSouth AfricaBNT162 VaccineCOVID-19 Vaccines

Identifiers

PMID40238055
PMCPMC12259799

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.