VaxPulse: Active Global Vaccine Infodemic Risk Assessment.

Vaccine infodemics, driven by misinformation, disinformation, and inauthentic online behaviours, pose significant threats to global public health. This paper presents our response to this challenge, demonstrating how we developed VaxPulse Vaccine Infodemic Risk Assessment Lifecycle (VIRAL), an AI-powered social listening platform designed to monitor and assess vaccine-related infodemic risks. Leveraging interdisciplinary expertise and international collaborations, VaxPulse VIRAL integrates machine learning methods, including deep learning, active learning, and data augmentation, to provide real-time insights into public sentiments, misinformation trends, and social bot activity.

Enhancing Vaccine Safety Surveillance: Extracting Vaccine Mentions from Emergency Department Triage Notes Using Fine-Tuned Large Language Models.

This study evaluates fine-tuned Llama 3.2 models for extracting vaccine-related information from emergency department triage notes to support near real-time vaccine safety surveillance. Prompt engineering was used to initially create a labeled dataset, which was then confirmed by human annotators.

VaxPulse: Monitoring of Online Public Concerns to Enhance Post-Licensure Vaccine Surveillance.

The recent vaccine-related infodemic has amplified public concerns, highlighting the need for proactive misinformation management. We describe how we enhanced the reporting surveillance system of Victoria's vaccine safety service, SAEFVIC, through the incorporation of new information sources for public sentiment analysis, topics of discussion, and hesitancies about vaccinations online. Using VaxPulse, a multi-step framework, we integrate adverse events following immunisation (AEFI) with sentiment analysis, demonstrating the importance of contextualising public concerns.

Validating community concerns of menstrual changes associated with COVID-19 vaccination using a self-controlled case series analysis of real-world data.

Objectives: Stories of menstrual changes occurring post COVID-19 vaccination have abounded, with many affected persons expressing frustration their concerns were not being heard. In an era where misinformation is rampant and can fuel vaccine hesitancy it is imperative to address and validate community concerns. We aimed to investigate evidence of increased menstrual disturbances associated with COVID-19 vaccination.

Lessons learnt during establishment of COVID-19 active vaccine safety surveillance in nine African countries.

Background: Globally, several gaps in vaccine safety surveillance exist, particularly in low- and middle- income countries (LMICs). Establishing and maintaining vaccine surveillance platforms in resource-constrained settings poses significant challenges. These countries often rely on paper-based medical records and immunization cards, lack unique patient identifiers across the healthcare systems, have limited electronic data capture capabilities, and face a shortage of clinical reviewers for case assessments.

Systematic review and meta-analysis of respiratory viral triggers for acute myocardial infarction and stroke.

Respiratory viral infections may trigger acute cardiovascular events. However, relative pathogen-specific associations are poorly understood, limiting optimal preventive recommendations. The aim of this study was to systematically review the association between respiratory viruses with two primary outcomes, acute myocardial infarction (AMI) and stroke.

Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.

Background: The association between Guillain-Barré syndrome (GBS) and certain COVID-19 vaccines is inconclusive. We investigated the risk of GBS after COVID-19 vaccination or SARS-CoV-2 infection.

Methods: Using a common protocol, we conducted a self-controlled case series study from 1 December 2020 to 9 August 2023 at 20 global sites within the Global Vaccine Data Network™ (GVDN®).

Hepatitis B vaccination of preterm infants and risk of bronchopulmonary dysplasia: a cohort study, Australia.

Objective: To determine whether hepatitis B virus (HBV) vaccination of extremely preterm infants (defined in our study as < 29 weeks gestation) within 24 hours of birth (birth-dose) increases the risk of developing bronchopulmonary dysplasia.

Methods: Using data from Australia, we conducted a population data linkage study using the Victorian Vaccine Safety Health Link. This platform links state-wide immunization and health outcomes from the Victorian Perinatal Data Collection and the Victorian Admitted Episodes Dataset.

Nuvaxovid NVX-CoV2373 vaccine safety profile: real-world data evidence after 100,000 doses, Australia, 2022 to 2023.

IntroductionNuvaxovid became available in Australia from February 2022, a year after the first COVID-19 vaccines. This protein-based vaccine was an alternative for people who had had an adverse event to and/or were hesitant to receive an mRNA or adenovirus-based COVID-19 vaccine. Although safety from clinical trials was reassuring, small trial populations, low administration rates and limited post-licensure intelligence meant potential rare adverse events were underinformed.

Clinical phenotype of COVID-19 vaccine-associated myocarditis in Victoria, 2021-22: a cross-sectional study.

Objectives: To describe myocarditis as an adverse event after coronavirus disease 2019 (COVID-19) vaccination, including a detailed description of clinical phenotypes and diagnostic test results and differences by age, sex, and degree of troponin level elevation.

Study Design: Retrospective cross-sectional study.

Setting, Participants: Cases of suspected myocarditis following the administration of a COVID-19 vaccine in Victoria during 22 February 2021 - 30 September 2022 reported to Surveillance of Adverse Events Following Vaccination In the Community (SAEFVIC), with symptom onset within 14 days of vaccination, and deemed to be confirmed myocarditis according to the Brighton Collaboration Criteria.

Detailed review of mortality reported following COVID-19 vaccination in Victoria, Australia: 2021-2023.

Introduction: The scale of the COVID-19 vaccine program, and appropriate focus on older individuals, emphasised monitoring of mortality as an important part of COVID-19 vaccine safety surveillance, noting many deaths temporally associated with vaccination may not be causally related. This cross-sectional study describes Victoria's vaccine safety service (SAEFVIC) process of reviewing mortality reports following COVID-19 vaccination, summarises report characteristics and identifies trends in mortality reporting.

Methods: Mortality cases reported to SAEFVIC following COVID-19 vaccination from 22 February 2021 to 22 February 2023 were included.

Establishing the Vaccine Safety Health Link: A large, linked data resource for the investigation of vaccine safety concerns.

Objective: Post-licensure vaccine safety surveillance of adverse events following immunisation is critical to ensure public safety and confidence in vaccines. This paper aims to describe the governance structure and data linkage methodology behind the establishment of the largest linked vaccine safety surveillance data resource in Australia - The Vaccine Safety Health Link (VSHL).

Methods: The Vaccine Safety Health Link contains linked records from the Australian Immunisation Register with records from hospital, perinatal, mortality, and notifiable disease datasets in near real-time.

Pandemic Incident Management for Vaccine Safety Challenges: Victoria's Alert Advisory Group Experience.

Safe vaccines are critical for biosecurity protection, yet adverse events-rightly or wrongly attributed to immunization-potentially cause rapid loss of confidence, reduced vaccine uptake, and resurgence of preventable disease. Effective vaccine safety incident management is essential to provide assessment and lead appropriate actions to ensure vaccination programs are safe and mitigate unwarranted crisis escalation that could damage vaccine programs and the effective control of vaccine preventable disease outbreaks or pandemics. Incident management systems (IMS) are used globally to direct emergency management response, particularly for natural disasters of fire, flood, and storm.

Near Real-Time Syndromic Surveillance of Emergency Department Triage Texts Using Natural Language Processing: Case Study in Febrile Convulsion Detection.

Background: Collecting information on adverse events following immunization from as many sources as possible is critical for promptly identifying potential safety concerns and taking appropriate actions. Febrile convulsions are recognized as an important potential reaction to vaccination in children aged <6 years.

Objective: The primary aim of this study was to evaluate the performance of natural language processing techniques and machine learning (ML) models for the rapid detection of febrile convulsion presentations in emergency departments (EDs), especially with respect to the minimum training data requirements to obtain optimum model performance.

Kawasaki Disease and Respiratory Viruses: Ecological Spatiotemporal Analysis.

Background: Kawasaki disease is an uncommon vasculitis affecting young children. Its etiology is not completely understood, although infections have been frequently postulated as the triggers. Respiratory viruses, specifically, have often been implicated as causative agents for Kawasaki disease presentations.

Laboratory-confirmed respiratory viral infection triggers for acute myocardial infarction and stroke: Systematic review protocol.

Background: Cardiovascular disease contributes substantially to global mortality and morbidity. Respiratory tract infections, particularly influenza, may trigger an increase in the short-term risk of acute myocardial infarction (AMI) and stroke. Recent studies have also linked this risk to other respiratory viruses, including respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Audiovestibular adverse events following COVID-19 vaccinations.

Introduction: Evidence regarding audiovestibular adverse events post COVID-19 vaccination to date has been inconclusive regarding a potential association. This study aimed to determine if there was an increase in audiovestibular events following COVID-19 vaccination in South-eastern Australia during January 2021-March 2023.

Methods: A multi-data source approach was applied.

The clinicopathological features of thrombosis with thrombocytopenia syndrome following ChAdOx1-S (AZD1222) vaccination and case outcomes in Australia: a population-based study.

Background: Thrombosis with thrombocytopenia syndrome (TTS) associated with viral vector COVID-19 vaccines, including ChAdOx1-S (AstraZeneca AZD1222) vaccine, can result in significant morbidity and mortality. We report the clinicopathological features of TTS following ChAdOx1-S vaccination and summarise the case outcomes in Australia.

Methods: In this cohort study, patients diagnosed with TTS in Australia between 23 March and 31 December 2021 were identified according to predefined criteria.

Snotwatch COVID-toes: An ecological study of chilblains and COVID-19 diagnoses in Victoria, Australia.

The COVID-19 pandemic has caused widespread illness with varying clinical manifestations. One less-commonly-reported presentation of COVID-19 infection is chilblain-like lesions. We conducted an ecological analysis of chilblain presentations in comparison with confirmed and suspected COVID-19 infections in a primary care setting to establish that a relationship exists between the two.

Shoulder injury following COVID-19 vaccine administration: a case series and proposed diagnostic algorithm.

Background: Shoulder Injury Related to Vaccine Administration (SIRVA) is a preventable adverse event following incorrect vaccine administration, which can result in significant long-term morbidity. There has been a notable surge in reported cases of SIRVA as a rapid national population-based COVID-19 immunization program has been rolled out across Australia.

Methods: Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC) in Victoria identified 221 suspected cases of SIRVA following the commencement of the COVID-19 vaccination program, reported between February 2021 and February 2022.