Implementation of smartphone application for reporting adverse events following immunization by the treating doctors in tertiary care teaching hospitals in Chennai, India: Pilot and feasibility study.

Background: Under-reporting of severe and serious Adverse Events Following Immunization (AEFIs) from tertiary care teaching hospitals is a pressing issue in India. This pilot study aimed to evaluate the feasibility of a smartphone-based reporting intervention to enhance AEFI surveillance by treating doctors in four public teaching hospitals in Chennai, India.

Methods: From August 2023 to March 2024, a digital intervention was implemented across four medical college hospitals involving pediatrics, community medicine, and pharmacology departments. The intervention included: [1] designation of nodal officers, [2] awareness and skill-building workshops for faculties and PG scholars, [3] deployment of a smartphone-based AEFI case notification application, and [4] visual job aids. Mobile app usage, Case Notification Form submissions, and national AEFI surveillance platform documentation were analyzed for feasibility using Terezi et.al 2022 framework with predefined progression criteria.

Results: A total of 179 doctors registered as notifiers; 27 unique notifiers submitted 56 pediatric serious and severe AEFI case notifications from November 2024 - March 2025. Post-notification, 2 cross-notified to other states and 1 discarded, led to 53 cases (100 %) that were successfully documented in the national Surveillance and Action for Events following vaccination (SAFE-VAC) portal with the case ID, case reporting, and investigation forms. All reporters are from the Pediatrics department. Most notifiers were postgraduate scholars, 23/27 (85 %). 16/56 (26 %), and 36/56 (64.2 %) CNFs reported on the same day and within four days of case identification, respectively. Key challenges included confusion on case notification form fields and incorrect documentation of vaccination site details, which were addressed through refresher training and individualized support.

Conclusions: The smartphone-based notification system for serious and severe AEFI was feasible, acceptable, and can effectively complement the passive AEFI surveillance systems. Engaging teaching hospitals through digital tools and tailored support offers a scalable strategy to strengthen AEFI reporting in low-resource settings.