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WHO/CDC standard tools for epidemiological analysis & surveillance

AEFI Causality Assessment

WHO Algorithm - Classify adverse events following immunization

Is there a valid diagnosis of an adverse event?

An adverse event is any untoward medical occurrence following immunization, which does not necessarily have a causal relationship with the vaccine.

WHO AEFI Classification Overview

A1: Vaccine Product-Related

Event caused by an inherent property of the vaccine. Known reaction consistent with product label/literature.

A2: Vaccine Quality Defect-Related

Event caused by a defect in the vaccine product (manufacturing, storage, handling).

A3: Immunization Error-Related

Event caused by inappropriate handling, prescribing, or administration of the vaccine.

A4: Immunization Anxiety-Related

Event arising from anxiety about immunization (vasovagal, hyperventilation).

B1: Temporal Relationship, Consistent

Temporal association is consistent but insufficient evidence to classify as A or C. Needs further investigation.

B2: Indeterminate

Insufficient information available to determine causality. Further information needed.

C: Coincidental

Event explained by another cause (underlying illness, medication, other exposure). Temporal but not causal.