title: Using automated text messages to monitor adverse events following immunisation in general practice.
abstract: OBJECTIVE
  To assess the performance of SmartVax, a prototypic active monitoring system for adverse events following immunisation (AEFI) using short message service (SMS) text messages and clinical data extracted from commercially available medical practice management software.
  
  
  METHODS
  Between 11 November 2011 and 10 June 2013, adult patients and parents of paediatric patients receiving routine vaccinations in general practice were sent an SMS by SmartVax enquiring if they had experienced any AEFI and requesting a reply by SMS. Attempts were made to telephone patients who did not reply by SMS.
  
  
  METHODS
  The proportion of patients sent an SMS who replied by SMS, and the proportion of respondents indicating possible AEFI.
  
  
  RESULTS
  Of 3281 vaccinated patients, 3226 (98.3%) had a mobile telephone number on record and were sent an SMS. Of 2342 patients (72.6%; 95% CI, 70.0%-75.1%) who responded by SMS, 264 (11.3%; 95 CI, 9.9%-12.7%) reported possible AEFI. The response rate was ≥ 70% for both paediatric and adult patients. Eighty-per cent of SMS replies were received within 2 hours of transmission of the query SMS. There was no significant difference in the proportion reporting possible AEFI between patients who replied by SMS and those who did not respond by SMS but were subsequently contacted by a telephone call (P = 0.99).
  
  
  CONCLUSIONS
  More than 70% of patients responded by SMS to an SMS query about whether they had any vaccine reactions, with the data received in near real-time. Active surveillance of AEFI using SMS has the capacity to complement existing passive reporting systems, potentially permitting more rapid identification of emerging safety signals.
authors.affiliation: Illawarra Medical Centre, Perth, WA, Australia. paul.effler@health.wa.gov.au.
authors.forename: Alan
authors.initials: A
authors.lastname: Leeb
authors.affiliation: School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia.
authors.forename: Annette K
authors.initials: AK
authors.lastname: Regan
authors.affiliation: Datavation, Perth, WA, Australia.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Peters
authors.affiliation: Illawarra Medical Centre, Perth, WA, Australia.
authors.forename: Candice
authors.initials: C
authors.lastname: Leeb
authors.affiliation: Bond University, Brisbane, QLD, Australia.
authors.forename: Gregory
authors.initials: G
authors.lastname: Leeb
authors.affiliation: Communicable Disease Control Directorate, Department of Health, Western Australia, Perth, WA, Australia.
authors.forename: Paul V
authors.initials: PV
authors.lastname: Effler
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D005260:Female; D058006:General Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D032541:Mass Vaccination / Q000009:adverse effects / Q000706:statistics & numerical data*; D011159:Population Surveillance; D017216:Telemedicine / Q000379:methods; D060145:Text Messaging / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines