Surveillance Activities Research Articles

A participatory approach to move towards a One Health surveillance system for anthrax in Burkina Faso.

The One Health approach calls for collaboration across various sectors and different scales to improve understanding of complex health issues. Regarding epidemiological surveillance, this implies the development of integrated systems that link several surveillance components operating in different domains (human, domestic animals, environment) and involving several actor networks. However, surveillance continues to operate in a very compartmentalized way, with little interaction between sectoral institutions and with the community for the governance and operation of surveillance activities. This is partly explained by the insufficient consideration of the local context and the late involvement of national stakeholders when developing programmes that aimed at strengthening the integration of surveillance. In low- and middle-income countries in particular, there is a strong influence of external partners on the development of intersectoral programmes, including surveillance systems. In this context, we developed and implemented a participatory planning process to support stakeholders of the surveillance system of anthrax in Burkina Faso, in the definition of the One Health surveillance system they wish for and of the pathway to reach it. The workshop produced an action plan that reflects the views and perspectives of representatives of the different categories of stakeholders and beneficiaries of surveillance. In addition, the participation of stakeholders in this participatory co-construction process has also improved their knowledge and mutual understanding, fostering a climate of trust conducive to further collaboration for surveillance activities. However, the quality of the participation raises some questions over the results, and contextual factors may have influenced the process. This underlines the need to include a monitoring and evaluation plan in the process to assess its implementation and ability to produce One Health surveillance modalities that are appropriate, accepted and applied over the long term.

Utility of MALDI-TOF MS for determination of species identity and blood meal sources of primary malaria vectors on the Kenyan coast.

Protein analysis using matrix-assisted laser desorption/ionisation time-of-flight mass-spectrometry (MALDI-TOF MS) represents a promising tool for entomological surveillance. In this study we tested the discriminative power of this tool for measuring species and blood meal source of main Afrotropical malaria vectors on the Kenyan coast. Mosquito collections were conducted along the coastal region of Kenya. MALDI-TOF MS spectra were obtained from each individual mosquito's cephalothorax as well as the abdomens of blood-engorged mosquitoes. The same mosquitoes were also processed using gold standard tests: polymerase chain reaction (PCR) for species identification and enzyme linked immunosorbent assay (ELISA) for blood meal source identification. Of the 2,332 mosquitoes subjected to MALDI-TOF MS, 85% (1,971/2,332) were considered for database creation and validation. There was an overall accuracy of 97.5% in the identification of members of the An. gambiae ( An. gambiae, 100%; An. arabiensis, 91.9%; An. merus, 97.5%; and An. quadriannulatus, 90.2%) and An. funestus ( An. funestus, 94.2%; An. rivulorum, 99.4%; and An. leesoni, 94.1%) complexes. Furthermore, MALDI-TOF MS also provided accurate (94.5% accuracy) identification of blood host sources across all mosquito species. This study provides further evidence of the discriminative power of MALDI-TOF MS to identify sibling species and blood meal source of Afrotropical malaria vectors, further supporting its utility in entomological surveillance. The low cost per sample (<0.2USD) and high throughput nature of the method represents a cost-effective alternative to molecular methods and could enable programs to increase the number of samples analysed and therefore improve the data generated from surveillance activities.

Regional aspects in assessment of performance and effectiveness of the risk-based model for control and surveillance activities in provision of sanitary-epidemiological wellbeing of the population

This research is relevant since it is important to assess performance and effectiveness of activities performed by Rospotrebnadzor bodies and organizations in RF regions. The aim of this study was to assess performance and effectiveness of control and surveillance activities performed by a territorial office of Rospotrebnadzor given the current reduction in scheduled inspections. Control and surveillance activities performed by the Rospotrebnadzor Rostov Regional Office in 2023 were selected as the research object. They were aimed at improving the quality of the environment for the region population and indirectly at reducing population incidence and mortality associated with exposures to harmful risk factors represented by ambient air, water, and soil pollution etc. The study was accomplished relying on methodical instruments developed by the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies and approved by the RF Chief Sanitary Inspector. The basic methodology establishes rules for calculating economic losses associated with population mortality and incidence (children, working age population and population older than working age) caused by environmental exposures. Calculations were based on the results of instrumental measurements of the environment quality in cities in the Rostov region and the results of scheduled and off-schedule control activities performed by the Rospotrebnadzor Rostov Regional Office in 2023. It was established that control and surveillance activities performed by the Service managed to prevent approximately 1760 deaths and more than 152.4 thousand diseases, which could actually occur should the Service fail to perform its regulatory actions. The total prevented economic losses equaled approximately 2.1 billion rubles in 2023. Economic effectiveness was established relying on prevented losses of the gross regional product and equaled 7.25 rubles per 1 spent ruble in 2023 prices. There are several promising trends in the scientific and methodical support provided by practical activities performed by Rospotrebnadzor. They include development and implementation of methodical approaches to assessing effectiveness of prevention activities; searching for new approaches to assessing performance and effectiveness of other activities accomplished by the Service (licensing, registration of new and hazardous chemicals and products, etc.).

Surveillance 5.0: Next-Gen Security Powered by Quantum AI Optimization

Surveillance 5.0, powered by Quantum AI Optimization, represents the highpoint of next-generation security, transforming traditional surveillance paradigms through the fusion of quantum-powered technologies and advanced artificial intelligence. Quantum AI Optimization stands as the essential, revolutionizing security operations for enabling real-time threat detection, proactive response approaches, and adaptive risk mitigation measures. Moreover, privacy preservation and ethical governance plays a major role in ensuring that surveillance activities maintain higher security and privacy rights. From real-time threat monitoring to emergency response coordination, Surveillance 5.0 empowers organizations across diverse sectors to safeguard assets, protect individuals, and enhance societal resilience. Lastly, prospective technologies and applications underscore the limitless potential of surveillance 5.0, with emerging technologies such as Internet of Things (IoT), artificial intelligence (AI), Blockchain, and edge computing driving continuous innovation and expanding the frontiers of security capabilities. In summary, Surveillance 5.0 represents a quantum leap forward in security, harnessing the interactions of Quantum AI Optimization to leverage protection, privacy, and ethical governance in an increasingly complex and interconnected world.

Reporting guidance for the One Health surveillance data collection

Abstract This technical report aims at guiding the data reporting to EFSA of analytical test results and the related metadata generated in the context of the One Health surveillance activities carried out by Member States under their direct grant agreements. The objective is to explain in detail the individual data elements that are included in the EFSA Standard Sample Description version 2 (SSD2) data model. The guidance is intended to support the reporting countries in data transmission using eXtensible Markup Language (XML) data file transfer through the Data Collection Framework (DCF) according to the protocol described in the EFSA Guidance on Data Exchange version 2 (GDE2). The data elements are explained, including information about data type, list of allowed terms and associated business rules. Instructions about how to report common sampling schemes are also provided to ensure harmonised reporting among countries.

Региональные аспекты оценки результативности и эффективности риск-ориентированной модели контрольно-надзорной деятельности в сфере обеспечения санитарно-эпидемиологического благополучия населения

This research is relevant since it is important to assess performance and effectiveness of activities performed by Rospotrebnadzor bodies and organizations in RF regions. The aim of this study was to assess performance and effectiveness of control and surveillance activities performed by a territorial office of Rospotrebnadzor given the current reduction in scheduled inspections. Control and surveillance activities performed by the Rospotrebnadzor Rostov Regional Office in 2023 were selected as the research object. They were aimed at improving the quality of the environment for the region population and indirectly at reducing population incidence and mortality associated with exposures to harmful risk factors represented by ambient air, water, and soil pollution etc. The study was accomplished relying on methodical instruments developed by the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies and approved by the RF Chief Sanitary Inspector. The basic methodology establishes rules for calculating economic losses associated with population mortality and incidence (children, working age population and population older than working age) caused by environmental exposures. Calculations were based on the results of instrumental measurements of the environment quality in cities in the Rostov region and the results of scheduled and off-schedule control activities performed by the Rospotrebnadzor Rostov Regional Office in 2023. It was established that control and surveillance activities performed by the Service managed to prevent approximately 1760 deaths and more than 152.4 thousand diseases, which could actually occur should the Service fail to perform its regulatory actions. The total prevented economic losses equaled approximately 2.1 billion rubles in 2023. Economic effectiveness was established relying on prevented losses of the gross regional product and equaled 7.25 rubles per 1 spent ruble in 2023 prices. There are several promising trends in the scientific and methodical support provided by practical activities performed by Rospotrebnadzor. They include development and implementation of methodical approaches to assessing effectiveness of prevention activities; searching for new approaches to assessing performance and effectiveness of other activities accomplished by the Service (licensing, registration of new and hazardous chemicals and products, etc.).

Predicting Community Participation in Passive Pest Surveillance

Predicting the willingness of people to engage in passive surveillance is crucial to the success of community-based efforts to manage invasive species and conserve native biodiversity. We draw on the marketing concept of involvement, which reflects the personal importance of an issue or behaviour, to understand and measure the motivation of members of the public to engage in passive surveillance. The usefulness of this concept was tested by analysing the responses of householders to surveys about their willingness to engage in passive surveillance for a purely environmental pest, Red-eared Slider Turtles (Trachemys scripta elegans), and their willingness to engage in passive surveillance for an economic and environmental pest, Argentine Ants (Linepithema humile), in New Zealand. We found that involvement influenced intentions, attitudes and surveillance behaviour for both invasive pests. We discussed the implications of these findings for (i) choosing between a surveillance strategy based on recruiting and training highly motivated members of the public and a strategy based on passive surveillance by any member of the public; (ii) growing the potential for passive surveillance by either increasing involvement with preventing the spread of a pest or increasing involvement with surveillance activities themselves; and (iii) determining the importance of convenient reporting mechanisms in promoting consistent reporting.

A 3D-Based Modeling and Analysis of an Artificial Palm Tree for Video Surveillance Activities

A study on the 3-D modeling and analysis of an artificial palm tree structure capable of housing a camera was made. The proposed system's design, simulation, and virtual testing were done using SolidWorks software. This work's primary objective was an aesthetically pleasing and functional solution that integrates with the urban landscape while providing an enhanced concealed security system. The natural form of a palm tree was incorporated into the artificial palm tree structure. The hidden camera ensures optimal coverage without compromising the overall appearance and presence of the device. This is so because, in the Nigerian situation, Miscreants will pull down the structure if they know of its presence. A detailed analysis of the system's structural integrity and stability was achieved using a 3D model of the artificial palm tree structure. Factors such as wind load, weight distribution, and material strength are considered to ensure the design can cope with environmental conditions. Virtual simulations allow for the maximization of the structure, ensuring it complies with safety standards, and the results of VonMise's stress show that the materialsselected for the design are suitable for the work.

A Perspective of the Epidemiology of Rabies in South Africa, 1998-2019.

Despite the implementation of various control strategies aimed at eliminating canine-mediated rabies, the disease is still endemic in up to 150 countries across the world. Rabies remains endemic to South Africa, with various reservoir species (both wildlife species and domestic dogs) capable of maintaining rabies infection, and the epidemiology of the disease is yet to be adequately defined. As such, this study used surveillance data collected between 1998 and 2019 from the two diagnostic laboratories in the country for a statistical space-time analysis to determine regions where significant disease clusters could occur. In addition, the robustness of surveillance activities across the country was evaluated through the mathematical evaluation and visualization of testing rates based on the average number of samples tested per species group. In our study, various significant disease clusters were detected for domestic animals, wildlife and livestock. The significant disease clusters for domestic animals and livestock were primarily restricted to eastern South Africa, while the significant disease clusters in wildlife species were detected across northern and western South Africa. Furthermore, the testing rates identified districts from various provinces where surveillance activities could be considered inadequate, consequently influencing the geographical range of the observed clusters. These results could be used to direct intervention campaigns towards high-risk areas, while also allocating the required resources to improve surveillance in the surrounding areas where surveillance was deemed inadequate.

Progress Toward Poliomyelitis Eradication - Worldwide, January 2022-December 2023.

In 1988, poliomyelitis (polio) was targeted for eradication. Global efforts have led to the eradication of two of the three wild poliovirus (WPV) serotypes (types 2 and 3), with only WPV type 1 (WPV1) remaining endemic, and only in Afghanistan and Pakistan. This report describes global polio immunization, surveillance activities, and poliovirus epidemiology during January 2022-December 2023, using data current as of April 10, 2024. In 2023, Afghanistan and Pakistan identified 12 total WPV1 polio cases, compared with 22 in 2022. WPV1 transmission was detected through systematic testing for poliovirus in sewage samples (environmental surveillance) in 13 provinces in Afghanistan and Pakistan, compared with seven provinces in 2022. The number of polio cases caused by circulating vaccine-derived polioviruses (cVDPVs; circulating vaccine virus strains that have reverted to neurovirulence) decreased from 881 in 2022 to 524 in 2023; cVDPV outbreaks (defined as either a cVDPV case with evidence of circulation or at least two positive environmental surveillance isolates) occurred in 32 countries in 2023, including eight that did not experience a cVDPV outbreak in 2022. Despite reductions in paralytic polio cases from 2022, cVDPV cases and WPV1 cases (in countries with endemic transmission) were more geographically widespread in 2023. Renewed efforts to vaccinate persistently missed children in countries and territories where WPV1 transmission is endemic, strengthen routine immunization programs in countries at high risk for poliovirus transmission, and provide more effective cVDPV outbreak responses are necessary to further progress toward global polio eradication.

Characteristics of logs with signs of oviposition by the polyphagous xylophage Asian longhorned beetle (Coleoptera: Cerambycidae).

During the eradication program undertaken against Anoplophora glabripennis (Motschulsky) in the Greater Toronto Area, information was collected on the numerous signs of injury found on wounded trees. Herein, we used a portion of this information to assess the characteristics of logs with signs of oviposition (i.e., pits). Specifically, we related the basal diameter, type (log bole vs. log branch), height above ground, and branch hierarchy level of logs with pits to tree size (i.e., height and diameter at breast height) and level of infestation intensity. In general, pits were concentrated on logs from the bole and branches that were 8-14cm in diameter in the lower 8 m of the bole and in the first 2 levels of the branching hierarchy. Oviposition pit location was strongly influenced by tree size-both height and diameter at breast height, with more pits on the lower bole in small trees and then higher on the bole and into the branches as tree size increased. As tree-level infestation intensity increased, pits were found on both larger and smaller diameter portions of the trees, presumably as preferred oviposition sites became saturated. These findings can improve the efficacy of surveillance activities for A. glabripennis.

Towards Understanding the Microepidemiology of Lymphatic Filariasis at the Community Level in Ghana.

Studies on the distribution of lymphatic filariasis (LF) have mostly focused on reporting prevalence at the community level and distribution at the district levels. Understanding the distribution patterns at community levels may help in designing surveillance strategies. This study aimed to characterize the spatial distribution of LF infections in four hotspot communities in Ghana. The research, involving 252 participants, collected demographic data, mass drug administration (MDA) information, household GPS coordinates, and antigen detection test results. The LF prevalence varied significantly among the communities, with Asemda having the highest (33.33%) and Mempeasem having the lowest (4.44%). Females had lower odds of infection than males (OR = 2.67, p = 0.003 CI: 1.39-5.13). Spatial analysis using kernel density, Anselin Local Moran's, Getis-Ord Gi models, Ordinary Least Squares, and Geographic Weighted Regression revealed mixed patterns of spatial autocorrelation. This study identified LF hotspots, indicating clusters of high or low prevalence with some areas showing disparities between MDA coverage and LF positivity rates. Despite these hotspots, the overall distribution of LF appeared random, suggesting the importance of purposeful sampling in surveillance activities. These findings contribute valuable insights into the micro-epidemiology of LF, emphasizing the need for community-specific investigations to understand the factors influencing the effectiveness of MDA programs in controlling filarial infections. The study highlights the importance of refining surveillance strategies based on community-level distribution patterns.

Prevention of Vascular Access Device-Associated Hospital Onset Bacteremia and Fungemia: A Review of Emerging Perspectives and Synthesis of Technical Aspects.

Significant events impacting healthcare over the last several years have been associated with escalating rates of healthcare-associated infections. This has resulted in increased efforts to reinstitute well-established and evidence-based infection prevention practices, particularly for central line associated bloodstream infections. However, implementation of prevention initiatives beyond central lines has not received the same level of acknowledgement and response as being a considerable risk to patients. This article, authored by infection prevention, infectious disease, and vascular access professionals, provides emerging perspectives and technical aspects associated with the complete lifecycle of a vascular access device. The intent is to provide insight and perspective into enhancing current IP practices in the acute care hospital setting. This will also help prepare hospitals for upcoming broader surveillance and intervention activities aimed at reducing Hospital Onset Bacteremia and Fungemia (HOB) associated with all types of vascular access devices.

Germany's national public health gets reorganized: A new institute shall take center stage

In the aftermath of the COVID-19 pandemic, the German federal government recently orchestrated a fundamental change to its public health infrastructure. This reconstruction centers around the founding of a National Institute for Prevention and Education in Medicine (Bundesinstitut für Prävention und Aufklärung in der Medizin, BIPAM) at the cost of two federal institutions, the Robert Koch-Institute (RKI) and the Federal Center for Health Education (Bundeszentrale für gesundheitliche Aufklärung, BzGA). Thus, the Federal Ministry of Health (Bundesministerium für Gesundheit, BMG) plans to dissolve the BzGA and integrate its personnel into the future BIPAM. Further, all RKI research and surveillance activities related to non-communicable diseases, including AI methods development will be transferred into the BIPAM. The RKI responsibilities will solely focus on infectious diseases. According to announced plans of the BMG the primary objective for establishing the BIPAM is to address non-communicable diseases and enhance overall population health. However, the medical specialist training for public health remains non-academic at a state institution. Simultaneously the BMG already replaced two thirds of experts of the permanent commission on vaccination (Ständige Impfkommission, STIKO) and determined new procedures for appointing future expert commissioners. With these changes, Germany embarks on an extraordinary reshuffling of its national public health organizations and responsibilities, by fundamentally separating all issues around non-communicable diseases from those of infectious diseases. Germany's unraveled research tasks of public health authorities however remains unmet. Thus, 2024 marks a pivotal caesura for public health in the modern history of Germany.

PENGEMBANGAN SISTEM INFORMASI SURVEILANS INFEKSI TERKAIT PELAYANAN KESEHATAN DENGAN METODE WATERFALL

Healthcare-associated infections (HAIs) are infections that occur when patients receive healthcare in a hospital or another healthcare facility. These infections can jeopardize patient safety, induce illness, and potentially lead to fatal outcomes. Prevention of HAIs involves the implementation of robust healthcare-associated infection surveillance practices and infection prevention and control measures. Surveillance activities, encompassing manual recording, daily monitoring, and manual reporting, may consume nursing time and pose a potential risk of inaccuracies. Therefore, we have undertaken the design of a healthcare-associated infection surveillance information system using the waterfall methodology. The information system has been developed using PHP language and a MySQL database. The deployment of this system aims to streamline and enhance the precision of record-keeping. The analytical insights derived from its reports can be harnessed to mitigate the incidence of healthcare-associated infections.

Comparatively analyzed pattern of Delta and Omicron SARS-CoV-2 genovariant dominated COVID-19 incidence in the population of the Saratov region

Despite the stable decline in SARS-CoV-2 virus-caused COVID-19 incidence in most countries worldwide by the end of 2023, spreading of this infection on a global scale remains relevant. Among all known SARS-CoV-2 genovariants, within the last about two years Omicron remains dominant. The distinctive properties of this genovariant are presented by short incubation period (1–5 days), high contagiousness, and a relatively mild disease course due to largest number of genomic mutations among all SARS-CoV-2 genovariants. The first case of Omicron genovariant-caused infection in Russia was recorded in early December 2021. Over many month-monitoring after active spread of the genovariant in Russia, it is obvious that in a number of key characteristics it differs profoundly from previous SARS-CoV-2 genovariants. Analyzing major patterns inherent in COVID-19 epidemic process particularly uncovering geographic features is one of the most crucial activities in COVID-19 surveillance. Here, we provide a comparatively analyzed pattern of Delta and Omicron SARS-CoV-2 genovariant dominated COVID-19 incidence in the population of the Saratov region. For this, there was used statistical reporting from the Office of Rospotrebnadzor for the Saratov Region. The main research method is based on epidemiological analysis. The study data showed that upon Omicron genovariant dominance, an increased percentage in COVID-19 cases among children of varying age, increased rate of infected subjects with unknown source of infection as well as improved clinical disease course were recorded. Regardless of the circulating genovariant, elderly people remain to be in risk group. Thus, after three years of the COVID-19 pandemic, the mutual adaptation for SARS-CoV-2 and human population can be observed, which is accompanied by altered biological properties of the former and the accumulation of herd immunity. Alleviated disease symptoms and decreased mortality rate among Omicron genovariant-infected individuals evidence in favor of further COVID-19 transformation into a seasonal infection.

IoT Based Surveillance Robot

The main objective is to develop a surveillance robot to perform surveillance activities in industrial areas, militarized war zones or radioactive field areas with the objective of analyzing, governing and protecting the areas from unwanted threats. The use of robots and their role in our day to day life has been rapidly increasing since the day they were introduced to the world, further reducing the errors and life risk to humans. The objective is to design and develop an Internet of Things (IoT) based surveillance robot at a low cost that will roam around freely and give live updates about their surroundings by broadcasting video and information through the sensors installed. The sensors collect the data from the surroundings and send it to the Arduino microcontroller which can be seen by the user any time. This technology is controlled by the user remotely through any device such as mobile phone, tablet or laptop with the help of IoT based services. The entire project is built and monitored by wireless platform to minimalize the use of wire and help it work smoothly in remote places

IMMUNOREACT 7: Regular aspirin use is associated with immune surveillance activation in colorectal cancer.

Long-term daily use of aspirin reduces incidence and mortality due to colorectal cancer (CRC). This study aimed to analyze the effect of aspirin on the tumor microenvironment, systemic immunity, and on the healthy mucosa surrounding cancer. Patients with a diagnosis of CRC operated on from 2015 to 2019 were retrospectively analyzed (METACCRE cohort). Expression of mRNA of immune surveillance-related genes (PD-L1, CD80, CD86, HLA I, and HLA II) in CRC primary cells treated with aspirin were extracted from Gene Expression Omnibus-deposited public database (GSE76583). The experiment was replicated in cell lines. The mucosal immune microenvironment of a subgroup of patients participating in the IMMUNOREACT1 (ClinicalTrials.gov NCT04915326) project was analyzed with immunohistochemistry and flow cytometry. In the METACCRE Cohort, 12% of 238 patients analyzed were aspirin users. Nodal metastasis was significantly less frequent (p=.008) and tumor-infiltrating lymphocyte infiltration was higher (p=.02) among aspirin users. In the CRC primary cells and selected cell lines, CD80 mRNA expression was increased following aspirin treatment (p=.001). In the healthy mucosa surrounding rectal cancer, the ratio of CD8/CD3 and epithelial cells expressing CD80 was higher in aspirin users (p=.027 and p=.034, respectively). These data suggested that regular aspirin use may have an active role in enhancing immunosurveillance against CRC.

Counterintelligence and escalation from hybrid to total war in the Russo-Ukrainian conflict 2014–2024

ABSTRACT This article examines certain counterintelligence (CI) aspects of the on-going conflict between Russia and Ukraine since 2014 in terms of key problems in current western CI concepts, doctrine and processes. It examines not only the CI threat to Ukraine during the Donbas ‘frozen war’ and 2022 invasion from the traditional CI triad of espionage, sabotage and subversion but also from Russian intelligence, surveillance and reconnaissance (ISR) capabilities and activities supporting both irregular and regular combatants. The article concludes that a UK and allied approach to CI shaped by a two-decade security focus on counterterrorism and counterinsurgency may not be fit for purpose in a contemporary strategic environment characterized by a persistent and escalating threat from strategic peers engaged in state-supported hybrid conflict.

Landscape review of active vaccine safety surveillance activities for COVID-19 vaccines globally

BackgroundEvidence of COVID-19 vaccine safety relied upon the global vaccine monitoring infrastructure due to shortened clinical development timelines and emergency use licensure. Differences in AVSS capacity between high-income countries (HICs) versus low- and middle-income countries (LMICs) were known prior to the pandemic. ObjectiveTo assess the global landscape of COVID-19 vaccine AVSS activities to identify gaps in safety evidence generation across vaccine products and populations with a focus on LMICs. MethodsA cross-sectional survey was conducted in January 2022 on AVSS activities evaluating adverse events following immunization (AEFI). Data collected included country, targeted population, COVID-19 vaccine product(s), design of surveillance/monitoring activities or study, and AEFIs to be monitored.To supplement these findings, we conducted a literature review of COVID-19 vaccine safety activities published in PubMed through January 2023. Observational activities assessing AEFI, specifically adverse events of special interest (AESI), following routine use of COVID-19 vaccines in medical practice were included; systematic reviews, benefit/risk assessments, clinical trials, and case reports/series were excluded. ResultsThe survey, completed by 34 respondents and compiled with reviews of 7 publicly available Risk Management Plans from five vaccine manufacturers, identified 79 monitoring activities in HICs, 24 in LMICs, and 9 in multiple regions. Most activities in LMICs were planned cohort event monitoring (CEM) studies (n = 18); two multi-national hospital-based sentinel surveillance studies for AESI were ongoing. Activities in LMICs evaluated multiple COVID-19 vaccine products simultaneously and were sponsored by health authorities. The literature review identified 1245 unique citations, of which 379 met inclusion criteria. The majority evaluated vaccines primarily used in high-income countries: Pfizer BioNTech (Comirnaty; n = 303), Moderna (mRNA-1273; n = 164), AstraZeneca (AZD1222; n = 126), and Janssen (Ad26.COV2.S); n = 62); 14 citations assessed vaccines used exclusively in LMICs: Sinovac (CoronaVac), Beijing CNBG (BBIBP-Corv), Bharat (Covaxin), SII (Covashield), and Gamaleya (Gam-Covid-Vac) vaccines. ConclusionsRobust safety evidence for input into benefit/risk assessments is likely unavailable for most COVID-19 vaccines used primarily in LMICs due to emphasis on cohort event monitoring methods. Goals for equitable vaccine access should be coupled with investment and support for building infrastructure and capacity for safety evidence generation to inform policy and regulatory decisions at local levels.