Qatar Journal of Public Health - Current Issue

Objective This research aimed to assess coronavirus disease 2019 (COVID-19) vaccine administration errors at Primary Health Care Centres (PHCC) in Qatar and provide corrective measures to enhance patient safety based on the Centre for Communicable Diseases recommendations.

Methods A retrospective analysis was conducted on the electronic medical records of patients receiving COVID-19 vaccines at PHCC between 23 December 2020 and 31 December 2021. Demographic information, vaccine details, administration dates, lot numbers, and vaccination sites were extracted. A descriptive analysis was performed to calculate the percentages of common vaccine administration errors outlined by the CDC.

Results PHCC administered 2,797,941 and 694,643 vaccine doses in 2021 and 2022, respectively. The primary error category was data quality, with the highest observed error being a discrepancy between vaccine expiration dates and actual dates (3.1% in December 2022). In 2021, all error percentages within data quality were below 0.37%. Notably, the most prevalent vaccine administration deviation in 2021 was interval rule 2, where the second dose was administered more than 42 days after the first dose. The highest deviation (1.59%) was reported in November.

Conclusions Vaccination remains crucial for disease prevention, necessitating accurate vaccine administration processes. The study underscores the importance of effective implementation and monitoring of vaccination programmes. PHCC’s strategies, including ongoing training, adherence to guidelines, and a monitoring dashboard, contributed to better error understanding. This approach facilitated targeted training and communication efforts to enhance patient safety and minimise potential harm. The findings highlight the significance of continuous improvement in vaccine administration to ensure the success of public health interventions.

Background Fever without a source of infection (FWS) is a common presentation in infants and children. Kawasaki disease (KD) is a rare but serious illness that can sometimes present with FWS. Early diagnosis of KD is important in infants younger than 6 months because delayed treatment has a poor outcome in this age group.

Case presentation A 5-month-old male child, who was first taken by his parents to the primary health center with a complaint of fever, was referred to the hospital Pediatric Emergency Center (PEC). A viral cause was suspected, and he was sent home on oral antipyretic medicine. The next day, the infant developed decreased oral intake and lethargy, so he was admitted to the PEC for observation. The infant was initially diagnosed with sepsis and admitted to the pediatric intensive care unit (PICU). On the fourth day of fever, the infant developed a skin rash, bilateral nonpurulent conjunctival congestion, strawberry tongue, and left posterior cervical lymphadenopathy. The infant was diagnosed with KD and received intravenous immunoglobulin (IVIG) and aspirin. The infant made a full recovery and was discharged home after 11 days of hospitalization.

Discussion KD is a rare but serious illness that can affect infants and children. Infants younger than 6 months with KD tend to have incomplete forms of the disease, which can make the diagnosis difficult. Delays in the diagnosis and treatment of KD can have serious consequences, including the development of coronary artery aneurysms (CAAs).

Conclusion This case report highlights the early presentation of KD in a 5-month-old infant. The early signs and symptoms of KD can be vague or mimic other common illnesses such as viral infections and sepsis. The diagnostic criteria may not be met in the early phase of the disease. Laboratory tests are not specific or diagnostic. Early diagnosis and treatment are essential to prevent serious complications. The patient in this case report was fortunate to be diagnosed and treated early. He responded well to treatment and made a full recovery.