Adverse reactions during routine immunisation of children to be covered under health scheme in Karnataka

To ensure coverage of routine immunisation of children (aged up to five years) under the National Health Mission with Ayushman Bharat Pradhan Mantri Jan Arogya Yojana PMJAY CM’s Arogya Karnataka (AB PMJAY CM’s ArK), the State Health Department has now made a provision for treatment of all adverse events following immunisation (AEFI) under the health scheme.

According to a circular issued by the Health Department, all empaneled network hospitals (both government and private) should utilise the mapped package codes listed under AB PMJAY CM’s ArK for AEFI treatment, excluding minor reactions. The adverse events should be attended to without any delay by admitting the child, the circular states.

What are adverse events? An AEFI is any untoward medical occurrence which follows immunisation and which does not necessarily have a relationship with the usage of the vaccine. Adverse events are categorised into minor, serious and severe. Minor reactions are common and self limiting that usually occur within a few hours of injection and resolve after a short period of time, and pose little danger.

While severe reactions can be disabling but are rarely life threatening (do not lead to long term problems), serious adverse events can result in death, in patient hospitalisation, persistent or significant disability. State Health Commissioner Randeep D. said severe reactions and serious adverse events require medical attention, and hospitalisation in a few cases.

“The existing AB PMJAY ArK package has no code for AEFI. However, there are several codes in the package which are direct and related to the existing codes. Only severe and serious adverse events are enlisted. Out of the 19 reactions, 10 are directly mapped to existing codes while nine are mapped to related codes,” he said.

An analysis of the mapped codes from 2018 till date has revealed that acute febrile illness, febrile seizures, incision and drainage of large abscess, anaphylaxis and acute abdomen are the top five utilised codes. Hence, all empaneled hospitals have been directed to treat children who develop AEFI under the scheme, he said.

Mandatory registration of private facilities In order to bring the three components of healthcare system — the patient with Ayushman Bharath Health Account (ABHA), healthcare facility (hospital/ clinic/ laboratory/ physiotherapy) with Health Facility Registry (HFR) ID and healthcare provider (doctors, nurses and others) with Health Professionals Registry (HPR) ID — into a single digital ecosystem, the Health Department has made it mandatory for all private medical institutions to integrate into the Ayushman Bharat Digital Mission (ABDM).

“It is reiterated that all private medical institutions and their healthcare providers (doctors and nurses) should register themselves in the HFR by creating facility ID and HPR by creating healthcare professional ID (HP ID). It is mandatory for all private medical establishments to update both facility ID (under HFR) and HP ID (under HPR) on the Karnataka Private Medical Establishment (KPME) portal,” stated another circular.

“All District Health Officers (DHOs) have been directed to coordinate with the already licensed facilities under KPME to verify whether they have registered their facilities in the HFR. If not, the facilities have to be instructed to register for the HFR within 15 days from the date of intimation,” states the circular.

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