Background Although all vaccines used in National Immunization Programmes are safe and effective, no vaccine is completely risk-free and adverse events occasionally occur after an immunization. Failure to report adverse events following immunization (AEFI) can lead to death and misconceptions about vaccine safety hence vaccine hesitancy. Alleged vaccine quality and safety issues must be dealt with rapidly and effectively. This study assessed level of knowledge and reporting of AEFI among healthcare workers and caregivers at Mengo Hospital, Kampala.

Methods A health facility-based mixed-methods cross-sectional study design was used. Eligible participants were caregivers of children and healthcare workers. Qualitative data were collected through self-administered questionnaires. Focus group discussions (FGDs) among caregivers and Key informant interviews (KII) among healthcare workers collected data on knowledge and reporting procedures of AEFIs. Level of knowledge of AEFI was assessed using the Likert scale and logistic regression was used to analyse the association of different factors with reporting of AEFI. Qualitative data were analysed manually into themes.

Results A total of 388 participants enrolled with mean age (SD) of 28.75 (5.65) years and 51.8% were female. Over two-thirds (61.3%) had poor knowledge about AEFIs. Less than half (41.8%) had ever reported an AEFI to the hospital. Unemployment (OR= 1.628), good knowledge of AEFI (OR=1.572), and parity less than four (OR= 2.070) were found to increase odds of reporting of AEFIs. From the 7 KII and 6 FGDs, we found that most healthcare workers and caregivers had good knowledge of AEFIs but the majority had never reported nor knew the procedure for reporting of AEFI.

Conclusion The reporting of AEFIs was low among caregivers in Kampala. There is need to sensitize caregivers about the necessity to report AEFIs.

Funding: The study was sponsored by EACRR2 which was funded by EDCTP2, Grant number: RegNet2015–1104-EACCR2.