Pharmacovigilance of COVID-19 vaccines in the context of Nepal: an assessment based on early adverse drug reaction reports

Objective The objective of this study was to assess the ongoing pharmacovigilance of coronavirus disease-19 (COVID-19) vaccines in the Nepalese context based on the available preliminary adverse drug reaction (ADR) reports and suggest approaches for strengthening pharmacovigilance mechanisms. Methods Currently, many COVID-19 vaccines are under advanced development and some have begun to be administered. In Nepal, the vaccination programme was initiated with Oxford/AstraZeneca COVID-19 AZD1222 (Covishield) vaccine on January 27th targeting frontline healthcare professionals, sanitary staff and security workers. Newspaper reports and ADR reports received at a regional pharmacovigilance centre in Nepal were analysed. Nepal initiated a national pharmacovigilance programme 15 years back and has 14 functioning regional pharmacovigilance centres. The authors examine the strengths and challenges facing the current pharmacovigilance system in ensuring the safety of COVID-19 vaccines. Key findings The news coverage has not mentioned any deaths till date with COVID-19 vaccination. Some patients reported vomiting, urticaria and sudden increase in blood pressure. Few people suffered from headache, fever and myalgia after being vaccinated. A vaccine, approved in an accelerated manner may have safety concerns. The vaccine may cause several types of reactions, but serious reactions have not been reported. Occurrence of adverse effects due to the vaccine is being studied. Conclusions Involving key stake holders, training health professionals and strengthening existing reporting procedures are important. Developing a system of reporting and analysing ADRs daily can help generate actionable intelligence to improve the safety of the vaccination programme. Establishing functioning communication channels between regulatory authorities and other stakeholders is crucial.

Extended reality in educating the next generation of health professionals

COVID-19 has severely impacted health professions education and assessment has mostly shifted online. Major challenges remain especially about teaching-learning and assessment of clinical skills. Interacting with an individual online does not provide the range of information provided by an in-person meeting. There have been dramatic advances in computers and the internet in the last 60 years. Extended reality (XR) is all real- and virtual-combined environments and human-computer interactions generated by computers and wearable devices. The future physical world is likely to face multiple challenges. It is likely that human interactions and learning will increasingly occur in XR spaces. Three-dimensional holographic avatars and interacting and manipulating objects in XR spaces will become easier. Most medical education can occur in these spaces. Universities will invest substantially in these spaces. The safety of the physical world, the cost and usability will determine the extent of use of these learning spaces. © Malaysian Association of Education in Medicine and Health Sciences and Penerbit Universiti Sains Malaysia. 2021