BACKGROUND: The African Region Monitoring Vaccine Effectiveness network (AFRO-MoVE) was established by the World Health Organization Regional Office for Africa in March 2021 to support implementation of COVID-19 vaccine effectiveness studies in the region. OBJECTIVES: Primary goals of the evaluation were to assess how AFRO-MoVE addressed its objectives supporting regional vaccine effectiveness (VE) studies, to describe challenges and opportunities, and make recommendations to strengthen future efforts related to regional VE research. METHODS: From September 2023 through June 2024, a mixed-methods approach was employed to synthesize information from: (1) documentation provided by AFRO-MoVE; (2) a standardized study review tool; (3) an electronic stakeholder survey; and (4) a series of key informant interviews. Data were collected and exported via REDCap and summarized using Microsoft Excel. Thematic analysis was used to analyse the qualitative data. Perceived challenges were summarized together with perceived support by the network in addressing each challenge. RESULTS: AFRO-MoVE provided support to ten VE studies, including support for protocol development, study implementation, data management, and analysis, while also facilitating knowledge exchange and experience sharing among study implementers. While respondents reported strengthened capacity for VE studies at the national and regional levels in these areas, enrollment of SARS-CoV-2 positive cases was challenging, due to a decline in reported cases in network countries in mid-2022, when many studies were launched. These challenges contributed to a lack of published VE estimates from network study sites in time to inform vaccine policy. CONCLUSION: AFRO-MoVE technical assistance and financial support was viewed positively by network members and contributed to increased capacity for conducting VE studies in the region. Publication of study results would further bolster the impact of the network. These finding underscore opportunities to enhance capacity for rapid VE generation and support preparedness for future pandemics.

Event-based surveillance (EBS) systems have been implemented globally to support early warning surveillance across human, animal, and environmental health in diverse settings, including at the community level, within health facilities, at border points of entry, and through media monitoring of internet-based sources. EBS systems should be evaluated periodically to ensure that they meet the objectives related to the early detection of health threats and to identify areas for improvement in the quality, efficiency, and usefulness of the systems. However, to date, there has been no comprehensive framework to guide the monitoring and evaluation of EBS systems; this absence of standardisation has hindered progress in the field. The Africa Centres for Disease Control and Prevention and US Centers for Disease Control and Prevention have collaborated to develop an EBS monitoring and evaluation indicator framework, adaptable to specific country contexts, that uses measures relating to input, activity, output, outcome, and impact to map the processes and expected results of EBS systems. Through the implementation and continued refinement of these indicators, countries can ensure the early detection of health threats and improve their ability to measure and describe the impacts of EBS systems, thus filling the current evidence gap regarding their effectiveness.

BACKGROUND: Flu Near You (FNY) is an online participatory syndromic surveillance system that collects health related information. In this manuscript, we summarized the health-care seeking behavior of FNY participants who reported influenza-like illness (ILI) symptoms. METHODS: We applied inverse probability weighting to calculate age-adjusted estimates of the percentage of FNY participants in the United States who sought health care for ILI symptoms during the 2015-16 through 2018-19 influenza season and compared seasonal trends across different demographic and regional subgroups, including age group, sex, census region, and place of care using adjusted Chi-square tests. RESULTS: The overall age-adjusted percentage of FNY participants who sought health care for ILI symptoms varied by season and ranged from 22.8% to 35.6%. Across all seasons, health care seeking was highest for the <18 and 65+ age groups, females had a greater percentage compared with males, and the South census region had the largest percentage while the West census region had the smallest percentage. CONCLUSIONS: The percentage of FNY participants who sought health care for ILI symptoms varied by season, geographical region, age group, and sex. FNY compliments existing surveillance systems and informs estimates of influenza-associated illness by adding important real-time insights into health-care seeking behavior.