Abstract
Active vaccine safety surveillance, which involves directly engaging with vaccine recipients to actively solicit information on adverse events following immunization, complements spontaneous reporting systems. This commentary provides a comparative overview of three national active vaccine safety surveillance systems: AusVaxSafety (Australia), CANVAS (Canada) and V-safe (United States) across six key surveillance system evaluation attributes. Each system played an essential role during the COVID-19 pandemic and continues to contribute to global post-marketing vaccine safety surveillance. Each has various strengths and limitations. AusVaxSafety, established in 2014, is well integrated with routine healthcare settings for opt-out surveillance and offers frequent public reporting. CANVAS, established in 2009, offers a unique cohort-based design with inclusion of control groups. V-safe, established in 2020, has proven scalability and broad population reach due to its accessible web-based design. The various features of each system offer insights to inform future vaccine safety surveillance efforts.