Abstract
PROBLEM: Once COVID-19 vaccines were rolled out, there was a need to monitor real-world vaccine effectiveness to accumulate evidence to inform policy and risk communication. This was especially true in Japan and the Philippines, given historical issues that affected vaccine confidence. CONTEXT: Neither country had public health surveillance that could be enhanced to evaluate vaccine effectiveness or readily available national vaccination databases. ACTION: Study groups were established in multiple health-care facilities in each country to assess vaccine effectiveness against both symptomatic infection and severe disease. OUTCOME: In Japan, multiple study reports were published in Japanese on the web site of the National Institute of Infectious Diseases and presented at the national government's advisory board. Nationwide media coverage facilitated transparency and increased the confidence of the government and the public in the vaccination programme. In the Philippines, the launch of the study was delayed so as to align the research plan with the interests of various stakeholders and to obtain institutional review board approval. Ultimately, the studies were successfully initiated and completed. DISCUSSION: There were four main challenges in conducting our studies: finding health-care facilities for data collection; obtaining exposure (vaccination) data; identifying epidemiological biases and confounders; and informing policy and risk communication in a timely manner. Preparedness during inter-emergency/epidemic/pandemic periods to rapidly evaluate relevant interventions such as vaccination is critical and should include the following considerations: (1) the establishment and maintenance of prospective data collection platforms, ideally under public health surveillance (if not, clinical research networks or linked databases); (2) uniform and practical protocols considering biases and confounders; and (3) communication with stakeholders including institutional review boards.