To your second question: many do have drug reporting on paper, mostly because GAVI requires an AEFI committee to access vaccine funding but in practice it's not the case which is why I said "(or just wouldn't do it)", virtually no Pedia would write a report for a kid having a headache post vaccination. As of 2022, apparently only 43% of ALL countries met WHO's absolute minimal bar of ONE serious report per million people per year, SE Asia is at 9%, a third of countries report close to zero.
And this isn't bad faith on my part, these are WHO and CDC's own numbers, not an opinion.
[1] https://www.who.int/docs/default-source/documents/global-vac... [2] https://iris.who.int/bitstream/handle/10665/70854/WHO_IVB_12... [3] https://www.cdc.gov/mmwr/volumes/72/wr/mm7249a2.htm [4] https://pmc.ncbi.nlm.nih.gov/articles/PMC5857292/ [5] https://www.gavi.org/sites/default/files/sites/default/files... [6] https://www.fda.gov.ph/pharmacovigilance/ [7] https://link.springer.com/article/10.1007/s40801-025-00492-z [8] https://siapsprogram.org/wp-content/uploads/2016/03/15-125-P...