According to the World Health Organization (WHO)), vaccination helps prevent diseases, disabilities and deaths from preventable diseases, preventing between 2 and 3 million deaths each year.
Therefore, vaccines are considered one of the most successful health interventions in the history of humanity, being responsible for increasing life expectancy globally by more than 20 years.
Mexico, for example, has one of the best free vaccination schedules in the world. However, its coverage is insufficient, particularly in the poorest and most marginalized communities, being children the most affected population.
Digital Immunization Card
To protect every child, the most important factor is that vaccination must be carried out in a timely manner, at the ages specified in the card. This requires a monitoring system that keeps the proper resources working at all levels and, consequently, a complete renovation of the Universal Vaccination Program (UVP) to meet the current epidemiological, demographic and economic challenges.
This is how the Digital Immunization Cardemerges, a digital health ecosystem developed by Carlos Slim Foundation that enables the reengineering of the Universal Vaccination Program, with the objective of increasing its impact, that is, to ensure that all people receive all the vaccines they need at the right time. The Digital Immunization Card was developed based on the recommendations of the Commission for the Future of Vaccines in Latin America (COFVAL)[i], and is being implemented in collaboration with the Rio Arronte Foundation.
The Digital Immunization Card is guided by 5 strategic axes:
- Improve the vaccination coverage and timeliness of vaccination through CDV Platform.
- Efficient management of health workers by using the CDV Platform.
- Promote the co-participation of people in vaccination actions through the VacunAcción App.
- Monitor access, timely implementation, coverage and quality of vaccines through the Analytical Platform and the use of predictive risk models.
- Have trained and updated professionals through the Institute of Higher Health Studies
It is directed to health workers in order to track the administration of all vaccines for children between 0 and 13 years old, as well as the application of the flu vaccine to the whole population.
For the vaccination actions record, the CDV Platform includes a mobile app for Android devices, as well as an online cloud-based platform. Through them, vaccinators register the administration of vaccines in real time, and follow up the vaccination schedule. It is important to highlight that the CDV Platform is designed to operate in areas with no internet access, which allows its implementation in marginalized or remote communities.
Due to the dynamic process of vaccination follow-up, where the parents can take his or her child to different health units, or even to different municipalities, the information on the vaccines administered to each person is available on the paper vaccination booklet itself, through a chip with NFC technology, or a QR code.
What is the Digital Immunization Card?
The Digital Immunization Card (CDV) is a computer-based tool for health workers to follow up the vaccination of children between 0 and 13 years old in an individual and timely manner. It consists of three key components:
- CDV App
- QR tags
- VacunAcción App
The CDV App is installed on mobile electronic devices (optimally tablets, although it can also work on smartphones) with Android operating system and at the same time it can be used on PCs with internet connection. This software allows vaccinators to record children's identification information, data on their individual vaccination schedule, as well as the vaccines they are administering in real time (online) and even in the absence of connectivity (offline).
This information is transferred to a tag with NFC technology -which enables communication and data transfer between devices even without internet or mobile network- which is attached to the child's vaccination booklet, turning it into an electronic information repository. The data stored in the electronic tag can be read and edited by the vaccinators, always under strict protocols that ensure the confidentiality of the individual's data.
In order to guarantee the system's operation, even in places without connectivity networks, QR codes have also been implemented, generated by the CDV App, and can be scanned by any device through the camera (cellphones, tablets and computers). For this, parents and caregivers are invited to use the VacunAcción App and in so being able to share the information of the vaccination schedule of children between parents and healthcare workers, securely and without the need for connectivity.
Functions of the CDV
- To determine the degree of vaccination of each child/person.
- Improve individual follow-up of vaccination schedules.
- Decrease the administrative workload of the workers.
- Operate online/offline for the inclusion of technology in low connectivity areas.
- Interoperate with other electronic systems that are currently in operation.
"Vaccines in the palm of your hand."
In Latin America, the prevalence of mobile phones, and specifically smartphones, is very high, and they have become indispensable devices for our daily lives.
With this in mind, Carlos Slim Foundation developed VacunAcción, a mobile app available for Android and iOS devices, which allows individualized follow-up of people's vaccination schedule. In a very significant matter, VacunAcción allows to know which vaccines have been applied, which are missing, when the next doses should be applied, as well as general objective and scientifically supported information about vaccines, thereby avoiding confusion generated by other communication channels where it is very common to receive misinformation.
Specifically, VacunAcción allows you to have the vaccination schedule in the palm of your hand.
Use of information for decision making
Having timely and reliable information is essential in the reengineering process of the Universal Vaccination Program. Therefore, the digital health ecosystem of the Digital Immunization Card includes the following:
- The Mexican Vaccination Observatory (OMEVAC)in collaboration with the Rio Arronte Foundation, the Mexican Vaccinology Association and the Mexican Society of Public Health, OMEVAC displays information on the number of children enrolled, vaccines applied, coverage and timeliness in their application, as well as causes related to the non-application of vaccines. OMEVAC is open to the public, and provides information at different levels: national, by state and by health unit.
- Specific reports and nominal database, through the CDV Platform, restricted to health service providers, provides access to reports and reports that facilitate the operation of the vaccination program, as well as specific analyses. This functionality adheres to the highest standards of privacy, security, personal data protection and confidentiality, in compliance with applicable legislation.
- Quality Index of Vaccination Actions (ICAVac)), which measures the performance of health units, jurisdictions or delegations, states and the national level in fulfilling the actions established in the vaccination program.
- Predictive risk models, to determine the risk of not applying a vaccine, based on the health unit's existing capacity, as well as the context of the individual and their family.
Training of health care workers
Keeping the workers up to date is the most efficient strategy to encourage correct decision making when vaccinating,as well as to promote the proper use of supplies.
The following refresher courses have been developed for vaccination personnel working at all levels of responsibility:
- Vaccinology Diploma, available with updates and now targeted at all professions involved in the vaccination processes.
- CDV expert course, which provides an overview of the expected improvements to be made to the system and will offer relevant content for the operation in the short term.
With these courses, healthcare workers will get the essential tools for the vaccination management and will develop the required skills for the management of the Digital Immunization Card.
The CDV is currently operating in health centers of the Ministries of Health of Durango, Guanajuato, Hidalgo, Querétaro and San Luís Potosí, as well as in health units of the Mexican Social Security Institute (IMSS) in its Ordinary and Welfare schemes in Campeche and Hidalgo.