By Gift Briton and Fidelis Rukwaro

With one in every two deaths among under five-year-old children globally happening in sub-Saharan Africa due to low vaccination coverage, the African Population and Health Research Center(APHRC) has launched a research project that is set to reduce vaccination inequalities through digital vaccine cards.

By collaborating with the University of Michigan in the United States of America (USA) and the Ministries of Health in Kenya and Uganda, APHRC seeks to develop a Short Message Service(SMS)-based digital vaccine card and registry that will facilitate the electronic collection of individual data at health facilities to allow improved monitoring of vaccine coverage and timeliness by both healthcare providers and parents.

This would in turn ensure that every child both in rural and urban settings receive every vaccine for which they are eligible (vaccine equity).

The digital vaccine cards will be designed in a way that by just keying in the child’s details, parents and health workers can get an SMS text about which vaccines the child has received, the vaccines the child is due for and text reminders for the upcoming vaccinations.

According to Dr Gershim Asiki, a Public Health Physician and Research Scientist at APHRC, vaccination disparities still exist within communities and countries, with children coming from poorer communities and whose parents have low education levels being the most likely not to get vaccinated.

Furthermore, analysis of the Demographic Health Survey data indicates that the number of unvaccinated children (those who have not received even a single vaccine) has remained the same since 2000.

Dr. Asiki notes that the unvaccinated children will act as a reservoir for infectious diseases that will keep coming back to the community, adding, “You cannot eliminate a disease from a community if you have not vaccinated more than 95% of its population.”

“To stamp out infections in our settings, we need to look at a way of filling the inequalities gaps, and digitalizing vaccination is one of the approaches,” Dr Asiki observed.

He adds, “The quickest way to fix this problem is to digitalize the vaccination cards because children from poor households are more likely to lose their cards and therefore when they go for care, the health workers cannot know what exactly they missed and the dates for receiving the next vaccination. But when we have an electronic registry, they just key in the child’s details and generate the child’s immunization cards.”

Dr. Emily Treleaven, a Demographer and Social Epidemiologist and Research Associate Professor at the University of Michigan, pointed out that digitalizing the vaccination cards will help facilities to know the group of children that are coming late for vaccination and use that information to form an effective vaccination outreach for that particular group in order to make sure that all children are vaccinated on time.

“Some children are not eligible for immunization because they have other issues for which they cannot medically receive vaccines. So, the only way we can protect them is by vaccinating everyone around them,” Dr Treleaven said.

She adds that the digital vaccine cards will remove barriers including the knowledge barrier of when the child needs to go for immunization and the knowledge barrier from the health worker’s perspective of which child is not coming for vaccination and where they are.

“We know that it will only work if it works for everyone. So, it has to work for parents, health workers, community health promoters, and the government. And if it doesn’t work for any of those groups it will not be successful. So we hope the consultative nature of designing and implementing the project will lead it to work for everyone,” Emily said.