Mitigating the Impact of COVID-19 on Global Vaccination Efforts

When we think about vaccines, it’s almost impossible to overlook the incredible progress the global community has made in producing and distributing COVID-19 vaccines. Sixteen months after the identification of the COVID-19 virus, safe and effective vaccines had been administered to more than 1 billion people (though with uneven coverage, as we’ll discuss later). Despite this achievement, the focus on COVID-19 can overshadow the impact the COVID-19 pandemic has had on routine immunization efforts that have been in place for years.

Routine immunizations are some of the most cost-effective and important public health tools available. Vaccines are available for the prevention of 25 diseases, with 15 more in development. Globally, they are responsible for a consistent decline in deaths that can be wholly or partially prevented through vaccination.

However, experts have warned that disruptions in routine immunization due to COVID-19 can lead to secondary health crises, with unvaccinated individuals susceptible to vaccine-preventable diseases such as measles and rubella. The risks are particularly acute for children; in 2020, 23 million children missed out on basic vaccines, with 17 million of these children not receiving a single vaccine during the year. 

In many LMICs, disruptions to routine immunization services have been accompanied by limited or no access to COVID-19 vaccines, with researchers estimating that individuals in lower-income countries won’t receive COVID-19 vaccines for another two years. While over 80% of all COVID-19 vaccines have been administered in high- and upper-middle-income countries, less than 1% of doses have been administered in low-income countries. As a result, lower- and middle-income countries are tasked with resuming routine immunization services while also preparing to equitably distribute COVID-19 vaccines when they become available.

Making up for lost time

There is a need to maintain our focus on the equitable delivery of COVID-19 vaccines while also restoring previous rates of routine immunization. In order to make progress on both COVID-19 and routine immunization in parallel, countries need to be equipped with the right tools to identify gaps in immunization and deliver counseling and vaccines to their communities; one should not happen at the cost of the other.

According to the World Health Organization, catching up on routine immunizations “will require strategies to track and follow-up with individuals who missed vaccinations, assess immunity gaps, and re-establish community demand”. These are challenges that digital solutions are uniquely suited to solve, with the tracking of individuals and assessment of vaccination coverage made easier through features like case management, longitudinal data tracking, and data analysis.

As COVID-19 vaccines become available, digital solutions can support countries in prioritizing the vaccination of healthcare workers to minimize the risk they face while performing routine immunization activities. Digital solutions can also aid in registration and eligibility screening to ensure that COVID-19 vaccines are distributed equitably and according to eligibility protocols. For routine immunization, digital solutions can assist frontline workers with the process of registering patients, administering vaccines on the basis of national vaccine schedules, and tracking patients over time to ensure full immunization. 

Across both of these efforts, digital counseling and training tools can equip health workers with knowledge about the latest policies and scientific information while also providing tools for engaging with communities around vaccine hesitancy and misinformation.

The Dimagi Vaccine Solution

In November 2020, Dimagi released a COVID-19 Vaccine Delivery solution to assist lower- and middle-income countries with the equitable distribution of COVID-19 vaccines. As of today, more than one million COVID-19 doses have been tracked using this solution. Now, in recognition of the larger mandate to maintain a focus on COVID-19 vaccination and routine immunization, Dimagi is offering a comprehensive vaccine solution that supports both.

The Dimagi Vaccine Solution offers a combination of service delivery, workforce, and facility management, with tools for frontline workers, program administrators, and clients. The solution is a ready-to-deploy toolkit for vaccine management that includes six micro-applications, each one designed to address a unique challenge related to vaccination programs at scale. Each micro-application can be used on its own or in combination with the other micro-applications and vaccine schedules can be configured based on local or national guidelines. 

Building on a foundation 

These digital tools for immunization can serve as a foundation for a digital infrastructure that unifies health service delivery on a single platform. In the future, we aspire to support partners in creating holistic health solutions that move beyond one service delivery area such as immunization or maternal and child health. Instead, we aim to build digital infrastructure that unifies health service delivery through a common digital health platform. 

According to GAVI, immunization provides an ideal opportunity to strengthen primary health care for universal coverage because it reaches more households than any other routine health services. Worldwide, 90% of children are reached through routine immunization and the majority of households come into contact with the health system five or more times during a child’s first year of life. Given its wide reach and the high number of touch points with young children and their families, we believe immunization is a natural starting point to building a patient base for a robust digital health infrastructure. 

Once patient records are created for immunization, those same records can be updated through a patient’s lifetime. By creating the record early on in an individual’s life, there is an opportunity for digital solutions to add value by triggering appointment reminders, tracking patient health over time, and aiding frontline workers in providing age-appropriate counseling and services for years to come.

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It will be critical for countries to maintain their focus on COVID-19 immunization while also making up for lost ground on routine immunization service delivery. By investing in digital solutions for immunization, countries can make progress towards these goals while also establishing a foundation for future service delivery efforts.

To learn more about how the Dimagi Vaccine Solution can be leveraged for immunization, please write to vaccinesolution@dimagi.com.