Monitoring the world’s largest and fastest vaccine rollout: developing information systems to track COVID-19 vaccination worldwide (Preprint)

BACKGROUND The COVID-19 vaccine rollout presented all immunization information systems (IIS) with challenging demands – requiring in-depth vaccine implementation data at all health system levels in real-time. The system development approaches taken by countries were heterogeneous, with some countries opting to adapt existing systems and others implementing new ones. OBJECTIVE Using data reported by Member States to the World Health Organization (WHO), develop a global understanding of a) the types of IIS to monitor COVID-19 vaccination implemented in 2021 and b) the approaches taken by countries to develop these systems. METHODS A descriptive analysis of data reported through a supplemental questionnaire of the WHO/UNICEF Joint Reporting Form for Immunization, collecting data for 2021 on a) the use of and developmental approaches taken for seven IIS functions, and b) on modifications needed to digital health frameworks to permit COVID-19 vaccination monitoring. RESULTS 188 of 194 WHO Member States reported data. For each of the seven IIS functions explored, greater than 85% of responding countries reported that the system was in place for COVID-19 vaccines. In total, two in three (68%) countries reported establishing at least one new system, ranging from 72% in high-income countries (HIC) to 61% in low-income countries (LICs). Concurrently, many countries adapted existing systems to include COVID-19 vaccines, notably those for stock management and safety surveillance. Overall, 55% of countries reported adapting at least one system already in place to COVID-19 vaccines, with 62% of HICs reporting this compared to ~53% for other income groups. On digital health frameworks, 31% of responding countries reported needing to adapt them in relation to COVID-19 vaccination systems, mostly HICs. CONCLUSIONS Nearly all countries have adapted existing and / or developed new IIS to monitor COVID-19 vaccination. The approaches varied, notably by income group. Reflection is needed on how to sustain investments made in IIS during the pandemic. Continued support for IIS is critical, given their essential role in program monitoring and performance.