A National Vaccine Registry Blueprint

Thank you for this informative article (1).

Canada continues to lack a tracking system for adult vaccines. Instead, provinces and territorial public health records contain vaccination records for children only (2). Vaccines provided to adults in all settings including clinicians’ offices, private pharmacies, long term care homes, prisons, First Nation reserves, and those administered to adult newcomers to Canada are missing.

Yet it is adults, especially those over 60 years and with chronic conditions who are most at risk of hospitalization and death from COVID-19.

Should a vaccine for COVID-19 be developed, the lack of an adult vaccine registry may be further compounded by potential vaccine shortages. It is imperative that we have the ability to provide potentially limited vaccines to those jurisdictions with higher disease rates to optimize vaccine distribution and coverage.

Using bar codes to create such registries would prove indispensable in this effort. Standardized bar codes are currently found on nearly all commonly administered vaccines and contain the vaccine’s name, lot number and expiry date.

Patients would need to be electronically assigned a unique bar code if one doesn’t already exist. Ontario already has this on its health cards.

In this model, the patient’s bar code would be scanned along with that of the vaccine being provided at all locations, including pharmacies, offices and health units.

Once scanned, 3 records would be simultaneously updated including the:

1. Patients’ electronic health record

• Saves clinician entry time and time needed to reorder vaccines
• Reduces manual transcription errors (3)
• Reduces the provision of unnecessary vaccines (4)

2. Local Public Health Unit’s record

• Automates vaccine supply to offices
• Reduces vaccine wastage by better matching quantities delivered to those actually used

3. Provincial / Territorial Vaccine Registry (PTVR) with features that include:

• Patient portal to increase patient autonomy
• Automated e mail reminders to improve adherence to vaccine schedules (5)
• Educational resource on vaccines including addressing vaccine hesitancy

The universal utilization of scanning bar codes would benefit Ministries of Health by:

• Allowing a comparison of vaccine coverage with disease rates within specified areas
• Optimizing the distribution of scarce vaccines during a pandemic or when faced with vaccine shortages
• More easily recalling vaccine lots due to contamination
• Redistributing vaccines nearing expiry to locations with immediate need

Using bar codes has been shown to save time, improve user experience, simplify documentation, reduce transcription errors and would create robust and comprehensive PTVRs.

Critically robust PTVRs, once anonymized would form the building blocks for a National Immunization Registry, a long sought-after goal of public health.