Potential for eHealth to increase vaccination coverage

The European Immunisation Week, which took place from 24th to 30th April, was the perfect opportunity for the European Centre for Disease Prevention and Control (ECDC) to release its report on immunisation information systems in the EU and EEA. The report provides information on the status of immunisation information systems (IIS) in the EU/EEA countries and describes the functionalities of these systems. Its promotion fitted with the objective of the European Immunisation Week to increase awareness of the importance of immunisation. The publication is particularly important for those countries that have not yet set up systems, that are in the early stages of implementation or are updating their systems. The report summarises the results of 2 surveys that ECDC conducted on IIS in the EU/EEA countries. The research focuses on the one hand on countries with an established IIS and on the other hand targeted countries in an earlier stage of IIS implementation.

14 surveyed countries reported that they have a national system in place that digitally records information about vaccination, while in 7 others innovative systems are currently being piloted. Many of the IIS currently in operation or being set up include the possibility to record wholeof-life vaccination data, with a small number being able to print the personal immunisation history of an individual. Automated reminders are also used by 5 IIS. These systems are capable of producing lists that identify under vaccinated populations, determine which vaccines are due or overdue, and generate reminders for providers and vaccine recipients. The importance of digital immunisation records is also recognised by the 2014 EU Council Conclusions on vaccination as an effective tool in public health and further endorsed by the World Health Organisation’s European Vaccines Action Plan.

Overall, the report shows that strong information systems are an integral part of the well-functioning vaccination programme that offer individuals the possibility to stay up-to-date with their immunisations throughout their lives and removes uncertainties over vaccination statuses. Immunisation information systems (IIS) are defined as confidential, population-based, computerised databases that record all immunisation doses administered by participating providers to persons residing within a given geopolitical area. At the point of clinical care, they support practitioner decision-making in ensuring appropriate individual vaccination and adherence to applicable policies. At population level, IIS provide aggregate data on vaccinations for use in surveillance and programme operations, and in guiding public health action to improve vaccination rates and reduce vaccine-preventable diseases. The European Council conclusions on vaccinations from both
2011 and 2014 recommend the adoption of such systems and the World Health Organization’s European Vaccine Action Plan 2015–2020 recognises IIS as ‘an integral part of well-functioning health systems’. IIS have the potential to improve performance of vaccination programmes and to increase vaccine uptake, but the design, development and implementation of such systems can be challenging for national programme managers. The European Centre for Disease Prevention and Control (ECDC) is currently running activities to support the Member States in establishing IIS. One important initial activity was to gather information about the implementation level and the functionalities of existing immunisation information systems in European Union/European Economic Area (EU/EEA) countries. To do this, ECDC, in close collaboration with subjectmatter experts, developed surveys on IIS status and functionalities in EU/EEA countries.