The COVID-19 pandemic has disrupted billions of lives worldwide leading to over 1.8 million deaths while unleashing serious economic hardship with outsized impacts on the poor and precariously employed. But the start of vaccination campaigns around the world now raises hopes for a global recovery.
However, vaccine delivery—including their distribution and administration—comes with challenges including manufacturing delays, the availability or reliability of ultra-cold supply chains, risks of delays in vaccine shipments crossing borders, prioritization of populations to receive vaccinations, complexity of scheduling vaccinations, ensuring the quality of vaccines, tracking recipients for follow-up, and ensuring that the majority of people are mobilized and vaccinated.
Given the anticipated scale and speed of the vaccine delivery process, digital technologies can play a critical role to support the planning, delivery, monitoring, and management of vaccination programs. Indeed, there are many tools being considered to support vaccine delivery efforts, globally. In some cases, countries are testing new registration or decision support systems including using open source platforms. Existing digital tools could also be rapidly deployed in support of the vaccination effort. Countries like India plan to repurpose digital platforms used in ongoing immunization programs to track the movement of stocks of COVID-19 vaccines.
The design and implementation of these digital tools will need to consider the infrastructure and regulatory environment in each country. These vary significantly across and within countries and interventions will typically need to be designed specifically for the context in which they are to function.
For example, the success of digital logistics applications that use mobile networks will depend on the coverage and quality of mobile network in a country. Similarly, digital vaccination recording and follow-up systems may benefit from using ID systems to determine eligibility and track patients between doses if those systems and digitized and offer reliable unique identification of the population. These systems should also be secured to prevent unauthorized access or tampering of data, and to protect the privacy of patients and staff. And the ability of governments to use personal data to prioritize and track vaccination programs will also depend on the legal and regulatory framework around personal data use, as well as the data governance and exchange platforms to share and match data.
A balancing act
Hence, the use of digital tools for such a large-scale and high-profile activities will also create challenges and risks for governments. Challenges include identifying and deploying appropriate tools given the variations in the digital readiness of countries, the coverage and capacity of communications networks, the capacity of governments to design and implement digital solutions, and the level of digital literacy among healthcare workers and the population.
Risks emerge due to weaknesses in regulation of digital technologies, the possible exclusion of people or locations due to design flaws, or because of limited institutional capacity. For example: how might national vaccine delivery programs be designed in countries where there are widely varying levels of digital capacity (e.g., between urban and rural areas)? How should countries manage issues of data security and privacy or respond to low levels of trust? Cybersecurity risks should also be considered with hackers already targeting the COVID-19 vaccine supply chain and stealing data related to vaccine development.
Countries will need to ensure that the “must-have” enablers and safeguards are in place, permitting the use of appropriate digital tools. This will be specific to each country, given the multitude of combinations of country digital readiness, type of vaccines being delivered, and mix of digital tools that are appropriate to the social and economic context.
Our initial analysis finds that must-have enablers and safeguards include widespread telecommunications connectivity, data storage and interoperability capabilities, cybersecurity measures, robust privacy and data protection frameworks, inclusive and trusted identification systems, and data standards and interoperability frameworks.
Some digital enablers also could be rapidly expanded, scaled up, or deployed to support the effort. For example, strengthening and expanding the coverage of foundational ID systems, working with governments and private sector service providers to expand access to the internet and provision of mobile devices for program delivery, or to rapidly expand capabilities of existing information system through private, secure cloud-based service providers.
Digital technologies could play a critical and useful role as humanity embarks on what will likely be its largest public health campaign. COVID-19 vaccine development has already demanded an immense yet careful scientific effort. As countries worldwide deliver countless vaccinations to protect people’s physical health, they should similarly seek to harness digital technologies but manage the associated risks and challenges through the right mix of enablers and safeguards.