Scanning 2d barcodes on vaccine vials to link vials to immunized child, a pilot study

Abstract Background Vaccine stockouts contribute to millions of children missing their routine immunizations globally. This is often due to inadequate forecasting and management of vaccine stocks, especially in low and middle-income countries, such as Pakistan, already characterized by suboptimal coverage. Tracking vaccines via 2D barcodes on each vial, could improve management of vaccine stocks. Vial level data can then be linked to Electronic Immunisation Registry (EIR) data (2D Bar codes already used), facilitating data quality improvements which could unlock programmatic gains. Our aim was to test feasibility and acceptability of scanning vaccine vials in a “live” setting. Methods We conducted a pilot in 12 vaccination sites in Karachi/Pakistan. Vaccinators were divided into 3 groups and allocated to use one of the following: their existing android phone (government of Sindh's Zindagi Mehfooz [Safe life; ZM-EIR]); a Zebra touch computer; a handheld scanner. The box of dummy vaccine vials of pneumococcal conjugate vaccine (PCV) and oral polio vaccine (OPV) each with a 2D barcode on it, was scanned by the stockroom manager prior to deployment. Vaccinators were required to scan the corresponding dummy vial and immunization cards while working. We integrated the OneScanTM API on the ZM-EIR to link vial to child data and evaluated the vaccinator's experience through thematic analysis of interviews. Results 2,310 vaccine vials were scanned and linked to immunized children (Zebra Touch Computer 72.6%, Android phone 19%, Handheld device 8.4%). Overall, vaccinators gave positive feedback and highlighted that scanning vials would simplify their work and save time, contingent on the program going paperless. Likewise, managers outlined digitally tracked vials would greatly reduce stock mismanagement. Conclusions Linking vaccine vial to child is a feasible and effective solution for vaccine stock management, acceptable by both vaccinators and stock managers. Key messages Linking vial to child is an acceptable method for accurate vaccine stock management and usage, improving forecasting and reducing stock outs. Linking vial to child will better facilitate rapid tracking of reported adverse events from vaccinated child back to the exact vaccine vial.