Sri Lanka tracks COVID-19 vaccine jabs and vaccination certificate

The national COVID-19 surveillance system of Sri Lanka, based on the DHIS2 platform, was developed soon after the outbreak in Sri Lanka. The information system was critical for epidemiological monitoring and measures to control the outbreak and proved to be a key support to Sri Lankan health authorities’ battle against the disease. The system enabled health authorities from local to national level monitor the rate of vaccination in all regions of the country, including remote areas, and to identify areas where more effort was needed to protect the population through vaccination. The information system generated open-source real-time data which facilitated the government’s issuance of the digital Smart Vaccination Certificate (SVC). The certificate was required for travel abroad or other activity where presentation of the SVC was obligatory. Ease-of-access to the SVC was made possible by the COVID-19 immunization tracker, which was developed in 2021 by the WHO Country Office in Sri Lanka in partnership with the Health Information Systems Programme Sri Lanka, the core District Health Information Software (DHIS2) developers’ community from the University of Oslo, Norway, and the Information and Communication Technology Agency of Sri Lanka.

Sri Lanka was one of the first countries in the world to deploy a DHIS2-based COVID-19 vaccination information management system. This system was shared with other countries in the region as a public good and was adapted by Timor-Leste in developing their own vaccine tracker.

How did Sri Lanka do it, and how did the WHO Secretariat support Sri Lanka?

• Free and open-source – The immunization tracker was developed on the free and open-source DHIS2 platform and the generic tracker application was adapted to suit Sri Lanka’s needs. Its design was based on the WHO/United Nations Children's Fund (UNICEF) 2020 Guidance on Developing a National Deployment and Vaccination Plan for COVID-19 Vaccines.

• How the immunization tracker worked
  • The immunization tracker recorded the date each vaccine dose was administered as well as information on any adverse effects following immunization.
  • As the primary data source for COVID-19 vaccination information, the system was capable of measuring vaccine coverage by geographical area, age, gender, priority groups, and vaccine product.
  • It could analyse and make data visible on dashboards at different user levels, ranging from local level vaccination centers to district, provincial and the Ministry of Health, while serving as a platform to generate and disseminate the SVC.
• Key results of the immunization tracker
  • Obtaining real-time disaggregated data for accurate monitoring and evaluation of the COVID-19 vaccination process.
  • Measuring the uptake and coverage of vaccination over time in the different geographical areas and target groups.
  • Facilitating provision of the SVC according to national policies and to meet travel or other requirements.
  • Ensuring availability of data for use in coverage surveys, safety and disease surveillance and vaccine-effectiveness studies.

• Easy registration – Sixteen million records were pre-registered in the system using Sri Lanka’s National Election Database. User-interfaces and data flow were simplified. A comprehensive end-user package was developed to rollout vaccination registration nationwide in a short period of time. This included one-page user guides for each key function, standard operating procedures, vaccination system performance monitoring solutions, and short data entry training videos.

• Tools and training for data analysis – Standard and built-in analytic tools were used in DHIS2 for both basic and advanced data analysis. Basic data analysis was automated, and the outputs were displayed as pivot tables, graphs and charts and geographic information system (GIS) maps on the dashboards for each organizational unit level. Relevant stakeholders were trained on advanced data analytics. Detailed dashboards were generated for the different institutional levels from vaccine centers to district, provincial and national levels so system users could develop their own needs-based dashboards.

• Smart Vaccination Certificate (SVC) – An integral part of the immunization tracker, the SVC was upgraded through leadership from the technical team in the WHO Country Office. Developed in accordance with WHO guidelines, it included, among other things, a cryptographically verifiable QR code generated through the Digital Infrastructure for Vaccination Open Credentialing (DIVOC) server and was disseminated by SMS and email.

The main benefits of the development of the immunization tracker were two-fold:

1) Monitoring for COVID-19 vaccination coverage at national and sub-national levels; and

2) Verification through the SVC portal supported the government’s efforts to revive the economy by opening international travel and trade and was a critical support for Sri Lankans seeking employment overseas.

The immunization tracker reduced the risk of contracting COVID-19 by removing the need to visit Medical Officer of Health offices to obtain the SVC. The SVC online portal simplified, streamlined and improved accountability in the SVC issuance process and minimized the workload for Ministry of Health staff.

Photo Credit: © WHO Country Office in Sri Lanka

Photo Caption: COVID-19 vaccination centre and example of Smart Vaccination Certificate.