High agreement between the new Mongolian electronic immunization register and written immunization records: a health centre based audit

Abstract

IntroductionMonitoring of vaccination coverage is vital for the prevention and control of vaccine-preventable diseases. Electronic immunization registers have been increasingly adopted to assist with the monitoring of vaccine coverage; however, there is limited literature about the use of electronic registers in low- and middle-income countries such as Mongolia. We aimed to determine the accuracy and completeness of the newly introduced electronic immunization register for calculating vaccination coverage and determining vaccine effectiveness within two districts in Mongolia in comparison to written health provider records.MethodsWe conducted a cross-sectional record review among children 2–23 months of age vaccinated at immunization clinics within the two districts. We linked data from written records with the electronic immunization register using the national identification number to determine the completeness and accuracy of the electronic register.ResultsBoth completeness (90.9%; 95% CI: 88.4–93.4) and accuracy (93.3%; 95% CI: 84.1–97.4) of the electronic immunization register were high when compared to written records. The increase in completeness over time indicated a delay in data entry.ConclusionThrough this audit, we have demonstrated concordance between a newly introduced electronic register and health provider records in a middle-income country setting. Based on this experience, we recommend that electronic registers be accompanied by routine quality assurance procedures for the monitoring of vaccination programmes in such settings.

Determining the pneumococcal conjugate vaccine coverage required for indirect protection against vaccine-type pneumococcal carriage in low and middle-income countries: a protocol for a prospective observational study

“…In Mongolia, we have validated the newly introduced electronic immunisation record against clinic health records, finding a high degree of concordance. 31 We are also in the process of validating the population registers at health centres in Mongolia.…”

Direct and indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with pneumonia from formal and informal settlements in Mongolia: an observational study

“… 17 , 47 The electronic immunisation register, which was used as an adjunct to parent-held child health cards to determine participant vaccination status, has previously been demonstrated to have high degree of accuracy when compared to family health centre records. 23 However, at a district level, population movement between districts eligible and ineligible for PCV means that the real vaccine coverage may be lower than the documented administrative estimates. This suggests that indirect effects may in fact be achievable in Mongolia at lower rates of vaccine coverage than we have reported.…”

“…PCV13 status was determined using written records from parent-held child health cards and validated against an electronic immunisation register. 23 PCV13 vaccination status was based on documented PCV13 doses at least 14 days before enrolment. Participants were defined as ‘vaccinated’ if they received an adequate number of doses for immune protection (i.e., two or more PCV13 doses at <12 months of age or at least one dose after the age of 12 months).…”

Evaluation of a phased pneumococcal conjugate vaccine introduction in Mongolia using enhanced pneumonia surveillance and community carriage surveys: a study protocol for a prospective observational study and lessons learned

“…A paper-based log of all queried and corrected values is maintained by the PCV impact evaluation team. An electronic register of PCV13 dose administration was developed for use in the immunisation clinics [ 39 ]. Information recorded on the CRF regarding the case’s PCV13 status (ideally documented by direct reference to the patient-held immunisation card, or if not available by parent report) is validated against the PCV13 immunisation database.…”