Immunizations & Vaccination Schedule in O3 (GSOC 2025)

Priority User Stories / Goals

1. See status: where they are with what’s been given

2. Remind about what’s due, what’s missing

3. See what’s upcoming: Is there something due I can give them, even if they’re here for something else? Do I need to book an appointment or remind them to come in for an upcoming dose?

4. See standards/best practice recommendations: Via a link or picture of the latest guidance.

Context

• Immunization “schedules” are like “Timings”: A place’s immunization schedule shows “when a certain immunization is meant to be given, and how many times, after how long of intervals.” They also help to:

  • Show a record of what & when things were given

  • Prompt a provider to remember that something else is due

  • Guide a provider in cases that are not clear (e.g. catch-up, medical risk factors, and more). → EMR Scope: Because this gets so complicated, EMR will not replace the detailed guidance/documentation for providers on schedules and caveats.

• Differences: These Schedules are often different by country or region. Just look at the WHO’s records to see comparisons showing how many countries have different timings for different types of immunizations.

• Key Concepts:

  • ⚠️ Children: Babies, toddlers, and school-aged children are high-priorities for vaccination because they are the most vulnerable to infectious diseases. If you like cartoons, these visuals are a fun way to learn how certain immunizations at particular ages protect kids from certain diseases.

  • 🟡 Adults: Adults need regular vaccinations too. So there are usually different Vaccination Schedules for Adults as well.

  • 🔴 People with Risk Factors or Medical Conditions: These people

  • ⚠️“Catch-Up Immunization”: It is very common for a child (or adult!) to receive a vaccination late, for many legitimate reasons. When this happens, there is often guidance for clinicians about the time-range of the patient’s age or time-range after the last dose for when the next immunization should be given.

  • Series vs Series re-start: _____

Examples from around the world

Electronic Examples from other Systems

⚠️ Important Requirements

• To do: Review FHIR requirements & considerations / insights https://www.hl7.org/fhir/immunization.html

• Concept-driven: For example, Partners In Health uses these CIEL concepts (obsgroup with obs for immunizations, immunization sequence number, and vaccination date): https://www.openconceptlab.org/orgs/CIEL/sources/CIEL/concepts/1421/

• Configurability. These Schedules are often different by country, state/province, region, or even organization (I know, it’s surprising it’s not the same world-wide!). This means this feature will need to be very configurable.

• Lessons Learned from PIH:

  • Challenge: Immunization schedule for children goes beyond Booster 1, 2 → e.g. 5+ doses of deworming. May not be part of immunization schedule but ARE a part of their immunization history. And, handling how you capture Catch-up / Off-Schedule and Series re-start.

  • Configuration logic is a lot. e.g. Vitamin A: If they don’t get BGC at birth, but at 6 weeks, do you enter it in the “Birth” column? Too inflexible.

  • Easier to just allow people to enter in the individual immunizations, then display.

  • Allows for Past Data Entry:

    

  • So: Made changes to visual layout. Want to focus on showing info (display), rather than for data entry or CDS.

Doesn’t show “Next due”, Series, etc etc. Alert for “Third dose due on XX date”?

Why not editable in dashboard? Didn’t want someone entering from dashboard because want it to be recorded within a Visit’s Encounter. But, want something easy to enter.

Key for pregnancy

View only chart:

Bulk Vaccination e.g. 100 Polio vaccine day.