The US must develop a national vaccine registry

Vaccine distribution in the United States to this point has been inefficient and ineffective. The incoming Biden administration offers hope that efforts can be turned around, but the concrete strategies to accomplish the turn-around are yet to be detailed. To simplify vaccine data systems, I propose a national vaccine registry that tracks vaccination records across the country. What would a national vaccine registry look like, and how would such a system help public health officials with their vaccine efforts?

The most straightforward aspect of the national vaccine registry would be managing records for who has received the vaccine and who has not. If the U.S. government anticipates vaccinating all 300 million-plus Americans, there must be a standardized system to keep tabs on who has received their shots. A method for tracking vaccines nationwide exists in Operation Warp Speed’s Tiberius, but the path for data to reach this system is fragmented.

After a patient has their vaccine administered, a physician inputs their data into their state’s immunization information systems, which takes several steps between the CDC, state health officials, commercial distribution centers, mass data storage centers and more before it reaches Tiberius. The process needs to be simplified and streamlined. Physicians must be able to upload vaccine data directly to a national registry and associate the patient’s social security number with a vaccine ID. This would produce an accurate and continuously updated track of who is vaccinated and who is not.

The registry comes with secondary benefits. Associating patients with a vaccine ID means we could have national data on vaccine efficacy. Physicians could update vaccine ID profiles if a patient comes back with COVID-19 symptoms after being vaccinated. Then we could see which vaccine they took and oversee long-term efficacy by the vaccine manufacturer. This would also present the opportunity to track long-term antibody duration and analyze that data based on demographic information.

The incoming Biden administration seems willing to adopt such a program. It ambitiously aims to administer 100 million vaccines in its first 100 days and, according to Democratic strategist Liza Acevedo, will “utilize every resource possible” to achieve that goal. The opportunity to right the ship with an incoming administration is promising and hopeful.

To achieve such an efficient and complete national registry, we should look to other countries that have already accomplished the same. Australian health officials require providers to report vaccine administrations, including for the ongoing COVID-19 vaccines. Terry Slevin, chief executive of the Public Health Association of Australia, notes that “it is mandatory to have this kind of information to protect the population’s health.” Australia has done a phenomenal job of controlling the pandemic, with daily infection rates fewer than 1 in 100,000 people.

Japan and South Korea are requiring similar registries for their COVID-19 vaccination efforts. Both countries had codified vaccination registries before the pandemic, requiring municipalities to maintain administration records for years after the visit. Both Japan and South Korea have controlled COVID-19 with a similar aptitude as Australia. Japan’s current daily infection rate is 5 in 100,000, and South Korea’s is as low as 1 in 100,000.

These other nations, which inarguably have handled the pandemic far better than the current U.S. administration, are concluding that a national vaccine registry maintains quality and consistent records of vaccinations. Scientists estimate that at least 70 percent of a population needs to be immune to COVID-19 to achieve herd immunity. In the United States, that number is around 230 million vaccinations. If we are to achieve that, there should be a simplified and standardized way to track who has had their shot and who has not. It’s up to the incoming Biden administration to take the reins and implement such a system.

William Haseltine is president of ACCESS Health International. An infectious disease expert, Haseltine was formerly a Harvard Medical School professor and founder of the university’s cancer and HIV/AIDS research departments.