Governments Will Want to Track Who Has Had a Covid-19 Vaccine

Getting the vaccine in Newcastle, England, on Tuesday, when the U.K. rolled out its inoculation program.

Getting the vaccine in Newcastle, England, on Tuesday, when the U.K. rolled out its inoculation program.

Photo: Owen Humphreys/Associated Press

SYDNEY—As they prepare to roll out Covid-19 vaccines, governments world-wide are grappling with how to keep track of those who have been immunized.

Many developed countries maintain lists of who has received vaccines, but those registries can rely on incomplete data provided voluntarily by doctors, pharmacies and even health-care providers that distribute flu shots to corporate clients in winter. The U.S. doesn’t have a national database, but states and some localities maintain their own.

Health experts say it will be crucial for governments to monitor accurately who gets inoculated, particularly because many vaccines are under development and some are expected to require multiple doses. Widespread tracking would also enable health officials to detect any adverse reactions, which is important because the vaccines are being developed much faster than usual.

“It is mandatory to have this kind of information to protect the health of the population,” said Terry Slevin, chief executive of the Public Health Association of Australia. Government health officials there plan to require health-care providers to report who gets a coronavirus vaccine to that country’s register.

Requiring reporting presents several challenges to authorities, including the security of patient health data. Early in the pandemic, an Australian government initiative to develop an app that would record whether someone was in contact with anyone infected with the coronavirus foundered when many people avoided it on privacy grounds.

Knowing who has a vaccine could enable economies to open up more quickly. Airlines are among the companies that could benefit from the data. Getting vaccination information directly from the government could allow them to more easily clear passengers for overseas travel. However, some governments have said they wouldn’t disclose the data to private companies and that people would need to decide for themselves whether to provide their vaccination status to businesses.

In the U.K, which rolled out a vaccination program this week after  granting emergency-use authorization to a vaccine from
Pfizer Inc.
and
BioNTech SE,
senior health officials say coronavirus vaccinations must be recorded by a person’s primary-care doctor. The U.K. regulator said a random selection of people who receive the vaccine would be sent letters asking them to take part in a survey for long-term monitoring of its effects.

The vaccine is also being reviewed by the Food and Drug Administration in the U.S., where a similar emergency authorization could come later this month and a rollout before the end of the year. The U.S. Centers for Disease Control and Prevention is backing a smartphone-based system, called V-Safe, that can conduct health checks on vaccine recipients through text messages. An existing national system that collates reports of vaccine problems from doctors, vaccine manufacturers and the public will also be used to monitor the rollout.

Health experts say it will be crucial for governments to monitor accurately who gets inoculated.

Health experts say it will be crucial for governments to monitor accurately who gets inoculated.

Photo: dado ruvic/Reuters

Efforts to create a national U.S. vaccine registry failed in the early 1990s, in part because people were uncomfortable with submitting their personal information to a database maintained by the federal government, said Rebecca Coyle, executive director of the American Immunization Registry Association. Some states have signed up to a new system that will allow them to more easily share information with one another on who has received vaccines.

“It’s sort of a hodgepodge of policies out there,” said Ms. Coyle, noting that not all states have the same reporting requirements for their registries.

An effort by the CDC, however, to use this new data-sharing system to collect information on who has received coronavirus vaccines is running into resistance, Ms. Coyle said. Jurisdictions are being asked to sign agreements that will allow the data to be shared with the CDC, though some personally identifiable information could be stripped away.

Ms. Coyle said she is concerned people would be more hesitant to receive a coronavirus vaccine if they know their personal information could possibly be accessed by the federal government. States and localities have years of expertise running their own vaccine registries and reporting the relevant statistics while protecting personal patient information, she said.

“They can manage what’s happening in their jurisdictions. To send all that up to the CDC and expect them to do it, I don’t think it’s going to go as well as everyone hopes it will go.”

The CDC didn’t immediately respond to a request for comment.

In Japan, municipalities are obliged by law to keep vaccine-administration records for five years or more on a ledger, which includes a person’s name and address. Coronavirus vaccines will be administered like any other, a health-ministry official said. South Korea also requires vaccines for other diseases to be recorded on its vaccine registry and will likely also require coronavirus vaccines to be recorded, a South Korean health official said.

The experience in Australia—which set up its registry in 1996 to record children’s vaccines—highlights the difficulties in reliably tracking who gets vaccines. More than 90% of many children’s vaccines administered are now reported to the database, but the adult reporting has been much less comprehensive. It was only expanded to include adult vaccinations in 2016.

The register’s data is more reliable for children in part because those vaccines are often given in doctor’s offices, which frequently have software that makes it easy to report information to the register, said Frank Beard, a public-health physician and associate director at the National Centre for Immunisation Research and Surveillance, an independent research organization. Adult vaccines, such as for the flu, are more often given in workplaces by providers that don’t automatically link to the system, he said.

“The stimulus for making reporting mandatory is obviously the rollout of the Covid vaccination program,” Dr. Beard said.

Australia offers government-funded health care to its citizens and has high vaccination rates. About 95% of 5-year-olds are considered to be fully vaccinated against the usual diseases, according to government data. Still, antivaccine activists held rallies in several Australian cities earlier this year. A recent survey from Australian National University found that 13% of Australians definitely won’t or probably won’t get a coronavirus vaccine.

Australians won’t be required to receive the vaccine, said Health Minister Greg Hunt. Authorities are on track to possibly approve coronavirus vaccines by the end of January, with the first inoculations for health-care workers and residents of retirement homes in March.

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Write to Mike Cherney at mike.cherney@wsj.com