The digital COVID vaccine system in Bhutan that ensures no one is left behind

After Bhutan’s remarkably rapid and successful COVID-19 campaign of vaccinating more than 70 percent of the country’s population, managed by the innovative digital Bhutan Vaccine System supported by UNDP, the country turns its focus to ensure that no children between the ages of 12 and 17 are left behind in being vaccinated.

Teachers and health workers pre-screen students using the Bhutan Vaccine System during a COVID-19 vaccine campaign at Bajo Higher Secondary School, Wangduephodrang. Photo: UNDP/Kinley Wangmo.

The multipurpose hall at Bajo Higher Secondary School in Wangduephodrang was abuzz with activity. Students filing in through the back door were greeted by a group of teachers and health staff with the Bhutan Vaccine System open in their mobile phones, ready for pre-registration before the COVID-19 vaccine was administered.

The students, all between 12–17 years old were lined up for their first dose of the vaccine, procured by the Royal Government of Bhutan earlier this month.

The vaccination rollout for the children, which ran from 18 to 21 September, saw 99 percent of the children in the 12–17 age group receive their first dose of COVID-19 vaccine. A total of 75,205 children received doses of Moderna and Pfizer vaccines.

To ensure smooth and efficient rollout of the vaccines, soon after the vaccines landed in the country, district health officers advised local governments, district administration and schools to inform parents to register their children for the vaccine on the UNDP supported Bhutan Vaccine System.

The Bhutan Vaccine System is an innovative digital system that registers, tracks and manages COVID vaccine beneficiaries that was put in place for Bhutan’s remarkably successful COVID-19 vaccine campaign with support by UNDP, in close collaboration with WHO and UNICEF. The system has been critical in ensuring real-time data for an equitable, effective, safe and efficient rollout of vaccine doses, ensuring quick delivery and comprehensive coverage. The key features of the system include monitoring stock, providing pre-registration, generating vaccination schedules, monitoring and tracking side effects following vaccination, as well as generating real-time reports and producing vaccine certificates.

To help students who could not register themselves or had parents who were not literate, teachers took on the task to register them. While some districts started their vaccination campaigns on 18 September, Wangdue administered it on 20 and 21 September, following a local festival.

Behind the success of the rollout was the concerted effort of various stakeholders, including the local government, health centres, hospital staff, health ministry and schools.

12–17-year-old children are pre-screened before receiving COVID-19 vaccine shots at Bajo Higher Secondary School in Wangduephodrang. Photo: UNDP/Kinley Wangmo.

Over the two days, over 4,000 children were vaccinated in the district through its 21 vaccination centres.

At the Bajo high school pre-screening desk, teachers volunteered to check if students were registered for the vaccine. Then the health workers took over and screened the children by asking a series of questions related to health, medication and allergies, which were entered into the Bhutan Vaccine System, before they were vaccinated by nurses.

Outside, students who received their doses waited the 30-minute observation time, before being cleared to go home. Those who reported adverse events after immunization were attended to, although no serious ones were reported.

A school captain provides comfort to a student receiving a COVID-19 shot. Photo: UNDP/Kinley Wangmo.
Students sit outside the centre for the 30-minute post vaccination observation period. Photo: UNDP/Kinley Wangmo.

According to Bajo Higher Secondary School Principal Shankaralal Dahal, of the 1,121 students in the school, 889 were in the 12–17 age group.

“Some parents registered their children for the vaccine and higher-grade students had registered themselves,” he said, adding that those who could not register themselves at home were assisted by the class teachers.

“Except for a few cases, where students couldn’t remember their citizenship identity card numbers, it went smoothly,” he said, noting the Bhutan Vaccine System was easy to use and essential to the success of the vaccinations.

In Jalla Primary School, about two hours from Bajo, officials went above and beyond to ensure no child was left behind. “Owing to access issues because of bad road conditions and unavailability of vehicles to transport the children to a vaccine centre, two health staff from the Jalla primary health care centre were sent to vaccinate the children,” said district health officer Tshering Zangmo. “The local government office provided a vehicle to transport the health care workers and the vaccines.”

Children line up outside Jalla Primary School vaccination centre for their first dose of COVID-19 vaccine. Photo:UNDP/Kinley Wangmo.
A monk receiving his first dose of COVID-19 vaccine shot at Jalla Primary School. Photo: UNDP/Kinley Wangmo.

The principal and four teachers at the school registered the students for vaccination. A monk from a nearby monastery was also vaccinated at Jalla school.

Principal of Jalla school, Namgyal Dorji, said that without the Citizenship Identity Card (CID) numbers in school records, students were registered using the date of birth provided to the school. In the Bhutan Vaccine System, where CID numbers are unavailable, registration can be done using the ‘others’ option.

However, to confirm that the children were not below 12 years of age on the vaccination day, the teachers contacted family members and asked for the CID numbers. By using the CID number for registration, it was found that some of the students were not eligible for the vaccine. Through the Bhutan Vaccine System, which is linked to the census and registry information, the real birth dates and years could be traced and established with accuracy.

With the rollout successfully completed, health ministry officials are currently going through the data registered in the Bhutan Vaccine System, and health workers will now vaccinate any remaining vulnerable children who were missed during the campaign at their homes, leaving no one behind.

Jalla Health Assistant Tshering Zangmo pre-screens a school girl before the vaccine shot. Photo: UNDP/Kinley Wangmo.

The campaign was guided by His Majesty the King who secured the vaccines for the eligible population in Bhutan.

Jalla Primary School children who received the first dose of COVID-19 vaccine with the school staff and health workers. Photo: UNDP/Kinley Wangmo.

Story by Kinley Wangmo, Programme Communications and Advocacy Analyst, UNDP Bhutan and Ian Mungall, Programme Analyst (Communications and KM), UNDP Bangkok Regional Hub with contributions from Sangay Wangmo, Portfolio Head, Governance and Advocacy, UNDP Bhutan and Hakan Bjorkman, Regional Health and Development Advisor for Asia and the Pacific, UNDP.

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