Deploying Electronic Immunization Information Systems in Low and Middle Income Countries in Response to COVID-19: Systematic Review of Best Evidence Practices

Background: Electronic Immunization information Systems (IISs) have been recognized as crucial in the response to COVID-19. For low and middle income (LMIC) countries, establishing an effective IIS or expanding existing IISs for mass vaccination needs may be challenging. This systematic review aimed to highlight some of the best evidence practices around IISs benefiting LMICs in its pandemic response as well as in strengthening routine immunization settings.Methods: In this systematic review, we searched PubMed and IEEE Explorer as well as selected peer reviewed journals and grey literature for studies around health information systems published from 2011 to 2021. We used a search phrase consisting of keywords information system, vaccine registry, vaccine, immunization, electronic, mobile and e-registry linked with Boolean operators. Selected publications were screened for its relevance before applying a thematic analysis technique to identify the key themes emerging from these studies. Findings: We identified 405 studies and 131 were selected for the full text review. There were case studies(n=26), cross-sectional studies(n=13), randomized control trials(n=7), experimental studies(n=6), system reviews(n=4), cohort studies(n=3) and 17 other studies belonging to 12 study types. Five key themes were identified and these were scope of IISs (n=15), immunization related functionality(n=48), socio-technicality of IISs(n=29), scalability of IISs(n=19), and quality enhancement(n=8). We have used these themes to present the most notable elements or areas of interest around IISs.Interpretation: We highlight the scope of IIS, key elements related to functionality, socio technicality, scaling and quality enhancement of IISs that need focus when such systems are implemented, particularly in LMICs. We believe these elements help overcome IIS related inter-connected concerns of user expectations, technology readiness, and the need for citizen participation in a particular context.Registration Details: The protocol for this study was published in PROSPERO (Reg. No: CRD42021229030) prior to commencement of review.Funding Information: No funding to declare.Declaration of Interests: No competing interests to declare.