Outcomes and costs of the transition from a paper-based immunization system to a digital immunization system in Vietnam

The electronic National Immunization Information System (NIIS) was introduced nationwide in Vietnam in 2017, and starting in 2018, Hanoi and Son La provinces transitioned to paperless reporting. This study analyzed pre- and post-intervention data to assess changes in NIIS data quality, changes in immunization program outcomes, and the economic costs of using the NIIS versus the traditional paper system.

The findings show that data timeliness significantly improved in both provinces after transitioning to the NIIS, though improvements in data quality were not associated with improvements in the immunization program outcomes, though the COVID-19 pandemic likely had a negative influence on these.

Up-front costs associated with developing and deploying the NIIS were estimated at US $0.48 per child in the study provinces. The commune health center level showed cost savings from changing from the paper system to the NIIS, mainly driven by human resource time savings. At the administrative level, incremental costs resulted from changing from the paper system to the NIIS, as some costs increased, such as labor costs for supportive supervision and additional capital costs for equipment associated with the NIIS.