As vaccination rates continue to decline and infectious diseases become an increasing threat to global health, it is important to engage with citizens to build trust in vaccination.
Providing citizens with a means of communicating with competent authorities about their motivation, doubts and questions could help invert this trend.
Through the Yellow Button, citizens could, if they wished, express their vaccination hesitancy by completing specific questionnaires, provided by the competent regional or national authorities via EHR portals and apps, to share with them their hesitancy motivations. Additionally, through the same platforms they could receive selected scientifically evidence-based information about the risks and benefits of the specific vaccine, or even further details about how they are developed and how they work.
On one hand, this would help public health authorities better understand the causes of vaccine hesitancy and plan interventions; on the other, it would support informed decision-making on immunization by citizens, reducing the chances of decisions being influenced by non-scientific information easily found online. Through the Yellow Button citizens could also have the chance to add vaccination information to their EHR as self-reported information if not already included.
Document Version: V1.0
Responsible Party: xShare WP4
Source:
As-Is Situation
While vaccination information is included in the patient summary, patients cannot usually add EEHRxF data on vaccination themselves. This might be needed for example, if they received a vaccination in a different country. Furthermore, citizens are often exposed to multiple sources of information about the benefits and risks of vaccination, making it challenging to identify reliable, evidence-based content on which to base informed decisions.
Currently available products/services and its vendors
EHR
Which health-related standard does your organisation uses and its alignment to the EEHRxF?
Patient summary, questionnaires
Actors/Users and their Roles
| Citizens | Receive selected scientific information about benefits and risks of specific vaccinations. They are also able to send EEHRxF-compliant additional vaccine information to their EHR.Citizens can also be anbled to provide vaccine hesitancy information though specific questionnaires provided on their health portals/web by public health authorities |
| Local Public health authorities | Provide information about risks and benefits of vaccination when requested. Receive EEHRxF-compliant additional data from patient about vaccination and in case, approve its inclusion in the EHR. Authorities can decide to collect information on vaccine hesitancy through standardised questionnaires distributed through the health portals/apps. |
User Perspective
Citizens can obtain selected information by relevant authorities on benefits and risks of vaccination. Additionally, they can add vaccination information, if missing, to their EHR.
Citizens can also be invited to provide vaccine hesitancy information to public health authorities via standard questionnaires through their health portal/apps.
System Perspective
EHR systems should be enabled to accept data on immunization status directly from citizens if not already included.
The Yellow Button can be used to trigger download of vaccine safety and efficacy information.
The Yellow button could be used to upload vaccine hesitancy information.
Health Information Domain(s) – HIDs:
- Patient Summary
Scenarios for the xShare Yellow Button
| HIDs | xShare Yellow Button basic functionality | Maturity | |||
| Download | One-time share | Linked options | Start TRL | End TRL | |
| Patient Summary | x | Upload | 0 | 0 | |
xShare Yellow Button
The Yellow Button can be used to download selected vaccination-specific information on the patient personal page.
The Yellow Button can be used to upload additional vaccination-specific information to the EHR. The Yellow Button can be used to upload also vaccine hesitancy information from citizens
National/regional strategy
National and regional public health authorities could base interventions on more complete vaccination data also addressing hesitancy issues with targeted actions.
Strategy towards EHDS
Empower patients to make informed decisions and share their data
Business Goals/Benefits and KPIs
- Provide patients with selected scientific information about the risks and benefits of vaccination to help increase vaccination rates.
- Ensure that all vaccination records, including those obtained in other European countries, can be included.
- Understand the causes of vaccination hesitancy
- Increase vaccination rates
KPIs
- Number of downloads of vaccine information
- Number of uploads of additional vaccine information
- Numbers of vaccine hesitancy questionnaires submitted
Application
Yellow button, EHR
Data Preconditions
EEHRxF compliance (also for the vaccine hesitancy questionnaire)
System Preconditions
Yellow Button-enabled EHRs.
User Preconditions
Citizens are willing to receive and provide information on vaccinations
Trigger
Need for trustworthy information/Possibility to add data to EHR
Challenges/Limitations
Set up of the download and upload functionalities for vaccine-related data
Involved stakeholders in the BUC definition
Charité, EHTEL, Sciensano
Application of pseudonymisation filters
No
Basic Workflow
- Citizen is hesitant to receive vaccination because he/she is not sure about positive/negative effects of the substance. They fill out a standardised questionnaire offered by the competent authorities through the patient app/portal and click the Yellow Button to upload their answers and share with them the reasons for their hesitancy.
- Through the Yellow Button citizens can also request and receive specific scientific evidence- based information on the safety and efficacy of vaccination
- Citizen read the scientific material and decides to get vaccination
- Through the Yellow Button updates his/her EHR if the information is not up to date
- Public health authorities identify possible causes of vaccine hesitancy and plan targeted communication campaigns
