It’s among the most common situations in preventive care. An adult American walks into her annual physical and, during the conversation with her doctor, is asked a handful of questions about her recent vaccinations. 

Has she received her flu vaccine yet? When was her most recent Covid shot? Did she receive her second dose of the shingles vaccine? How about RSV? Pneumococcal disease? Tetanus?

Some individuals might have been fortunate enough to receive all of their vaccines from the same provider (and thus have much or all of their healthcare information centralized in a single electronic health record); a few others might have self-kept their records or committed each previous administration to memory. But given the ever-expanding list of recommended vaccines – not to mention constantly evolving prioritization and sequencing recommendations – the lack of universal vaccine records in the United States stands out as a true systemic blind spot.

Prior to the arrival of Covid-19, the creation of such a record didn’t rank high on the priority lists of many health-adjacent organizations. It fell in the nice-to-have bucket, rather than the must-have one. Nearly four years after the first Covid vaccine shots went into arms, the need is more pronounced.

Simply put, it cuts to the heart of patient well-being. An individual who can’t recall when or if she received a certain shot could be under-vaccinated or over-vaccinated. Without a more universal data set on vaccine uptake, pockets of under-vaccination are harder to identify for targeted education or interventions.

The consequences can be dire. It’s not uncommon for college-age students and young adults to receive the MenACWY vaccine (which protects against four strains of bacteria) and assume that they’re fully protected against meningitis – only to fall ill because they weren’t administered the MenB vaccine (which protects against a fifth).

This is said about far too many American healthcare systemic shortfalls, but it doesn’t have to be this way.

Mind you, the creation of a universal vaccine record system is a logistically daunting task. The sheer number of people and organizations who need to be on board for such an effort to succeed – patients, physicians, health systems big and small, hospitals, outpatient clinics, retail pharmacies and employers, just to start – is intimidating. And that’s before one attempts to tackle the system interoperability that’s an unfortunate defining characteristic of circa-2024 U.S. healthcare.

The good news: Few public-health officials and health-tech wonks believe that it’s too late to start now. Creating a universal vaccine record system may be a heavy technological lift, but most experts believe that the technical challenges can be easily enough overcome – and, in so doing, help the country get its vaccine-administration and -data houses in order in advance of a future pandemic. 

Don’t buy it? Look to Europe, where the U.K. and several Nordic nations have long had such records in place. It’s not an apples-to-apples comparison – in countries where healthcare is a government-led service, the maintenance of personal health information is centralized in a single place, as opposed to the U.S.’s mishmash of doctor’s offices, emergency clinics, retail pharmacies, grocery stores and employer sites – but vaccine records and systems upon which a U.S. service could be modeled do currently exist.

Before any such effort commences, however, two major questions must be answered. One skews toward the political/philosophical, while the other relates to leadership and infrastructure.

The rollout of Covid vaccines, still fresh in the public memory, didn’t proceed as smoothly as anticipated. In its wake, it left widespread mistrust: about the vaccines themselves, the mandates some people believe were misguidedly enacted and the ability of government health entities to ensure the security of personal health information.

Overcoming this skittishness and countering the reams of vaccine-related misinformation still festering in the digital realm represent a monumental challenge. Without addressing it, there’s a hard ceiling to the number of people who will avail themselves of a universal vaccine record, and thus a diminished potential benefit to the larger healthcare system.

Then there’s the question of who should head up the creation of a universal vaccine record. Fairly or not, the aforementioned trust issues could rule out some governmental agencies. UnitedHealth Group, Kaiser Permanente and other major insurers have much of the needed vaccine information in their own records – they know many of the shots you’ve received and when you’ve received them – but haven’t been especially keen in the past to share their data. It’s also worth noting that individuals switch payers and providers on a regular basis, meaning that even these organizations lack complete longitudinal information on the vaccine histories of the people they insure. Finally, these insurers, along with other non-public entities, might not be enthusiastic to assume a huge, time-consuming project that offers little promise of immediate public health or financial gain. 

Perhaps the CDC can serve as a convener of sorts. It could cast itself as the organization that, by dint of its size and influence, can rally together companies in pursuit of a universal vaccine record system. They could unify a coalition of payers and vaccine manufacturers, then tap a health-minded tech organization – Google or Apple come immediately to mind – to lead the creation of the universal record. It will take a community effort to address a key problem: That public health agencies and healthcare providers have limited access to personal vaccine data, and thus are unable to provide appropriate education and interventions.

Once these two problems are addressed, rolling out the universal vaccine record program to the broader public should prove comparatively undemanding. The goal would be to start small with a motivated population: Adults who are pro-vaccine and eager early adopters of programs designed to improve their health. Many of these people are enthusiastic users of health apps, so it’s not a reach to assume they would be willing to share their data (essentially, what vaccines they received and when they received them).

A modest, successful launch – one in which the health-tech community can provide support in the form of addressing logistical and operational roadblocks – could ease some of the fears related to government overreach and health data privacy. In theory, that could prompt states to pilot vaccine record programs of their own.

What’s missing is that first win. But once it happens – and people in all reaches of the healthcare business are optimistic that it will – the push toward a universal vaccine record will accelerate. It makes far too much sense not to.

Have some thoughts on the need for a universal vaccine record, or ideas that could accelerate its creation? Drop us a note at [email protected], join the conversation on X (@KinaraBio) and subscribe on the website to receive Kinara content.