Leapfrogging with technology: introduction of a monitoring platform to support a large-scale Ebola vaccination program in Rwanda.

Continued outbreaks of Ebola virus disease, including recent outbreaks in the Democratic Republic of the Congo (DRC), highlight the need for effective vaccine programs to combat future outbreaks. Given the population flow between DRC and Rwanda, the Rwanda Ministry of Health initiated a preventive vaccination campaign supported by a vaccination monitoring platform (VMP). The campaign aimed to vaccinate approximately 200,000 people from Rwanda's Rubavu and Rusizi districts with the two-dose vaccine regimen Ad26.ZEBOV, MVA-BN-Filo. The VMP encompassed: biometric identification (iris scanning), mobile messaging, and an interactive reporting dashboard. The VMP collected data used to register and identify participants at subsequent visits. Mobile message reminders supported compliance. To 13 November 2020, the campaign was half complete with Ad26.ZEBOV administered to 116,974 participants and MVA-BN-Filo to 76,464. MVA-BN-Filo should be given to participants approximately 8 weeks after the Ad26.ZEBOV with a compliance window of -14 and +28 days. Of the 83,850 participants who were eligible per this dosing window for the subsequent MVA-BN-Filo vaccine, 91.2% (76,453/83,850) received it and 82.9% (69,505/83,850) received it within the compliance window defined for this campaign. Utilization of the VMP was instrumental to the success of the campaign, using biometric technology, dashboard reporting of near real-time data analysis and mobile phone communication technology to support vaccine administration and monitoring. A comprehensive VMP is feasible in large-scale health-care campaigns, beneficial for public health surveillance, and can allow effective response to an infectious disease outbreak.

Overcoming the challenges of iris scanning to identify minors (1-4 years) in the real-world setting.

OBJECTIVE: Biometric identification techniques for pediatric use are limited. This investigation studied iris scanning in minors aged 1-4 in two exploratory studies in Belgium (n = 197) and Sierra Leone (n = 230), and in a subsequent clinical study in Sierra Leone (n = 635). Images of participants' irises were captured using a camera, while a survey assessed the ease of use with children. RESULTS: The image capture success rate per individual was high; 86.0% of the participants had ≥ 2 successful captures. Iris scan quality and surface were similar in all age groups and in the matching population database. When including feasibility in the analysis of minors aged 3-4, sensitivity and specificity were non-inferior compared to using the biometric of a guardian. However, the quality of iris scanning in minors aged 1-4 was worse than the iris scanning reference quality in adults. A mean total usability score of 1.55 ± 0.27 was calculated; a usability threshold of 1.45 is required for routine use. Overall, this technique is feasible in minors aged 3-4, replacing the use of guardian biometrics. Additional work is ongoing to improve this technique further, striving for uniformity from the age of 1.