National Immunisation Registry (NIR) of Dominica

The National Immunisation Registry (NIR) of Dominica stands as the digital sentinel of the nation’s Expanded Programme on Immunisation (EPI). The registry has successfully transitioned from a fragmented, paper-heavy system to a centralised, electronic database integrated into the DHIS2 (District Health Information Software 2). This evolution is the cornerstone of the island’s health resilience agenda, providing a real-time, life-course record for every citizen.

The current state of the registry is defined by a shift toward precision epidemiology. Following the appointment of the Medical Laboratories Council in March 2026, the registry is no longer just a list of names; it is a legally governed, technologically advanced ecosystem that ensures no child or vulnerable adult is left unprotected in an increasingly interconnected Caribbean.

The 2026 Schedule: Hexavalent and PCV-20 Integration

In response to the global resurgence of vaccine-preventable diseases in the 2020s, the NIR has overseen the most significant update to Dominica’s vaccination schedule in a generation.

• Hexavalent Transition: The registry now prioritizes the Hexavalent vaccine over the traditional pentavalent series. By combining protection against Diphtheria, Tetanus, Pertussis, Hepatitis B, Polio, and Haemophilus influenzae type b into a single injection, the NIR has recorded a 12% increase in schedule compliance among infants in rural districts.
• PCV-20 Rollout: To combat the “Seasonal Pneumonia Spike” observed in late 2025, the NIR now tracks the 20-valent Pneumococcal Conjugate Vaccine (PCV-20). This is not restricted to infants; the registry includes a specialised module for seniors (age 65+), aligning with the 2026 Healthy Aging Mandate.
• The Big Catch-Up Module: In line with PAHO’s April 2026 initiatives, the NIR has launched a sub-registry specifically for children whose vaccinations were disrupted by post-hurricane logistics. This module identifies immunity gaps by neighbourhood, allowing for surgical interventions.

Digital Infrastructure: The DHIS2 Tracker

The NIR operates on the DHIS2 Tracker platform, which utilizes a Single Source of Truth model for patient data.

• The Call-Back Algorithm: The NIR is equipped with an automated Defaulter Tracking system. If a child in St. David Parish or Grand Fond misses an appointment, the DHIS2 system sends an automated SMS to the parent and generates a task for the district nurse’s tablet.
• Digital Health Passports: Citizens now access their records via vax.dominica.gov.dm. This portal allows for the retrieval of QR-coded certificates that are biometrically linked to a user’s social security or passport data. These certificates are essential for travel, meeting the rigorous standards of the IATA Travel Pass and regional OECS health protocols.
• Cold Chain Telemetry: The registry is uniquely integrated with the physical infrastructure of Dominica’s 52 health centers. Digital thermometers in vaccine fridges feed live data into the NIR; if a fridge at Portsmouth loses power, the NIR automatically flags all affected batch numbers as potentially compromised, preventing their use.

Legislative Shield: The Reforms

The integrity of the registry’s data is now enforced by the Medical Profession Act 2026 and the Medical Laboratories Act 2024, which provide the legal framework for Data Authenticity.

Under the Medical Profession Act 2026, doctors and nurses must undergo mandatory Digital Health Literacy training for the annual renewal of their practicing certificates. This ensures that the data being entered into the NIR from every village clinic meets national standards for clinical documentation.

Performance Metrics and Watch-List

As of the latest report for Vaccination Week in the Americas, Dominica has achieved remarkable coverage, though specific Priority Alerts remain.

• Primary Vaccine Coverage: 94.5% (The national objective for 2026 is ≥95%).
• Measles (MMR) Status: Currently at 89%. Due to the global rise in measles cases in early 2026, the NIR has activated a High Alert status, triggering mandatory record checks at all daycare facilities and schools across the island.
• HPV Coverage: Has risen to 68% following the integration of the school-based health tracker into the NIR, allowing for better follow-up of the two-dose series for adolescents.

The One Health Sentinel System

The NIR is no longer an isolated database. Today, it is part of a broader One Health strategy.

If a cluster of fever-related illness appears in the DHIS2 Disease Surveillance module, the NIR instantly cross-references the vaccine status of the affected population. This allows the Ministry to determine within minutes if an outbreak is due to an ‘Immunity Gap’ or a ‘Vaccine Breakthrough’.

This level of integration is what allows Dominica to maintain its status as a Safe Destination. By 2030, the registry is expected to expand into Genomic Tiering, helping to track how specific genetic markers in the Dominican population respond to new mRNA platforms for seasonal viruses.