Australian Health Department criticised over accuracy of COVID-19 vaccination data

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Australia’s Department of Health and Aged Care has been criticised for not having enough assurance over the quality of data it uses for monitoring and reporting COVID-19 immunisation coverage.

A recently published report by the Australian National Audit Office (ANAO) reviewed the department’s conduct of the COVID-19 vaccine rollout, which it said has been “one of the largest exercises in health logistics in Australian history”.

WHY IT MATTERS

The Health Department has set up four key systems to manage and monitor the vaccine rollout, namely the Australian Immunisation Register (AIR), the Vaccine Administration System (VAS), the COVID-19 Vaccine Administration System (CVAS) and the Vaccine Data Solution. The data collection and IT management for these systems were outsourced from IT service firms, including Services Australia (for AIR), Salesforce (for VAS and CVAS), Accenture (for reporting dashboards), and Amazon Web Services (for CVAS). 

According to the audit report, the department cannot outsource its responsibilities under various laws for the confidentiality, privacy and security of data collected through these systems.

“Health does not have [the] assurance that third parties have IT controls in place to ensure the confidentiality, integrity and availability of data,” it said. 

The report also found that the department has “not formally reviewed the data” entered into these systems, which resulted in “undetected and undisclosed inaccuracies” in data, particularly in the AIR and CVAS systems.

It was said that the department did not clarify its responsibility for data quality in the AIR, where all vaccination records are mandated to be reported. The national register was noted for having a 14% error rate, based on a 2018 study by the National Centre for Immunisation Research and Surveillance. While the mandatory vaccination reporting through AIR may have improved its error rate, “there is no evidence available to support this,” the report said.

Additionally, the audit highlighted that there have been gaps in data relating to the vaccination status of some priority and target groups. The department has been flagged for not having accurate data on the vaccination rate of critical and high-risk workers – a priority group under the first phase of the vaccine rollout – “as occupation data was not collected in the AIR”. 

Meanwhile, the ANAO still recognised the department’s use of available data for planning and supporting the vaccine rollout despite inaccuracies in its data collection. “However, [the Health Department] has not quantified the inaccuracies in its internal or external data processes in the period examined.”

In response to the auditor general’s findings and recommendation, the Health Department agreed to establish processes to ensure it “regularly obtains and reviews” assurance over data quality and IT controls in place in externally managed systems on a risk basis, including IT security, change management and batch processing. “The department will undertake an independent review of its IT controls and application of its internal quality assurance framework”.

THE LARGER CONTEXT

The ANAO said it conducted the audit to provide independent assurance to the parliament that the country’s COVID-19 vaccine rollout was “planned and implemented effectively”.

In gist, it found that while the Health Department’s final governance arrangements in managing the vaccine rollout have been “largely effective,” its implementation has been “partly effective” with its vaccine administration to priority groups and the general population “not meeting targets”.

The auditor-general then recommended improving data quality and IT controls and the conduct of a comprehensive review of the vaccine rollout. “The [Health] Department is committed to effective implementation of recommendations and has already commenced steps to address the issues identified in this audit,” it said in response.

Since administering the first COVID-19 vaccines in February last year, the department has administered about 63 million doses nationwide as of August 2022.

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