Human-Centered Design: Simple Bracelets as Vaccine Reminders

Our bracelets were designed specifically to fit the needs of uneducated moms living on $1.25 or less a day. Designed with indigenous moms and nurses, the bracelet uses only numbers and symbols – no words – to convey a child’s entire vaccination record. Corresponding guides help nurses and moms decode the symbols. 

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By looking at the bracelet, a mom knows the number and type of vaccines her child has received and the date of the child’s next immunization. Each symbol represents a different vaccine, and each number represents the child’s age in months. Nurses hole punch out symbols on the bracelet to show that a child has been vaccinated. It's designed to be worn by the child from birth to 4 years. Nurses can easily put it on babies with minimal time and effort. The bracelets are highly customizable to local culture and needs and are very low cost. They are also waterproof, durable, comfortable, and baby-safe. 

We directly address vaccine acceptance in two ways. First, our bracelet offers poorly-educated, low-income moms a way to better understand vaccines, how they work, and why they’re important. Second, it enables moms to easily remember the dates of their children’s vaccinations, so more children are immunized and in a timely manner.

Beyond reminders, the bracelets can help increase moms’ awareness about the individual vaccinations her child requires and received. The majority of moms, when asked, don't know the names of the vaccines their children have received and the diseases these vaccines protect against. This information is important to build community champions for vaccinations, which has the potential to increase vaccination timeliness and reduce moms' concerns about vaccines. 

Potential Impact of Our Bracelets

Economic burden of late vaccination

Vaccine preventable diseases such as pneumonia, diarrhea, measles, pertussis and tetanus are the leading causes of child deaths in these countries. For example, in Nigeria, they account for about 30% of all under-five deaths. Besides death, the associated disabilities exert physical, social and economic burden on children, their families and communities. It has been estimated that more than 600,000 lives can be saved and $17bn in economic losses averted in Nigeria over a 10-year period if the country can achieve 90% coverage with Hib, pertussis, pneumococcal, measles and rotavirus vaccines.

Demand from mothers for bracelets

We know that there is a demand from moms to use our bracelets from their feedback in our initial study. 

  • 91% of mothers who used our bracelets said the bracelets helped remind them of their children's vaccination dates
  • 90% of mothers said they would continue using the bracelets in the future if possible
  • 87% of mothers would recommend the bracelets to other moms to use 

Moms who weren’t able to participate who saw the bracelets asked questions about how they worked and asked to use them, creating an opportunity to educate the broader community of parents about the need to vaccinate their child and to stimulate an interest in and demand for the bracelets.

Demand from health care workers

At the end of our initial study, every Ministry of Health nurse we worked with in Peru and Ecuador recommended that the bracelets be incorporated into official vaccination program protocol. Nurses said the bracelets are “something that needs to be continued”, “good for the mothers”, and "an easy way of reminding mothers about vaccinations”. One nurse from the Ecuador pilot site said, “Mothers are now arriving to vaccination appointments on time. Before initiating this program, we had problems with the mothers’ punctuality.” Having their support is critical to the long-term sustainability of this project.

Demand from global vaccine community

Many individuals from governments, NGOs, pharmaceutical companies, and communities across the developing world (and even in the US and UK) have approached Alma Sana asking to use the bracelets, stating that vaccine timeliness and coverage are challenges in their areas too. Armed with evidence after this Phase II study, we’ll be able to partner with these organizations to reach tens of thousands of parents and help every child be fully immunized on time.

Supplemental Materials

A laminated information card pictorially represents how moms can use the bracelet to understand when the child's upcoming vaccine visit it. The card also contains a simple code to indicate which symbols represent which vaccines.  A similar laminated card exists for nurses that is on display at the clinics. The information card for mothers and nurses are original designs by Alex Bozzette