With Better Immunization Cards, Will More Kids Get Vaccinated?

The Gates Foundation challenged the global health community to redesign immunization cards. Here are the results.


This final week in April is World Immunization Week–a campaign by the World Health Organization (WHO) aimed at raising awareness of the vital importance of vaccines, which prevent 2 to 3 million deaths every year. Yet despite the sophisticated vaccines available, studies show that 1 in 5 children still miss out. In 2012, an estimated 22.6 million infants didn’t receive routine immunizations. More than half of these children live in three countries: India, Indonesia, and Nigeria.


Could something as simple as a redesigned immunization card help more parents stay up to date with their children’s vaccinations? That was the premise behind the Bill and Melinda Gates Foundation’s Records for Life contest, which challenged the global health community to redesign children’s health records to be more informative and user-friendly.

Yian and Sarah

“Everyone knows what vaccination cards are, but no one’s really looked at them from a design angle,” Skye Gilbert, a program officer for vaccine delivery at the foundation, tells Co.Design. “The more we can involve the design community in global health issues, the more things like this will come to light.” The Foundation received 321 submissions from individual designers and firms around the world, from which they chose 10 finalists and a grand prize winner.

The WHO’s guidelines for immunization cards currently include no reference to how they should be designed. So, not surprisingly, the 193 different versions of cards currently in use have a slew of design problems. “A lot of countries’ cards were missing key pieces of information,” Gilbert says. “Some didn’t include when to return to the clinic for follow-up appointments, for example. And a lot were very text heavy, which doesn’t work in countries with high illiteracy rates.” Many also used complicated visual structures, like matrices, which can be difficult to follow for those without much schooling. “No one likes matrices. They prefer simpler tables or lists,” Gilbert says.

It was also difficult for the cards’ two primary users–the child’s caregiver and the health worker–to sort out which pieces of information were geared towards which person. Each user has different sets of information they need to look at. But current designs mixed this information together rather than clearly separating it out.

Gravity Tank

To top it off, most cards are made of flimsy material, because it’s cheaper–but this means that these vitally important documents are easily destroyed, whether from children chewing on them (true) or from wear and tear over time.


When the Gates Foundation announced the contest, they outlined five criteria they were looking for in the card redesigns: clarity, adaptability (Can the card accommodate changes in available vaccines?), value to caregivers (Will parents see this document as a prized possession?), value to health workers, and durability.

From the 10 finalists, the Gates Foundation ultimately chose a redesign by GravityTank called Project Pasteur, after Louis Pasteur, the French chemist and biologist, as the winner. “Project Pasteur stood out because it was designed in a way that made it important for families,” Gilbert says. The design consists of a pouch made of durable material on a string and with a photograph of the child on the front, so that it doubles as a picture frame that can be displayed by hanging it from a hook on a wall. The pouch also allows for flexibility in how much information can be included–fact sheets on health issues can be added or taken out, for example.

Lisa Scharoun

So how will this redesign be implemented around the world? “There are some exciting changes on a policy level,” Gilbert says. “We’re working with the World Health Organization to develop guidelines for bare minimum principles of design for these cards.” Especially given the anti-vaccine backlash from quack celebrities with no medical training, the importance of this campaign can’t be underestimated.

See more on the 10 finalists here.

About the author

Carey Dunne is a Brooklyn-based writer covering art and design. Follow her on Twitter.