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Immunization Reminder Bracelets


Despite widespread efforts to expand routine immunization coverage, under-immunization persists in Pakistan, leaving millions of children at risk of death and disability. One of the major factors associated with suboptimal coverage is lack of parental awareness regarding vaccination due dates.  Existing mechanisms that are meant to address this problem, such as government-issued immunization cards, SMS reminders, and phone calls, are either difficult to understand, or can’t be scaled and often have an uneven impact across the socioeconomic spectrum.

In low-resource settings where the majority of  caregivers are illiterate and without access to mobile phones, technology and text-based interventions are unlikely to succeed, making it imperative to introduce a simple and affordable tool to improve routine immunization coverage.

Our Approach

IRD is conducting a three-arm Randomized Controlled Trial  to evaluate  the effectiveness of using two different types of silicon bracelets as vaccine reminders, to improve adherence to the immunization schedule.

The two intervention arms will each receive a different type of  bracelet (two different designs are being tested) while the control arm will not receive any intervention.

Both types of bracelets are simple, inexpensive, waterproof, durable and baby-safe. The bracelets contain  symbols instead of words, making them ideal for low income and low literacy areas, where other reminder/recall interventions fail to deliver.


The study is being conducted in 4 immunization centers of Landhi Town, Karachi, with a target to enroll and track over 1400 children during a period of 18 months. The results will provide a basis for scaling up the intervention to address the issue of under-immunization in some of the most deprived areas of Pakistan. Parents facing difficulty in reading the vaccination dates from EPI card found bracelet as a useful tool for reminding their child’s upcoming vaccine.

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