WHO Digital Documentation of COVID-19 Certificates: Vaccination Status (DDCC:VS)
0.2.1 - CI Build

WHO Digital Documentation of COVID-19 Certificates: Vaccination Status (DDCC:VS) - Local Development build (v0.2.1). See the Directory of published versions

Usecases

For the latest published definitions, refer to the Digital Documentation of COVID-19 Certificates guidance.

The scope of this implementation guide covers two scenarios of use for the DDCC:VS:>

  1. CONTINUITY OF CARE: Vaccination records are an important part of an individual’s medical records, starting at birth. The Continuity of Care scenario describes the primary purpose of a vaccination certificate. The vaccination record shows individuals and caregivers which vaccinations an individual has received, as part of that individual’s medical history; it therefore supports informed decision-making on any future health service provision.
  2. PROOF OF VACCINATION: Vaccination records can also provide proof of vaccination status for purposes not related to health care.

Continuity of Care

In the context of COVID-19, the use of a vaccination record for Continuity of Care is primarily to: ensure that individuals know if, and when, they will need a subsequent dose; for health workers to use the proof of COVID-19 vaccination to decide on provision of health services based on medical history; and for ensuring health workers have access to accurate vaccination history when an adverse event follows immunization. It will be up to Member States to define how this scenario is applied and adapted to their own context and level of digital maturity, in compliance with their legal and policy frameworks.

Use case IDUse case nameUse case description
UC001Paper firstA guideline-based vaccine administration is recorded on paper. After the vaccination event, data about it can be entered into a Digital Health Solution.
UC002Offline digitalA guideline-based vaccine administration is recorded using an offline secure Digital Health Solution, with the content uploaded, subsequently, to an online Digital Health Solution.
UC003Online digitalA guideline-based vaccine administration is recorded using an online secure Digital Health Solution which updates the content in real time.

Proof of Vaccination

The Proof of Vaccination scenario relies on the Public Health Authority (PHA) having access to a trusted means of digitally signing an HL7 FHIR document, which represents the core data set for the DDCC:VS. It will be up to Member States to define the purposes for which this scenario is applied and adapted to their own contexts and levels of digital maturity, in compliance with their legal and policy frameworks.

Use case IDUse case nameUse case description
UC006Manual verificationA Verifier verifies a DDCC:VS using purely visual means, based on his or her subjective judgement, as is currently done with International Certificate of Vaccination or Prophylaxis. This type of check is currently well accepted, is quick and easy to do, and requires no digital technology.
UC007Offline cryptographic verificationA Verifier verifies a DDCC:VS using digital cryptographic processes in an offline mode.
UC008Online status check (national DDCC:VS)This pathway is used when the DDCC:VS is being verified in the same jurisdiction as it was issued. A Verifier verifies a DDCC:VS using digital cryptographic processes in an online mode that includes a status check against the PHA’s DDCC:VS Registry Service and optionally the DDCC:VS Repository.
UC009Online status check (international DDCC:VS)This pathway is used when the DDCC:VS is being verified in a foreign jurisdiction to where it was issued. A Verifier verifies an internationally issued DDCC:VS using digital cryptographic processes in an online mode that includes a status check against the National PHA’s DDCC:VS Registry Service, which in turn accesses an International PHA’s DDCC:VS Registry and DDCC:VS Repository, if such services exist and such access is authorized by the issuing PHA. It is assumed in this workflow that a Verifier does not directly access an International PHA’s DDCC:VS Registry or Repository Service.

Workflows and Transactions

The following diagram illustrates the business requirement workflows as realized through the system level transactions. DDCC WorkflowsPublic Health AuthortityCertificate HolderCertificate HolderHealth CareWorker(e.g. VaccinatorNurse)Health CareWorker(e.g. VaccinatorNurse)ValidatorValidatorDigital HealthSolution(e.g openSRP)Digital HealthSolution(e.g openSRP)DDCC: CertificateGeneration Service(e.g. Reference App)DDCC: CertificateGeneration Service(e.g. Reference App)PKI Gateway(e.g. DDCCG)PKI Gateway(e.g. DDCCG)Knowledge RepoFHIR ServerKnowledge RepoFHIR ServerData StoreTrusted FHIR Server(DDCC Regsistry Service& DDCC Repository Service)Data StoreTrusted FHIR Server(DDCC Regsistry Service& DDCC Repository Service)Vaccination & Certificate Generation01:Establish PKItrust network(unspecified, reference implementation is DDCC Gateway)02:Patient registration03:Vaccinate subject of certificate holder04:Record vaccination event05:DDCC: Submit Health Event / Generate Health Certificate06:Ensure Digital Health Solution has node level authenticationIHE: ATNA07:Log transaction / audit trailIHE: ATNA (RESTful?)08:DDCC: Register Health CertificateMHDS: ITI-65FHIR: create Bundle: SubmissionSet & DocumentReferenceopt[store online content]09:DDCC: Store Health CertificateFHIR: Create Bundle: DDCC Document10:DDCC: Generate Health Certificate responseFHIR Bundle: DDCC Document11:Share HCID and/or QR codes (paper or wallet, unspecified)Contuinuty of Care12:Patient registration13:Share QR code14:Scan QR code15:Identify QR code typeDeserializeMap to DDCC Documentopt[retrieve online content]16:Authenticate and authorize usage (unspecified, reference implementation is KeyCloak)17:DDCC: Retrieve Health FolderMHD: ITI-66FHIR: query Listloop[DocumentReference]18:DDCC: Retrieve Health CertificateMHD: ITI-68FHIR: retrieve Bundle: DDCC Documentloop[DocumentReference: retrieve QR-codes or PDFs]19:DDCC: Retrieve Health Certificate ReferenceMHD: ITI-67FHIR: retrieve DocumentReference:attachments of pdf or image (e.g. png)20:Review immunization history21:Take any needed clinical action on subject of Card HolderValidate statusopt[refresh cache]22:Refresh FHIR ValueSet & Library resources (CQL/ELM) for validation business rules23:Refresh trust network public keys & revoked key list24:Share QR code25:Scan QR code26:Identify QR code typeDeserializeMap to DDCC Documentopt[retrieve online content]27:Authenticate and authorize usage (unspecified, reference implementation is KeyCloak)28:DDCC: Retrieve Health FolderMHD: ITI-66FHIR: query Listloop[DocumentReference]29:DDCC: Retrieve Health CertificateMHD: ITI-68FHIR: retrieve Bundle: DDCC Document30:Exectute CQL/ELM validation status business rules against DDCC Documents31:Review validation status32:Indicate result of validation check