The prototype that was most popular among our users was the refrigerator magnet with a corresponding smartphone app. The magnet was the most favorable device as it is non intrusive, inexpensive to manufacture, child proof, and positioned in a visible location that is frequented by the caregiver. The screen on the magnet will light up and change color when the child's immunizations become due as a visual cue that action needs to be taken. This feature can be tied to the application or could be programed into the device itself (it's basically a fancy kitchen timer). The app will be very simple and can help to identify barriers to accessing care, scheduling that first visit to the pediatrician, or be a resource to credible vaccine websites.
Education and distribution of the product will require the assistance of the Comprehensive Perinatal Services Program (CPSP) or Healthy Families America (HFA) home-visiting program that is managed by the Health Department, which we already have an existing relationship. However, further conversation with those managing the CPSP or HFA is needed if IDEO and Gavi are interested in further working with us to assist in making our product and services a reality.
From the literature, there is evidence that supports starting the conversation about the importance of child vaccinations early during pregnancy. In a CDC longitudinal study, they found that 85% of first time expectant moms made a plan for vaccinating their baby by their 2nd trimester. This result supports programs that provide early education to pregnant woman as impacting immunization rates. There also are currently legislative forces that are supporting our efforts as Governor Gavin Newsom has proposed spending $100 million to expand a home-visiting program — in which nurses and social workers visit young, low-income parents to give health and parenting advice such as the Nurse-Family Partnership (NFP) Program. NFP works by having specially trained nurses regularly visit young, first-time moms-to-be, starting early in the pregnancy, and continuing through the child’s second birthday. As an estimation of the kinds of outcomes we may be able to expect, the NFP in particular, has shown a 19% improvement in children being up to date on their vaccinations by 6 months old.
Finally, it is always cheaper to prevent disease than to treat it. There are direct costs associated with illness such as hospitalization costs. There are also indirect costs such as costs to contain an outbreak, lost wages by the caregiver, long-term effects of disease complications - deleterious costs to the child, family, and community. However, the cost to manufacture a bluetooth digital refrigerator timer/magnet is less than $16. There will be additional costs in managing the application, training staff on the product and services. But overall, it seems the money spent on prevention is justified in the potential cost savings if diseases and outbreaks can be prevented.