The vaccination registration portals of 12 countries were systematically assessed by authors and based on the assessment scoring using DISCERN and QUEST tool was undertaken in series. Author AP assessed the Republic of South Korea, VS assessed Bangladesh, AM assessed Argentina and Canada, AS the assessed Republic of South Africa and Nigeria, SB assessed Indonesia, Kazakhstan and the Czech Republic, SP assessed Australia and India, AR assessed the United Arab Emirates. The standardization in assessment was brought in by Guideline for authors (Table 3), by developing a consensus document to refer to in case of confusion.
In the results section, we are present the average score across all the member state for all the questions in DISCERN tool along with descriptive analysis on the reason for some member states scoring high while some scoring less. For the QUEST tool for all the seven areas the scores are presented in the table and descriptive analysis is presented
From our analysis, the Republic of South Korea, Indonesia, and the Czech Republic were the three countries that scored the highest overall score of 5 in DISCERN tool, Czech Republic and the United Arab Emirates scored a maximum score of 28 on the QUEST tool. Overall, across both the tools Czech Republic’s website for COVID-19 registration was found to be having the highest Quality of Information, Ease of Navigation and Interaction and was found to be mobile- friendly.
Vaccination Registration portals of all the 12-member state assessed were found to be mobile-friendly
DISCERN Tool Analysis
For question 1 (Are the aims clear?); all member states assessed except Bangladesh were rated a score of 5 on the Likert scale. The mean score across all the member states was 4.8 (SD ± 0.87) Bangladesh scored 2 because the website didn’t mention statistics on vaccination drive in the country “Providing information about the vaccination program”, the homepage did provide the link for registration and explained the process of getting vaccinated.
For question 2 (Does it achieve its aims?); the average score across all the member states was 4.6 (SD ± 0.67). Republic of South Korea, Argentina, Canada, Nigeria, South Africa, Indonesia, Kazakhstan, and the Czech Republic scored 5 on Likert scale of 0 to 5, Australia, India, and United Arab Emirates score 4 on Liker scale of 0 to 5, Bangladesh scored 3 as details on home screen were limited and not intuitive enough to explore details.
For question 3 (Is it relevant?); the average score across all the member states was 4.5 (SD ± 0.67). Republic of South Korea, Argentina, Canada, Indonesia, Kazakhstan, Czech Republic, United Arab Emirates scored 5 on a Likert scale of 0 to 5, Nigeria, South Africa, Australia, and Bangladesh scored 4 on the same Likert Scale. India scored 3 on relevance due to lack of information on, the advantage of getting vaccinated, is it compulsory to get vaccinated, adverse events on vaccination were not given, only details to contact in case of adverse events was given
For question 4 (Is it clear what sources of information were used to compile the publication?); the average score across all the member states was 3.8 (SD ± 1.42). Republic of South Korea, Argentina, Canada, Indonesia, Czech Republic scored 5 on a Likert scale of 0 to 5, South Africa, Australia, United Arab Emirates scored 4 on the same Likert Scale. Nigeria scored 3, India scored 2, Bangladesh scored 1 as the source of information was not quoted, in the case of Bangladesh and India all the information was without a single cited source, Nigeria had cited Nigeria Centre for Disease Control in some instances.
For question 5 (Is it clear when the information used or reported in the publication was produced?); the average score across all the member states was 3.8 (SD ± 1.71). The scores on the Likert scale were similar to question 4
For question 6 (Is it balanced and unbiased?); the average score across all the member states was 3.7 (SD ± 1.61). Argentina, Canada, Australia, Indonesia, Czech Republic, United Arab Emirates score 5 on a Likert scale of 0 to 5. Indian and Bangladesh scored 1 and Kazakhstan score 2 because no information was given safety profile, the efficacy of various vaccines available in the country, also no mention about common side effects were given on the website. Nigeria scored 3, with a little mention of adverse effects.
For question 7 (Does it provide details of additional sources of support and information?); the average score across all the member states was 3.6 (SD ± 1.68). Argentina, Canada, Australia, Indonesia, Czech Republic, United Arab Emirates scored 5 on Likert scale of 0 to 5, and the Republic of South Korea scored 4, as the links were provided to studies conducted by the vaccine manufacturer or clinical trial conducted within the country to comply with local approval procedures. South Africa and India scored 1 as no links for additional resources were mentioned across the website while Bangladesh and Kazakhstan scored 2 as they referred to helpline number for further information. While Nigeria Score 3 as it referred to infographics for further reading.
For question 8 (Does it refer to areas of uncertainty?); the average score across all the member states was 3.2 (SD ± 1.64). Republic of South Korea, Canada, Indonesia, and the Czech Republic scored 5 on the Likert Scale of 0 to 5 as the information referred to the uncertainty of getting infected even after complete vaccination, need to follow social distancing and other preventive measures. The United Arab Emirates scored 4 and Australia scored 3 as they emphasized the need to follow social.
The average score for Sect. 1 (Question 1 to 8) focused on reliability, was 4 (SD ± 1.28). Section 2 (Question 9 to 15) focused on the quality of information regarding treatment choices, the average score for Sect. 2 was 3.4 (SD ± 1.67)
For question 9 (Does it describe how each treatment works?); the average score across all the member states was 3.3 (SD ± 1.71). Argentina, Canada, Indonesia, Czech Republic scored 5 on a Likert scale of 0 to 5 as the information on how vaccines help in building immunity, how much per cent immunity against COVID-19 is demonstrated through studies, and variation in immunity between first and second dose was clearly explained. Republic of South Korea, Australia, United Arab Emirates scored 4 on the same Likert scale as the information on variation in immunity between 1st and 2nd dose was not reported. Kazakhstan, Bangladesh scored 2 and India, Nigeria and South Africa scored 1 as no information on pathways of immunity build-up, percentage of immunity achieved after first and second wave was provided.
For question 10 (Does it describe the benefits of each treatment?); the average score across all the member states was 4.0 (SD ± 1.54). Republic of South Korea, Argentina, Canada, Nigeria, South Africa, Indonesia, Czech Republic, and the United Arab Emirates scored 5 on the Likert Scale of 0 to 5. These countries have mentioned the benefit of getting vaccinated, for healthy individuals, special populations, Individuals previously diagnosed and treated for COVID-19. Australia scored 3, Bangladesh and Kazakhstan scored 2, as some kind of information is provided on the benefit of getting vaccinated. India scores 1 as no information was given on the benefit of receiving a vaccine against not getting it.
For question 11 (Does it describe the risks of each treatment?); the average score across all the member states was 3.7 (SD ± 1.56). Republic of South Korea, Argentina, Canada, Indonesia, Czech Republic, United Arab Emirates, scored 5 on Likert Scale of 0 to 5. These countries have included a section on common adverse events, severe adverse events if any, contact details in case of severe adverse events, the scheme for compensation in cases of severe adverse events, they also mentioned the risk associated with refusing to get vaccinated. Australia scored 4 as the compensation plan was not mentioned in case of severe adverse events. Nigeria scores 3 while Bangladesh and Kazakhstan scored 2 on the same Likert scale as information only on common adverse events was given. India scores 1 as no information on the risk of getting vaccinated was provided.
For question 12 (Does it describe what would happen if no treatment is used?); the average score across all the member states was 3.1(SD ± 1.73). Argentina, Nigeria, Indonesia, Czech Republic, scored 5 on the Likert Scale of 0 to 5, as they mentioned if the vaccine is compulsory or voluntary. Australia and the United Arab Emirates scored 4 as the information required navigation through the website to locate. Bangladesh, Kazakhstan, South Africa Scored 2, while the Republic of South Korea, Canada, India scores 1 as no information was available if the vaccine was refused.
For question 13 (Does it describe how the treatment choices affect the overall quality of life?); the average score across all the member states was 2.8 (SD ± 1.80). Canada, Indonesia, Czech Republic, United Arab Emirates, scored 5 on the Likert Scale of 0 to 5, as they have mentioned the effect on the quality of life in the short term, medium-term and long term. The Republic of South Korea scored 4 on the same scale as the only short-term impact on quality of life was mentioned. Australia, Bangladesh, Kazakhstan scored 2 while India, South Africa, Nigeria, Argentina scored 1 as little to no information was found regarding the impact on quality of life.
For question 14 (Is it clear that there may be more than one possible treatment choice?); the average score across all the member states was 4 (SD ± 1.65). Argentina, Canada, South Africa, Australia, Indonesia, Czech Republic, and the United Arab Emirates scored 5 on a Likert scale of 0 to 5 as they detailed out various vaccines available, safety profile and efficiency profile of each vaccine, allowed individuals to select specific manufacturers vaccine. The Republic of South Korea scored 4 on the same Likert scale as the information was available but didn’t allow individuals to choose the vaccine of their choice. India scored 4 as it allowed to choose between allowed vaccines by the information on safety and efficacy profile of various vaccines was not given. Kazakhstan scored 2 as it listed out various vaccines available. Bangladesh and Nigeria didn’t provide any information on the type of vaccines available nor allowed to choose between manufacturers
For question 15 (Does it provide support for shared decision-making?); the average score across all the member states was 3.4 (SD ± 1.51). Canada, Indonesia, Czech Republic and the United Arab Emirates scored 5 on a Likert Scale of 0 to 5 as they provided toll-free landline number to connect with GP on for any further questions, listed out dos and don’ts, asked individuals to consult to a general practitioner for more information. Republic of South Korea, Australia scored 4 on the same Likert scale, Nigeria, India, and Bangladesh scored 3. Kazakhstan scores 2 while South Africa and Argentina scored 1 as lesser information was provided to connect for further queries.
Overall, on DISCERN tool, the Czech Republic scored a perfect 5 across all the 15 questions, the average score across all the member states for DISCERN tool was 3.6 (SD ± 1.63). The UN Member state-specific scores are added in the supplementary material.
QUEST tool analysis
The maximum score on the QUEST tool was 28 across all 7 parameters. The Czech Republic and the United Arab Emirates scored 28(100%), followed by Indonesia, Kazakhstan and the Republic of South Korea. South Africa scored the lowest score followed by India. The detailed score is presented in Table 4 across all the 12-member states
QUEST tool was used to understand ease of use, concision and comprehensiveness, the Vaccination website of the Czech Republic and the United Arab Emirates scored the maximum possible points. The Czech Republic also scored 5 on a Likert scale of 0 to 5 on DISCERN tool.