Blockchain Interoperability for Sharing Immunization Records

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Lin Hao

Independent Researcher

Beilin District, Xi’an, China (CN) – 710003

Abstract— Immunization records underpin disease surveillance, continuity of care, and rapid verification during school admissions, employment screenings, and cross-border travel. Yet these records are fragmented across electronic health record (EHR) vendors, national/state registries, and paper cards, creating delays, duplication, and gaps in trust. This manuscript proposes and evaluates an interoperability architecture that uses blockchain as a verifiable trust fabric for sharing immunization records while keeping personal health information (PHI) off-chain. The approach combines: (i) HL7 FHIR–conformant data models for semantic interoperability; (ii) W3C Decentralized Identifiers (DIDs) and Verifiable Credentials (VCs) for patient-centric portability and selective disclosure; (iii) a consortium, permissioned blockchain for governance and audit; (iv) a cross-chain relay layer to interoperate among multiple permissioned domains and, where appropriate, public anchoring for tamper evidence; and (v) privacy protections including zero-knowledge proofs for status attestations.

Fig.1 Sharing Immunization Records,Source([1])

We outline a methods stack, a multi-site study protocol, and a results model based on operational metrics such as verification latency, reconciliation accuracy, cross-domain finality, and user acceptance. The proposed architecture reduces verification time from minutes to seconds, increases match accuracy, and supports cross-jurisdiction recognition without exposing raw clinical data. Findings suggest that blockchain—used judiciously as a trust and provenance layer—can materially enhance immunization record sharing when aligned with health data standards, robust governance, and human-centered design.

Keywords

blockchain interoperability; immunization records; HL7 FHIR; verifiable credentials; decentralized identifiers; cross-chain; privacy-preserving verification; health information exchange; permissioned ledger; zero-knowledge proofs

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