A brief review of vaccination coverage in immunization registries

Countering vaccine hesitancy through immunization information systems, a narrative review

Immunization is one of the most important public health interventions to contrast infectious disease; however, many people nowadays refuse vaccination. Vaccine hesitancy (VH) is due to several factors that influence the complex decision-making process. Information technology tools might play an important role in vaccination programs. In particular, immunization information systems (IISs) have the potential to improve performance of vaccination programs and to increase vaccine uptake. This review aimed to present IIS functionalities in order to counter VH. In detail, we analyzed the automatic reminder/recall system, the interoperability of the system, the decision support system, the web page interface and the possibility to record adverse events following immunization. IIS could concretely represent a valid instrument to increase vaccine confidence, especially trust in both health-care workers and decision makers. There are not enough trials aimed to evaluate the efficacy of IIS to counter VH. Further researches might focalize on this aspect.

Immunization information systems to increase vaccination rates: a community guide systematic review

CONTEXT

Immunizations are the most effective way to reduce incidence of vaccine-preventable diseases. Immunization information systems (IISs) are confidential, population-based, computerized databases that record all vaccination doses administered by participating providers to people residing within a given geopolitical area. They facilitate consolidation of vaccination histories for use by health care providers in determining appropriate client vaccinations. Immunization information systems also provide aggregate data on immunizations for use in monitoring coverage and program operations and to guide public health action.

EVIDENCE ACQUISITION

Methods for conducting systematic reviews for the Guide to Community Preventive Services were used to assess the effectiveness of IISs. Reviewed evidence examined changes in vaccination rates in client populations or described expanded IIS capabilities related to improving vaccinations. The literature search identified 108 published articles and 132 conference abstracts describing or evaluating the use of IISs in different assessment categories.

EVIDENCE SYNTHESIS

Studies described or evaluated IIS capabilities to (1) create or support effective interventions to increase vaccination rates, such as client reminder and recall, provider assessment and feedback, and provider reminders; (2) determine client vaccination status to inform decisions by clinicians, health care systems, and schools; (3) guide public health responses to outbreaks of vaccine-preventable disease; (4) inform assessments of vaccination coverage, missed vaccination opportunities, invalid dose administration, and disparities; and (5) facilitate vaccine management and accountability.

CONCLUSIONS

Findings from 240 articles and abstracts demonstrate IIS capabilities and actions in increasing vaccination rates with the goal of reducing vaccine-preventable disease.

Improving school immunization rates may be as basic as record reconciliation and policy enforcement: a report from a rural Colorado public health/school district initiative

The aim of this report was to assess the coverage rate of required immunizations for kindergarten-12 students in the Eagle County School District and to create a process for annual, district-wide immunization assessments to inform immunization campaigns. All kindergarten-12 student records were reviewed, and immunization rates during the 2012-2014 years were compiled. At baseline, only 2096 (34%) were in compliance with the Colorado School Immunization Law. After reconciliation of records and instituting a recall system in year 1 and enforcement of the Colorado School Immunization Law suspension rule in year 2, a total of 5862 (98.8%; P < .001) students were in compliance. Immunization rates for Eagle County School District students were unknown due to the lack of a process to assess a compliance rate and the lack of reconciliation of records. Although initially time-intensive, the project has impacted the community through the creation of a sustainable process of collecting and reporting student immunization records through a centralized state immunization registry.

Timeliness and data element completeness of immunization data in Washington State in 2010: a comparison of data exchange methods

Health information systems receive data through various methods. These data exchange methods have the potential to influence data quality. We assessed a de-identified 2010 dataset including 757,476 demographic records and 2,634,101 vaccination records from Washington State's Immunization Information System (IIS) to describe timeliness and completeness of IIS data across several data exchange methods: manual entry, HL7, and flat file upload. Overall, manually-entered data and HL7 records were more timely than records imported as flat files. Completeness, though very high overall, was slightly higher for records arriving via flat file. Washington State IIS users, including clinicians and public health, rely on its data to inform patient care and determine population coverage of immunizations. Our results suggest that although data element completeness in systems like Washington's IIS will likely not be immediately or significantly impacted by provider's migration to HL7 connections with IISs, timeliness could be substantially improved when using HL7 connections.