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Immunization Registries: Improving Immunizations through Enhanced Tracking

By Andrew Resignato, Director, San Francisco Immunization Coalition

Immunizations are disease prevention health interventions that have proven successful in reducing the prevalence of many deadly and costly diseases. Diseases like Haemophilus influenzae type b (bacterial meningitis), measles, polio, rubella and more have been nearly eliminated by widespread vaccination in the U.S.

But while we have come a long way with the amount of diseases vaccines have controlled or eliminated, we need to do a better job of keeping track of the vaccines given to patients.

Several times a month I will receive a call from an adult anywhere from 30 to 60 years old. They will ask me, “I lost my immunization record. Do you have any idea what I have been immunized for?” I have to explain to them that most records of people’s immunization histories only reside with the health care providers that administered those vaccines. They usually respond by telling me that those providers are scattered all across the state/country or they are no longer in practice. I have to tell them, “Sorry--but your immunization record is probably gone for good--unless, it was tracked through an immunization registry.”

While banking and financial information in this country has been computerized for more than two decades, health records have not.  Only recently have health records becoming computerized. Immunization registries have been developed in all states, including California, to provide a centralized shared database of immunization histories that can be accessed by authorized immunization providers. This allows the immunization record to follow a patient as they move across the health care system to several providers. It also ensures that the immunization record is not lost if the patient loses their copy, or a provider closes its practice.

The California Immunization Registry (CAIR) is a Web-based software that allows immunization providers the ability to store the immunization histories of their patients. It also recommends the correct immunization schedule for each patient based on their history and the current recommended schedule. The registry offers the following benefits:

  • Easy access to patient immunization records by providers, including immunizations that were given by other practices and clinics. The immunization registry tracks contraindications and precautions for each patient.
  • Improves accuracy by standardizing abbreviations and eliminating the handwriting errors of a paper-based system. 
  • Provides reminders and/or recalls to let patients and providers know when the patient is due or overdue for an immunization.
  • Helps providers keep track of vaccine inventory by lot number, manufacturer, and expiration date.
  • Saves providers’ staff time by easily printing the California Immunization Record (yellow card) when patients lose it or need it for school or child care. CAIR also allows authorized school, child care, and foster care workers to check immunization status without having to contact busy provider offices.
  • Makes it easy to keep track of new vaccines and changing immunization schedules.
  • Generates practice data needed for HEDIS reporting, vaccine usage reports, and immunization rates for practices.
  • Registries can also play a key role in contributing to vaccine safety by avoiding unnecessary duplication of immunizations due to lost records, keeping better track of adverse reactions, and giving clinicians the most up-to-date and accurate immunization history on which to base clinical decisions.  

For these reasons, I believe all practices and clinics in California should be entering immunizations into the California Immunization Registry. The Health People 2010 goal is to have 90 percent of all California children under five in the California Immunization Registry.

This will bring California into the 21st century with regards to keeping track of immunizations and help further reduce vaccine-preventable disease and adverse reactions associated with vaccines. For more information on the California Immunization Registry go to www.sfimmunize.org




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