Immunization Registries: The Next Generation is Needed Now

Immunization information registries have played an important public health role for many years, but COVID-19 brought these systems back into the spotlight. While the pandemic has highlighted the value of immunization information systems (IISs), it also has shed light on their shortcomings.

An immunization information system is a confidential, population-based, computerized database that records all immunization doses administered by participating providers to people residing within a certain geopolitical area.

At the individual level, an IIS provides clinicians with a comprehensive history of immunizations and a schedule of those needed in the future. At the population level, aggregated data can be used for disease surveillance and vaccination programs. With this information, public health officials can identify communities at high risk for vaccine-preventable diseases and also prioritize limited resources.

Standardization – The Achilles Heel of State Immunization Registries

In the United States, individual states are responsible for operating immunization information systems. As a result, no two are alike. For example, some track information about both adults and children, while others only track data about children. In addition, only 58% of jurisdictions require all immunization providers to file reports. While states should maintain authority over and responsibility for their IISs, these systems can't reach their full potential and deliver the maximum value unless there is some standardization across them.

A standardized approach to immunization registries could improve vaccination rates by identifying gaps that need closure. Standardized immunization data could also support initiatives to reduce healthcare inequities and disparities, promote healthcare consumerism through easy and secure patient access, and support quality measurements and pay for performance measures associated with vaccination rates.

The Cures 2.0 Act Could Reinvent Immunization Information Systems

Earlier this year, U.S. Representatives Diana DeGette (D-CO) and Fred Upton (R-MI) released a draft of the Cures 2.0 Act. This includes many important extensions to the 21st Century Cures Act which Congress signed into law in December 2016.

One key element of the Cures 2.0 Act is a proposal to expand IISs and to standardize them. If passed, the Cures 2.0 Act would appropriate $25 million to the Centers for Disease Control and Prevention for fiscal years 2022 through 2024 to strengthen immunization information systems.

This legislation would establish federal certification IISs and create standards for the minimum data elements to be captured across systems. Standardized immunization registries would collect vaccination information for all children and adults and would incorporate Medicare and military vaccination records into state immunization registries. All vaccinations would be reported to state registries, regardless of who gave the immunization or where it was administered.


Immunization registries are a foundational component of a modern healthcare system. Gainwell currently operates 14 of the 62 IISs in the United States. Based on our experience, we recognize that now is the time to enhance, modernize, and standardize these systems nationwide. This is what's needed to create a single source of vaccination truth and improve the health of all Americans.

To learn more about how we are working to improve public health outcomes in the communities we serve, visit our website.

The editorial staff had no role in this post's creation.