Not Just for Kids: The Case for Modernizing Immunization Registries

All states currently operate immunization information systems (IISs) to track vaccination information. Historically, these systems have focused primarily on capturing data for childhood immunizations. Data saturation among young people is very high, with IISs containing information for 95% of children.

Although IISs can also be used to track adult vaccinations, this hasn’t always been a high priority. COVID-19 changed that, however. The public health emergency has focused attention on the importance and utility of using immunization information systems for all members of the population — not just our children. In fact, the federal government’s Healthy People 2030 plan now includes an objective related to increasing the number of people represented in these systems.

The pandemic also shed light on the fact that existing IISs may not be prepared to handle the additional load of adult immunization data. Like other aspects of our public health infrastructure, many IISs haven’t kept pace with the quickly evolving health information technology landscape. Some legacy systems were built more than 20 years ago, so the underlying software and hardware are now outdated.

The Value of Modern Immunization Information Systems

Immunization information systems have the potential to achieve better health outcomes across populations and improve consumer access to health data. With an up-to-date immunization data infrastructure, it is possible for state public health agencies to securely exchange information with healthcare providers in real time. This could support programs to close care gaps, such as routine child or adult vaccinations that were missed due to the pandemic.

Another application for a modernized IIS is information sharing with healthcare providers, payers or health insurance exchanges about vaccination rates among different patient populations. This could help identify social determinants of health that may be barriers to immunizations, as well as to other important preventive care services.

On the consumer side, modern IISs enable individuals to easily access their immunization history. This is particularly important today, given the movement nationwide to grant patients access to their health information. Access to vaccine records may be needed to attend schools and universities, to work in certain industries like healthcare or simply to attend a concert or other event during a health emergency like the COVID-19 pandemic.

IIS Modernization: Top Challenges and Best Practices

One of the major challenges facing legacy IIS systems is the outdated hardware they run on. In most cases, on-premise servers cannot compete with cloud-based solutions. Cloud solutions are highly secure and offer redundancy that would be costly to achieve using on-premise hardware. In addition, cloud systems are highly scalable — they can be easily expanded as immunization data volumes grow, and they have nearly infinite capacity. Most cloud architectures are also highly configurable, so they can easily exchange information with other systems in the public health technology ecosystem.

Data quality is another challenge facing existing immunization information systems. A recent report from the American Immunization Registry Association (AIRA) found that data saturation and record completeness are two factors that drive both the overall success of an IIS and providers’ perception that an IIS is valuable and provides utility.

Modern IISs offer tools to automatically identify and often resolve data quality issues. For example, algorithms can identify duplicate patients or vaccinations and either resolve those issues immediately or flag them for human intervention. According to AIRA’s research, when stakeholders have higher confidence in IIS data, they tend to use it more often and for more complex and creative applications, such as gap identification, targeted outreach and justification for additional resources.

A modernized IIS with high-quality data supports a virtuous cycle — the more the IIS data is used, the more data it will receive, and the better its data quality will become. The result is better public health outcomes for people of all ages, as well as a better experience for consumers who want access to their information.

To learn more about what’s possible with a modern, secure and scalable IIS, read our recent blog, “The Hidden Power of Immunization Registries.”

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