MMWR Morbidity and Mortality Weekly Report
Progress in Immunization Information Systems —
United States, 2008
Immunization information systems (IISs) are linkages with other health information systems, data
confidential, computerized information systems that quality and use, vaccine management, software and
collect and consolidate vaccination data from multiple hardware capabilities, and report functions). All 56
health-care providers, generate reminder and recall grantees were asked to complete the IISAR, and 52
notifications, and assess vaccination coverage within did so for 2008. The percentage of all U.S. children
a defined geographic area (1). A CDC program goal aged <6 years participating in each IIS was calculated
for 2010 is to achieve >95% participation in an IIS by dividing the number of children aged <6 years
(defined as having two or more recorded vaccinations) participating in the IIS by the 2008 mid-year U.S.
among children aged <6 years. To monitor progress Census projection for all children aged <6 years.
toward this goal, CDC annually surveys immuniza- Approximately 18 million U.S. children aged <6
tion grantees in 50 states, five cities, and the District years (75% of all U.S. children in that age group)
of Columbia, using the Immunization Information participated in an IIS in 2008, compared with 15
Systems Annual Report (IISAR). All 56 grantees were million (65%) in 2006 (1). Of the 52 responding
asked to complete the IISAR; 52 did so for 2008. This grantees, 22 grantees (42%) reported that >95% of
report highlights results from the 2008 IISAR, which children aged <6 years participated in the IIS (Figure),
indicated that 75% of all U.S. children aged <6 years compared with 15 of 56 (27%) grantees in 2006. For
(approximately 18 million children) participated in an 2008, a total of 11 (21%) grantees reported child
IIS in 2008, an increase from 65% in 2006 (1). The participation ranging from 80% to 94%, compared
majority of grantees (82%) reported that their IIS had with 10 of 56 (18%) in 2006.
the capacity to track vaccinations for persons of all In 2008, an estimated 23 million adolescents aged
ages, compared with 70% in 2006 (1). Data-quality 11–18 years (65% of all U.S. adolescents) participated
measures of timeliness and completeness indicated in an IIS, compared with 22.3 million (66%) in 2006.
that in 2008, 67% of IIS data were received and pro- Also in 2008, 54 million adults aged >19 years (24%
cessed within 30 days of vaccine administration, and of all U.S. adults aged >19 years) participated in an
data were reported for six of 17 core data elements IIS, compared with 33.5 million (18%) in 2006.
in >90% of IIS records (both measures are similar to Nationally, 95 million persons of all ages (33% of
2006 results). Increased provider use of electronic the U.S. population) were participating in an IIS in
health record systems can benefit IISs and their users 2008. Overall, IIS participation for children aged <6
by producing immunization records that are more years accounted for 19% of all participants in IISs,
timely and complete. whereas adolescents and adults accounted for 25%
The 2008 IISAR, a self-administered, Internet- and 57%, respectively.
based questionnaire, was made available to state and IIS timeliness is measured by the interval between
local immunization program managers in the 50 1) a child’s birth and the establishment of an IIS record
states, five cities,* and the District of Columbia that and 2) administration of a vaccine and submission of
receive funding under section 317 of the Public Health its dose-related data to an IIS (2). In 2008, 71% of
Service Act,† as part of an annual reporting require- IISs reported that an IIS record had been established
ment. As in previous years, respondents were asked for newborn children within 6 weeks of birth (com-
about the number of children aged <6 years partici- pared with 69% in 2006) (1). For all vaccine doses
pating in the IIS; the number of health-care–provider administered and recorded in 2008 to children aged
sites participating; child, adolescent, and adult <6 years, 67% of all vaccine data were received and
vaccination series completion and coverage; and processed in the IIS within 30 days of vaccine admin-
programmatic and technical capabilities (e.g., data