Cardemil Cristina V, Cullen Karen A, Harris LaTreace, Greby Stacie M, Santibanez Tammy A
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Cardemil, Cullen, Greby, and Santibanez and Ms Harris). Dr Cullen is now with Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
J Public Health Manag Pract. 2016 May-Jun;22(3):245-54. doi: 10.1097/PHH.0000000000000278.
Use of Immunization information systems (IISs) by providers can improve vaccination rates by identifying missed opportunities. However, provider reporting of children's vaccination histories to IISs remains suboptimal.
To assess factors associated with provider reporting to an IIS.
Analysis of 2006-2012 National Immunization Survey (NIS) and NIS-Teen data. NIS and NIS-Teen are ongoing random-digit-dial telephone surveys of households with children and adolescents, respectively, followed by a mail survey to providers to obtain the patient's vaccination history.
A total of 115 285 children aged 19 to 35 months and 83 612 adolescents aged 13 to 17 years and their immunization providers in the United States.
The percentage of children and adolescents with 1 or more providers reporting to or obtaining vaccination information from their local IISs. Multivariable logistic regression was used to examine patient and provider factors associated with provider reporting to IISs and adjusted prevalence of children and adolescents with 1 or more providers reporting to IISs.
In 2012, 79.4% of children and 77.4% of adolescents had 1 or more providers report any of their vaccination data to an IIS, and 41.9% of children and 51.5% of adolescents had providers who obtained any of their vaccination histories from an IIS. During 2006-2012, children and adolescents were more likely to have any of their vaccination data reported to an IIS if they received care from all public versus all private providers (children: 84.4% vs 69.6%, P < .0001; adolescents: 84.6% vs 66.4%, P < .0001), had 1 or more providers who ordered vaccines from a state or local health department (children: 76.7% vs 59.5%, P < .0001; adolescents: 77.0% vs 55.6%, P < .0001), or had 1 or more providers obtain vaccination information from the IIS (children: 86.1% vs 71.2%, P < .0001; adolescents: 83.7% vs 64.6%, P < .0001).
Health department staff should target providers less likely to use IIS services, including private providers, and providers not ordering vaccines from health departments to ensure they use IIS services.
医疗服务提供者使用免疫信息系统（IIS）可通过识别错失的机会来提高疫苗接种率。然而，医疗服务提供者向IIS报告儿童疫苗接种史的情况仍不尽人意。
评估与医疗服务提供者向IIS报告相关的因素。
对2006 - 2012年国家免疫调查（NIS）和青少年NIS数据进行分析。NIS和青少年NIS分别是对有儿童和青少年的家庭进行的持续随机数字拨号电话调查，随后对医疗服务提供者进行邮件调查以获取患者的疫苗接种史。
美国共有115285名年龄在19至35个月的儿童、83612名年龄在13至17岁的青少年及其免疫接种服务提供者。
有1名或更多医疗服务提供者向当地IIS报告或从IIS获取疫苗接种信息的儿童和青少年的百分比。采用多变量逻辑回归分析与医疗服务提供者向IIS报告相关的患者和提供者因素，以及有1名或更多医疗服务提供者向IIS报告的儿童和青少年的调整患病率。
2012年，79.4%的儿童和77.4%的青少年有1名或更多医疗服务提供者向IIS报告其任何疫苗接种数据，41.9%的儿童和51.5%的青少年有医疗服务提供者从IIS获取其任何疫苗接种史。在2006 - 2012年期间，如果儿童和青少年接受的是所有公立而非所有私立医疗服务提供者的护理（儿童：84.4%对69.6%，P <.0001；青少年：84.6%对66.4%，P <.0001），有1名或更多医疗服务提供者从州或地方卫生部门订购疫苗（儿童：76.7%对59.5%，P <.0001；青少年：77.0%对55.6%，P <.0001），或有1名或更多医疗服务提供者从IIS获取疫苗接种信息（儿童：86.1%对71.2%，P <.0001；青少年：83.7%对64.6%，P <.0001），那么他们更有可能有任何疫苗接种数据被报告给IIS。
卫生部门工作人员应将目标对准不太可能使用IIS服务的医疗服务提供者，包括私立医疗服务提供者以及未从卫生部门订购疫苗的医疗服务提供者，以确保他们使用IIS服务。
