Scharf Lynn Gibbs, Coyle Rebecca, Adeniyi Kafayat, Fath Janet, Harris LaTreace, Myerburg Stuart, Kurilo Mary Beth, Abbott Elizabeth
Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Immunization Information Systems Support Branch (LG Scharf, K Adeniyi, J Fath, L Harris, and S Myerburg), Atlanta, Ga.
American Immunization Registry Association (R Coyle, MB Kurilo, and E Abbott), Washington, DC.
Acad Pediatr. 2021 May-Jun;21(4S):S57-S64. doi: 10.1016/j.acap.2020.11.008.
Immunizations have proven to be an important tool for public health and for reducing the impact of vaccine preventable diseases. To realize the maximum benefits of immunizations, a coordinated effort between public policy, health care providers and health systems is required to increase vaccination coverage and to ensure high-quality data are available to inform clinical and public health interventions. Immunization information systems (IIS) are confidential, population-based, computerized databases that record all immunization doses administered by participating providers to persons residing within a given geopolitical area. The key output of an IIS is high-quality data for use in targeting and monitoring immunization program activities and providing clinical decision support at the point of care. To be truly effective, IISs need to form a nationwide network and repository of immunization data. Since the early 2000s Centers for Disease Control and Prevention has made strides to help IIS move toward a nationwide network through efforts focused on improving infrastructure and functionality, such as the IIS Minimum Functional Standards, and the IIS Annual Report, a self-reported data collection of IIS progress toward achieving the functional standards. While these efforts have helped immunization programs achieve more functional standards, there is a need to shift focus from infrastructure and functionality improvements to high data quality through objective measurement of IIS performance and evaluating critical outcomes. Additionally, realizing the vision of a nationwide repository of high-quality immunization data requires tackling the many challenges that impact data quality and availability including those related to policy, data sharing, data use, aging IIS technology, sustainability, and participation in the IIS. This paper describes the current state of IIS in the United States, critical challenges impacting the quality of data in IIS, and potential components of a future IIS model to address these challenges.
免疫接种已被证明是促进公共卫生以及减少疫苗可预防疾病影响的一项重要工具。为了实现免疫接种的最大效益，公共政策、医疗服务提供者和卫生系统之间需要协同努力，以提高疫苗接种覆盖率，并确保有高质量的数据可用于指导临床和公共卫生干预措施。免疫接种信息系统（IIS）是基于人群的保密计算机化数据库，记录参与的医疗服务提供者向居住在特定地理政治区域内的人员接种的所有疫苗剂量。IIS的关键产出是高质量数据，用于确定免疫接种计划活动的目标和进行监测，并在医疗服务点提供临床决策支持。为了真正发挥作用，IIS需要形成一个全国性的免疫接种数据网络和存储库。自21世纪初以来，疾病控制与预防中心已通过专注于改善基础设施和功能的努力，推动IIS朝着全国性网络发展，例如IIS最低功能标准和IIS年度报告，后者是IIS在实现功能标准方面进展情况的自我报告数据收集。虽然这些努力帮助免疫接种计划实现了更多功能标准，但需要将重点从改善基础设施和功能转向通过客观衡量IIS绩效和评估关键结果来提高数据质量。此外，要实现建立全国性高质量免疫接种数据存储库的愿景，需要应对许多影响数据质量和可用性的挑战，包括与政策、数据共享、数据使用、老化的IIS技术、可持续性以及参与IIS相关的挑战。本文描述了美国IIS的现状、影响IIS数据质量的关键挑战，以及未来IIS模型应对这些挑战的潜在组成部分。
