1. Immunization Registries Update, 2003 Gail Williams, MPH, CHES National Immunization Program Centers for Disease Control and Prevention Gail Williams, MPH, CHES National Immunization Program Centers for Disease Control and Prevention

2. Increase to 95% the proportion of children (0<6 years of age) in a fully operational population-based immunization registry (Healthy People 2010, objective 14.26) Increase to 95% the proportion of children (0<6 years of age) in a fully operational population-based immunization registry (Healthy People 2010, objective 14.26) Healthy People 2010 Objective

3. Progress towards HP goal, 2001 Overall = 31% 0% to 33% (21) 34% to 66 % (15) 67% to 100% ( 15) Note: States in white have only non-population-based registries Source: Immunization Registries Annual Report, 2002

5. Strengthening Our Standards  12 Functional Standards  Reinforced in the upcoming guidance document  Supported in the Certification Process  PROW Standards of Excellence  NVAC endorsement  Design of demonstration sites  Notice to Readers: MMWR  12 Functional Standards  Reinforced in the upcoming guidance document  Supported in the Certification Process  PROW Standards of Excellence  NVAC endorsement  Design of demonstration sites  Notice to Readers: MMWR

6. Strengthening Our Partnerships  American Immunization Registry Association  Association of Immunization Managers  Committee on Immunization Registry Standards and Electronic Transactions  Connections  Every Child by Two  Health care professional organizations  Public health organizations  Government public health and financing organizations  American Immunization Registry Association  Association of Immunization Managers  Committee on Immunization Registry Standards and Electronic Transactions  Connections  Every Child by Two  Health care professional organizations  Public health organizations  Government public health and financing organizations

7. Strengthening Providers Participation  Health Care Professional Participation Work Group (HCPWG)  Members: AAFP, AAHP, AAP, AIRA, ANA, APA, ECBT, Kaiser, NACHC, NMA, CDC ! Registry Value ! Provider Marketing ! Marketing/Education ! Integration/Research  Health Care Professional Participation Work Group (HCPWG)  Members: AAFP, AAHP, AAP, AIRA, ANA, APA, ECBT, Kaiser, NACHC, NMA, CDC ! Registry Value ! Provider Marketing ! Marketing/Education ! Integration/Research

8. Strengthening Our Data Quality 1. Certification Certification 2. De-duplication test cases De-duplication test cases 3. National Immunization Survey National Immunization Survey 1. Certification Certification 2. De-duplication test cases De-duplication test cases 3. National Immunization Survey National Immunization Survey

9. Certification Helping registries become “certification-ready”  Technical Work Group  Pilot tested voluntary certification criteria in:, Michigan, New Jersey, Utah  Where are we now?  Technical Work Group  Pilot tested voluntary certification criteria in:, Michigan, New Jersey, Utah  Where are we now?

10. De-duplication Test Cases http://www.cdc.gov/nip/registry/dedup/dedup.htm

11. National Immunization Survey Pilot tested Arizona Michigan Oklahoma Washington, DC Provides Coverage Estimates Provider Verified Patient Histories  Assess completeness  Compare NIS to Registry data Pilot tested Arizona Michigan Oklahoma Washington, DC Provides Coverage Estimates Provider Verified Patient Histories  Assess completeness  Compare NIS to Registry data

12. Registry Sentinel Sites Oregon: Cities of Salem and Portland New York City Arizona: Coconino County Michigan: Jackson, Kent, Muskegon Co. Utah: Salt Lake County Oklahoma San Antonio Washington, D.C

13. Sentinel Sites: Profiles Site# of ChildrenProviders % with ≥2 doses Est. % Duplicates AZ 10,546ALL910-1 UT 18,259PUBLIC968 NYC 18,607PRIVATE10012.6 SAT 64,435WIC97<1 OK 112,574PUBLIC100<5 OR 28,497ALL98<1 MI 90,141ALL1005 DC 18,407Medicaid MCO’s92<1 Source: Sentinel Site Reports, May 2003

14. Sentinel Sites: Data  Describe vaccination coverage by age group and antigen  Compare vaccination series data with data from past quarters and the lower confidence interval of the 2001 National Immunization Survey (NIS) estimate  Describe immunization coverage by age group and antigen  Provide data on ad hoc requests NOTE: NIS 2001 data are not directly comparable to 2003 sentinel site quarterly reports.  Describe vaccination coverage by age group and antigen  Compare vaccination series data with data from past quarters and the lower confidence interval of the 2001 National Immunization Survey (NIS) estimate  Describe immunization coverage by age group and antigen  Provide data on ad hoc requests NOTE: NIS 2001 data are not directly comparable to 2003 sentinel site quarterly reports.

15. Sample:Timeliness of Registry Data

16. % Registry Consent and Participation, Preliminary Findings, May 2003

17. Challenges for Immunization Registries  Ensuring the participation of all or almost all immunization providers and parents,  Ensuring appropriate technical functioning of registries to enable high quality data collection, use, and exchange,  Ensuring the confidentiality of registry information and the privacy of registry participants, and  Ensuring a sustainable funding stream for continued immunization registry support.  Ensuring the participation of all or almost all immunization providers and parents,  Ensuring appropriate technical functioning of registries to enable high quality data collection, use, and exchange,  Ensuring the confidentiality of registry information and the privacy of registry participants, and  Ensuring a sustainable funding stream for continued immunization registry support.

18. Recommendations to Improve Immunization Registries….. Ensure Provider demand for registries Complete and accurate history Reminders and recalls Ensure registries support immunization program objectives 12 Functional Standards PROW Standards of Excellence Ensure Privacy and Confidentiality  Monitor state and federal legislation Research impact of state legislation on IR. Clear legal authority Ensure Provider demand for registries Complete and accurate history Reminders and recalls Ensure registries support immunization program objectives 12 Functional Standards PROW Standards of Excellence Ensure Privacy and Confidentiality  Monitor state and federal legislation Research impact of state legislation on IR. Clear legal authority

19. http://www.cdc.gov/nip/