CHILDHOOD IMMUNIZATION REGISTRY

Why Do We Need Childhood Immunization Registries?
The U.S. now enjoys the highest immunization rates and lowest disease levels ever, but the growing complexity and volume of immunization information makes it difficult to sustain those levels consistently. Immunization registries - confidential, computerized information systems - help to prevent the “peaks and valleys” of disease outbreaks by managing information about the immunizations that children receive more efficiently. Immunization registries are important tools for ensuring that all children are immunized on time. 

What Is the Goal for Immunization Registries? 
In 1999, the National Vaccine Advisory Committee (NVAC) issued a report on developing community- and state-based immunization registries that would help to maintain high immunization rates. Healthy People 2010 established a goal of enrolling 95% of children from birth through age 5 in a fully functioning immunization registry. The objective notes that “population-based immunization registries will be a cornerstone of the Nation’s immunization system by 2010.”

Where Are Immunization Registries Now?
Immunization registries are being developed or are operational in all 50 states. A registry can be based in a state, county, city or multi-county health jurisdiction. Twenty-two states have laws or rules specifically authorizing immunization registries, and 11 require health care professionals to report immunizations to their registries. Several cities, including New York and Baltimore, also have mandated provider reporting of immunizations. Approximately one-third of all children in the 34 states with operational registries are now included in the registries. 

Who Do Immunization Registries Benefit?
Registries benefit children, parents, doctors and nurses, health plans, schools, communities, and states. 
Registries consolidate a child’s immunizations from all doctors into one record so the child has a reliable immunization history when a family moves or switches health care providers. They provide current recommendations and information on new vaccines, facilitate the introduction of new vaccines or changes in the vaccine schedule, and help manage vaccine inventories. Registries produce “reminders” and “recalls” for immunizations due or overdue; complete required school, camp or day care immunization records. They generate coverage reports for managed care (e.g., HEDIS) and other organizations. In a letter of support for the development of registries, Secretary of Education Richard Riley noted that “the automatic printout of a student’s immunization status [produced by registries] will promote greater accuracy of records and avoid duplication of immunizations. This will enable schools to focus on other important health-related activities.”

Registries prevent disease outbreaks and control vaccine-preventable diseases by identifying pockets of under-immunized children. Where allowed, they can link with other health databases, such as newborn and lead screening, or other state registries. And they can help increase vaccine safety by reducing over-immunization and advising providers on recognized contraindications. They also can assist in the evaluation of reported adverse events associated with immunizations.

How Do Immunization Registries Protect Privacy and Confidentiality?
Immunization registries protect the privacy and confidentiality of children and families through technical and administrative safeguards that prevent inappropriate sharing of information. To be in compliance with national confidentiality policies for immunization registries, registries must comply with stringent specifications and guidelines. The specifications are consistent with federal recommendations for privacy legislation. 

How Much Has Been Invested In Immunization Registries? 
Since 1992, over $200 million has been invested in the development of registries by federal, state and local governments, and private foundations. 
Approximately $50 million annually is now being spent on registries. Of that, 42% is from federal funding for state immunization programs (federal Section 317 funding), while 58% is from states/counties/cities, HCFA/Medicaid, health plans, foundations, and fee-for-service.

What Immunization Registries Cost Annually
The cost to complete and maintain immunization registries is approximately $5 per child per year, for all children up to age 6, or $125 million annually.

Immunization Registries Will Save Twice What They Cost
Fully operational immunization registries could annually eliminate approximately $250 million in costs incurred in this country by making accurate, up-to-date immunization information available to health care professionals and schools. Additional savings to the health care system, such as reduced incidence of disease and prevention of vaccine wastage, are not yet included in this total.

Immunization Registry Development Is in Jeopardy Without Long-term Support
The largest source of support for registries, federal Section 317 immunization program grants, has declined every year since 1995. Registries continue to seek funding from other sources, including state Medicaid funding, but none comes with long-term guarantees.

Without steady, long-term funding of $125 million annually - $75 million more than is now being spent - further development of immunization registries across our country is in jeopardy.

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