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Economic Review of Immunization Information Systems to Increase Vaccination Rates: A Community Guide Systematic Review

Patel, Mona MPH; Pabst, Laura MPH; Chattopadhyay, Sajal PhD; Hopkins, David MD, MPH; Groom, Holly MPH; Myerburg, Stuart JD; Morgan, Jennifer Murphy MSPH; the Community Preventive Services Task Force

Journal of Public Health Management & Practice: May/June 2015 - Volume 21 - Issue 3 - p 253–262
doi: 10.1097/PHH.0000000000000100
Research Brief Report

Context: A recent systematic review found that use of an immunization information system (IIS) is an effective intervention to increase vaccination rates. The purpose of this review was to evaluate costs and benefits associated with implementing, operating, and participating with an IIS. The speed of technology change has had an effect on costs and benefits of IIS and is considered in this review.

Evidence Acquisition: An economic evaluation for IIS was conducted using methods developed for Community Guide systematic reviews. The literature search covered the period from January 1994 to March 2012 and identified 12 published articles and 2 government reports.

Evidence Synthesis: Most studies involving cost data evaluated (1) system costs of building an IIS and (2) cost of exchanging immunization data; most economic benefits focused on administrative efficiency.

Conclusions: A major challenge to evaluating a technology-based intervention is the evolution that comes with technology improvements and advancements. Although the cost and benefit data may be less applicable today due to changes in system technology, data exchange methods, availability of vendor support, system functionalities, and scope of IIS, it is likely that more up-to-date estimates and comprehensive estimates of benefits would support the findings of cost savings in this review. More research is needed to update and address limitations in the available evidence and to enable assessment of economic costs and benefits of present-day IIS.

The purpose of this study was to evaluate costs and benefits associated with implementing, operating, and participating with an immunization information system.

Community Guide Branch, Division of Epidemiology, Analysis, and Library Services (Mss Patel and Murphy Morgan and Drs Chattopadhyay and Hopkins), and Immunization Services Division, National Center for Immunization and Respiratory Diseases (Ms Pabst and Mr Myerburg), Centers for Disease Control and Prevention, Atlanta, Georgia; and Kaiser Permanente Center for Health Research (Ms Groom), Portland, Oregon.

Correspondence: Mona Patel, MPH, Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-69, Atlanta, GA 30329 (

Names and affıliations of Task Force members are available at

This review would not have been possible without the subject matter expertise and contributions of Daniel Martin and Gary Urquhart from the Immunization Information Systems Surveillance Branch at Centers for Disease Control and Prevention. The authors also thank Kate W. Harris, Kristen Folsom, and Onnalee Gomez for their assistance throughout the review process.

The authors declare no conflicts of interest.

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