Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Using an Immunization Information System to Improve Accountability for Vaccines Distributed Through the Vaccines for Children Program in New York City, 2005–2008

Metroka, Amy E.; Hansen, Michael A.; Papadouka, Vikki; Zucker, Jane R.

Journal of Public Health Management and Practice: September-October 2009 - Volume 15 - Issue 5 - p E13–E21
doi: 10.1097/PHH.0b013e3181a8c31f
Article
Buy
SDC

Background As new, higher-priced vaccines are added to the immunization schedule, Vaccines for Children (VFC) program costs are increasing and attention has been focused on strengthening accountability. In New York City, the VFC program distributes publicly purchased vaccines, worth nearly $117 million annually, to more than 1 500 enrolled facilities to immunize eligible children. In 2006, we changed our policy of requiring facilities to account for administration of VFC vaccines by submitting self-reported, aggregate doses administered reports (DARs) when ordering VFC vaccines to using DARs generated from our immunization information system (IIS), the Citywide Immunization Registry (CIR). New York City providers have been required to report immunizations to the CIR since 1997.

Objectives To increase VFC accountability and reporting to the CIR by linking vaccine ordering and distribution to reporting of doses administered.

Methods We matched all VFC facilities to those in the CIR. Using CIR and VFC data, we calculated a CIR-generated DAR percentage for each facility by dividing doses reported by doses distributed. We informed facilities that their CIR-generated DAR must be more than 90 percent or their VFC vaccine orders may be reduced.

Results After the policy change, doses reported to the CIR for children younger than 8 years increased 71 percent, and the percentage of doses distributed that were reported as administered to eligible children increased from 40 to 67. Few facilities protested; none dropped out of VFC.

Conclusions Replacing self-reported DARs with IIS-generated DARs improved VFC accountability and increased reporting to the IIS. Immunization programs nationwide may achieve similar success using this strategy.

This study describes the process used to implement the DAR policy change and the policy's impact on vaccine accountability, reporting to the CIR, and completeness of CIR immunization data.

Amy E. Metroka, MSW, is the Director of the Citywide Immunization Registry, Bureau of Immunization, New York City Department of Health and Mental Hygiene, New York, New York.

Michael A. Hansen, MPH, is the Coordinator of Vaccine Information Management, Citywide Immunization Registry, Bureau of Immunization, New York City Department of Health and Mental Hygiene, New York, New York.

Vikki Papadouka, PhD, MPH, is the Director of Research and Evaluation, Citywide Immunization Registry, Bureau of Immunization, New York City Department of Health and Mental Hygiene, New York, New York.

Jane R. Zucker, MD, MSc, is the Assistant Commissioner, Bureau of Immunization, New York City Department of Health and Mental Hygiene, New York, New York. She is also a medical epidemiologist with the Immunization Services Division, Program Operations Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.

Corresponding Author: Amy E. Metroka, MSW, Citywide Immunization Registry, Bureau of Immunization, New York City Department of Health and Mental Hygiene, 2 Lafayette St, 19th Floor, New York, NY 10007 (ametroka@health.nyc.gov).

This work was supported by the Centers for Disease Control and Prevention, Immunization Grant Program (grant H23/CCH222539). The authors thank Diana Bartlett and Karen Cullen for their very helpful comments on an earlier version of this manuscript.

© 2009 Lippincott Williams & Wilkins, Inc.