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

Groom, Holly MPH; Hopkins, David P. MD, MPH; Pabst, Laura J. MPH; Murphy Morgan, Jennifer MSPH; Patel, Mona MPH; Calonge, Ned MD; Coyle, Rebecca MPH; Dombkowski, Kevin DrPH, MS; Groom, Amy V. MPH; Kurilo, Mary Beth MPH, MSW; Rasulnia, Bobby PhD, MPH, MPA; Shefer, Abigail MD; Town, Cecile MPH; Wortley, Pascale M. MD, MPH; Zucker, Jane MD, MSthe Community Preventive Services Task Force

Journal of Public Health Management and Practice: May/June 2015 - Volume 21 - Issue 3 - p 227–248
doi: 10.1097/PHH.0000000000000069
Original Articles

Context: Immunizations are the most effective way to reduce incidence of vaccine-preventable diseases. Immunization information systems (IISs) are confidential, population-based, computerized databases that record all vaccination doses administered by participating providers to people residing within a given geopolitical area. They facilitate consolidation of vaccination histories for use by health care providers in determining appropriate client vaccinations. Immunization information systems also provide aggregate data on immunizations for use in monitoring coverage and program operations and to guide public health action.

Evidence Acquisition: Methods for conducting systematic reviews for the Guide to Community Preventive Services were used to assess the effectiveness of IISs. Reviewed evidence examined changes in vaccination rates in client populations or described expanded IIS capabilities related to improving vaccinations. The literature search identified 108 published articles and 132 conference abstracts describing or evaluating the use of IISs in different assessment categories.

Evidence Synthesis: Studies described or evaluated IIS capabilities to (1) create or support effective interventions to increase vaccination rates, such as client reminder and recall, provider assessment and feedback, and provider reminders; (2) determine client vaccination status to inform decisions by clinicians, health care systems, and schools; (3) guide public health responses to outbreaks of vaccine-preventable disease; (4) inform assessments of vaccination coverage, missed vaccination opportunities, invalid dose administration, and disparities; and (5) facilitate vaccine management and accountability.

Conclusions: Findings from 240 articles and abstracts demonstrate IIS capabilities and actions in increasing vaccination rates with the goal of reducing vaccine-preventable disease.

This article provides findings from 240 articles and abstracts demonstrating immunization information system capabilities and actions in increasing vaccination rates with the goal of reducing vaccine-preventable disease.

Community Guide Branch, Division of Epidemiology, Analysis, and Library Services (Dr Hopkins and Mss Murphy Morgan and Patel), Immunization Services Division, National Center for Immunizations and Respiratory Diseases (Mss Groom, Pabst, Shefer, and Town and Dr Zucker), Office for State, Tribal, Local, and Territorial Support (Dr Rasulnia), and Division of HIV/AIDS Prevention (Dr Wortley), Centers for Disease Control and Prevention, Atlanta, Georgia; The Colorado Trust, Denver, Colorado (Dr Calonge); American Immunization Registry Association (AIRA), Washington, District of Columbia (Ms Coyle); Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, Michigan (Dr Dombkowski); and Oregon Immunization Program, Portland, Oregon (Ms Kurilo). Ms Groom is now with Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.

Correspondence: Holly Groom, MPH, Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate Ave, Portland, OR 97227 (

Names and affıliations of Task Force members are available at

We gratefully acknowledge the team of consultants, referred to as the “team,” who helped us form the framework and research questions, and establish criteria for included studies for this review. We are also grateful to the CDC Immunization Information System Support Branch for the subject matter expertise they provided, and to Gary Edgar for his support throughout the review process. In addition, the authors thank Dr Robert Menzies, from the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS) at the University of Sydney, for his input on the sections pertaining to the Australian Childhood Immunisation Register.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

The authors declare no conflicts of interest.

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