Using the Immunization Registry to Track H1N1 Vaccinations

Approximately 30 to 40% of North Carolina providers (private and public) use the North Carolina Immunization Registry to electronically report H1N1 vaccine doses administered. The immunization registry is a secure, web-based clinical tool that serves as the state's key method of collecting information about vaccinations. While the state did not require the use of the Registry for H1N1 doses administered, many providers still chose to enter into the system. The system is not yet fully deployed to private sector providers, but it is fully deployed in all 100 local health departments (LHDs) in the state. Seventy-three LHDs chose to enter their H1N1 doses in the registry, while the rest did paper reporting. Use of the registry has helped to facilitate the tracking of H1N1 vaccinations.

Providers are asked to have all H1N1 doses in the NCIR or to fax back their aggregate forms to the state by Monday for the week's prior administration. (Those providers who do not currently use NCIR or choose not to enter H1N1 vaccination information electronically convey the data via a paper report). After the first three weeks of H1N1 vaccinations, the state also called back providers that had not reported to make sure they could capture all possible doses administered.

Every Tuesday afternoon, the Registry Unit runs a query for H1N1 doses administered from the system as well as from its paper-based Access database. The queries from the two sources are imported to produce summary counts. The state then inputs those reports into the national CRA system. Providers who did not report their data went on a non-responder list; if no data was reported for a two-week period, no additional vaccines are allocated to those providers.

The state also developed a Mass Vaccination Screen in the registry to help streamline data entry when dealing with a large volume of patients, particularly during mass vaccination clinics. Providers can input information for 10 patients and two vaccinations at a time. A focus group convened before implementation of the screen provided valuable input and allowed the state to create a program that was most suitable for the end user. The state also created a training module to assist providers in using the screen easily and effectively.

Using the NCIR to document H1N1 doses helped to facilitate CRA reporting because the information needed was already entered in the registry and could easily be retrieved from the system. Paper reporting, however, involved a great deal of data entry before the required information could be assembled. The system also monitors inventory, which was very helpful for the state and the providers when H1N1 vaccine was recalled or the expiration date shortened.

Use of the NCIR to record H1N1 doses also benefited local health departments. While it required slightly more effort at the time of administration, once completed, no further reporting was required and the reminder/recall function could be used to track when children needed to come back for their second dose of H1N1 vaccine.

In addition, the mass vaccination screen developed specifically for the H1N1 campaign allowed providers to document doses by presetting some fields such as the clinician ordering the vaccine and the person administering the vaccine. Health departments were very pleased with this additional feature and it can be used for other mass clinic situations such as large seasonal flu vaccine clinics.

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