189098 Crossing geographic borders: Methodological issues of sharing immunization data across states and its effect on vaccination coverage assessment

Monday, October 27, 2008: 11:10 AM

James A. Gaudino, MD, MS, MPH , Public Health Division, OFH-Immunization Program, Department of Human Services, State of Oregon, Portland, OR
Steve Robison , Oregon Immunization Program, Public Health Division, Oregon Health Authority, Portland, OR
Sherry Riddick, RN, MPH , CHILD Profile, Public Health Seattle-King County, Seattle, WA
Mary Beth Kurilo, MPH , Public Health Division, OFH-Immunization Program, Department of Human Services, State of Oregon, Portland, OR
Janna Bardi, MPH , Washington State Department of Health, Olympia, WA
Andrew W. Osborn, MBA , Public Health Division, OFH-Immunization Program, Department of Human Services, State of Oregon, Portland, OR
Martha Priedeman Skiles, MPH , Department of Maternal and Child Health, University of North Carolina, Chapel Hill, Chapel Hill, NC
After over 10 years of population-based IIS building within state jurisdictions, IIS are valued as primary sources for client-level immunization records consolidated from multiple healthcare facilities, and are becoming useful sources for population-based surveillance. However, until recently, few IIS routinely shared information across jurisdictions, even where populations cross borders and healthcare is routinely provided to residents in different IIS catchment areas. Oregon's IIS, ALERT, hosts a CDC-funded Sentinel IIS site, monitoring immunization coverage among Oregon residents younger than 19 years in the Portland area. The area also includes healthcare services and populations in Southwest Washington. Recognizing that residents of one state may receive immunizations in the other state, leaving gaps in IIS records, ALERT and Washington's IIS, CHILD Profile (CP) began exchanging data in 2006. Because state laws and technical IIS approaches differ, authorities in both states encountered and resolved key challenges. Initially, CP received over 450,000 immunizations from ALERT. Now, monthly, ALERT and CP exchange records for individuals residing in the other state, e.g., for Quarter 1 2008, CP received 16,975 immunization records, and ALERT received 32,523 immunization records (the latter representing 3,008 individuals). In 2007, approximately 80% of CP data merged with existing ALERT records, while another 20% represented new individuals in ALERT. Approximately 8% of the immunizations had not been previously reported to ALERT. In this case study, we will review key programmatic and methodological issues addressed, discuss the benefits for exchanges, and explore examples of the impact of data from other state IIS on immunization rates.

Learning Objectives:
1) Describe processes and issues related to ALERT and CHILD Profile IIS data exchanges. 2) Cite benefits identified from the Oregon-Washington IIS data exchange. 3) Discuss examples of immunization rates using and not using exchanged data including within the Oregon Sentinel IIS surveillance region

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a senior medical epidemiologist working in a state health department with years of working on immunization related projects and am the PI of the CDC Oregon Sentinel IIS Surveillance project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.