Limited availability and use of quality immunization data in international settings: Cause for alarm

Key to the success of national immunization programs is the ability to collect and analyze both coverage and surveillance data to guide program performance. Unfortunately, available data suggest that the quality of data currently in use needs to be dramatically improved. The issues of immunization data quality are complex and multifaceted. The collection, reporting, and use of the immunization data include multiple-layer stakeholders, e.g., health care workers, national and sub-national health officials, laboratory personnel, and data managers. In resource-limited countries, the data providers and users at each level are faced with different issues and challenges. Most national programs have immunization coverage monitoring system, acute flaccid paralysis/polio surveillance system, and measles surveillance system. For the regional and global monitoring purposes, each of these systems poses its own challenges on data standardization and accurate, timely, and complete data reporting.

Common factors associated with data quality include: poor record keeping practices, unstandardized data collection systems, disconnect between the laboratory and epidemiology units, irregular data entry and reporting, and inadequate training or skill level on data management.

The complexity and the multifaceted nature of the immunization data quality issues require a comprehensive and localized understanding of the data collection, use, and reporting situations so that appropriate interventions can be designed and implemented. This will be critical in developing a unified framework for all vaccine preventable disease surveillance and program monitoring, which was called for by the Global Framework for Immunization Monitoring and Surveillance, developed by the World Health Organization and its international immunization partners.