Measuring child participation in immunization registries: two national surveys, 2001 Diana Bartlett Immunization Registry Support Branch National Immunization Program
Objectives Describe the progress of immunization registries in reaching a national objective using two data sources Describe the percentage of children 19-35 months of age participating in an immunization registry Describe the characteristics of health providers who report vaccines to registries
National Objective for Immunization Registries Increase to 95% the proportion of children <6 years of age who participate in fully operational, population-based immunization registries (Healthy People 2010, objective 14.26)
CY2001 IRAR Methods Self-administered questionnaire to immunization program managers; yearly reporting requirement of Public Health Service Act 317b grantees Questions pertain to child and health provider participation in registries, vaccination coverage levels, and registry functionality Analysis focused on states and DC
NIS Methods (1) Random-digit-dialing survey of parents; collects vaccination coverage on children 19-35 months of age Validates parental responses with provider records via a mailed survey Beginning in April 1999, the mailed NIS provider survey asked: Did you or your facility report any of this child s immunizations to your community or state immunization registry?
NIS Methods (2) Answers are linked to child data; yes by at least one provider indicates a child in a registry Data from 23,531 children 19-35 months of age, weighted to represent U.S. population State of child s residence used as proxy for state of provider s practice SUDAAN 7.5 produced all NIS estimates and standard errors
IRAR- 19 to 35 months 41% 0% to 33% (13) 34% to 66% (11) 67% to100% (16)
NIS- 19 to 35 months 36% (35.1%-37%) 0% to 33% (22) 34% to 66% (16) 67% to100% (12)
Children 19-35 months of age who had at least one of their providers report their vaccination records to a registry 100% % of children in registries 80% 60% 40% 20% 36% 36% Healthy People 2010 goal 14% 14% In registry Not in registry N/A Unknown 0% Registry participation
Percentage of children 19-35 months of age by immunization facility type 100% % of children with survey data 80% 60% 40% 20% 14% 57% 7% 8% 14% All public All private Mixed Other Unknown 0% Immunization facility type
Children 19-35 months of age who had a provider report their vaccination records to a registry by provider type % of children who had records reported to registry 100% 80% 60% 40% 20% 0% 68% 29% Healthy People 2010 goal 72% 45% 13% Public Private Mixed Other Unknown Provider type
Percentage of children aged 19-35 months who had their vaccinations reported by at least one VFC or WIC provider By VFC provider By WIC provider % of children reported to registry 100% 80% 60% 40% 20% 0% 100% 80% 60% 56% 51% 40% 34% 20% 10% 0% VFC non- VFC WIC non- WIC % of children reported to registry
Conclusions (1) States still trying to reach the Healthy People 2010 goal Poor agreement between NIS and IRAR estimates Measure estimates differently NIS definition of registry
Conclusions (2) Children with only public providers or a mixture of public and private providers were almost three times more likely to have their vaccination records reported to a registry (2001 NIS) Children seen in WIC clinics or by VFC providers are more likely to have their immunization data reported to an immunization registry (2001 NIS)
Limitations Data are self-reported IRAR provider numbers unreliable All NIS results are child-specific, not provider-specific The state where a child resides was used as a proxy measure for the provider and registry location in the NIS analysis
Recommendations Registries should use results to target immunization marketing efforts to parents and health providers to increase child and provider registry participation CDC and local projects should continue to use the NIS to complement and/or validate registry participation data from the IRAR
For Further Information Contact: Diana Bartlett Public Health Analyst Registry Support Team CDC National Immunization Program 1600 Clifton Rd., MS E-62 Atlanta, Ga. 30333 phone: 404-639-1813 fax: 404-639-8171 email: dbartlett@cdc.gov