The Landscape of Immunization Information Systems in the United States: An Analysis of the Infrastructure and Readiness of IISs during the COVID-19 Vaccination Campaign and the Effects on Equitable Vaccine Distribution

Elena Tran, Gabbie Cesarone, Laura Farlow

MPH, Public Health Administration & Policy

Rebecca Wurtz

Immunization Information Systems, COVID-19 vaccination campaign


Background Immunization Information Systems (IISs) support public health surveillance and response by recording immunizations for children, and to a lesser extent, adults in the United States. The COVID-19 pandemic uncovered limitations for using IISs to report large volumes of immunization data, share data with all appropriate stakeholders, and ensure equitable vaccine distribution and access. The IIS landscape faced challenges while preparing to support the COVID-19 vaccination campaign due to lack of federal guidelines standardizing immunization data reporting and bi-directional data exchange, as well as insufficient investment in IIS infrastructure and modernization. We interviewed key stakeholders to assess the challenges faced by jurisdictions during the COVID-19 vaccination campaign.

Methods We conducted eight 90-minute interviews with four states, one system vendor, and two vaccination advocacy organizations. We created transcripts from the recordings and identified key codes and themes. 

Results We identified four main themes: 1) Expansion of existing systems, 2) Data management and analysis, 3) Data interoperability and regulations, and 4) IIS relationships and collaboration. We identified two additional themes that span and intersect the main themes: barriers and equity. Key findings and themes will be discussed further in the poster presentation.

Discussion The implications for this research will be detailed in a report on lessons learned and recommendations for best practices and policy changes for improvement in interoperability and the role of IISs in development of future immunization initiatives.

elena tran poster

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