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State-Level Immunization Information Systems: Potential for Childhood Immunization Data Linkages


Fuller, Jill E.; Walter, Emmanuel B., Jr.; Dole, Nancy; O'Hara, Rick; Herring, Amy H.; Durkin, Maureen; Specker, Bonny; & Wey, Betty (2017). State-Level Immunization Information Systems: Potential for Childhood Immunization Data Linkages. Maternal and Child Health Journal, 21(1), 29-35. PMCID: PMC5233617


Objectives: Sources of immunization data include state registries or immunization information systems (IIS), medical records, and surveys. Little is known about the quality of these data sources or the feasibility of using IIS data for research. We assessed the feasibility of collecting immunization information for a national children's health study by accessing existing IIS data and comparing the completeness of these data against medical record abstractions (MRA) and parent report. Staff time needed to obtain IIS and MRA data was assessed.
Methods We administered a questionnaire to state-level IIS representatives to ascertain availability and completeness of their data for research and gather information about data formats. We evaluated quality of data from IIS, medical records, and reports from parents of 119 National Children's Study participants at three locations.
Results: IIS data were comparable to MRA data and both were more complete than parental report. Agreement between IIS and MRA data was greater than between parental report and MRA, suggesting IIS and MRA are better sources than parental report. Obtaining IIS data took less staff time than chart review, making IIS data linkage for research a preferred choice.
Conclusions: IIS survey results indicate data can be obtained by researchers using data linkages. IIS are an accessible and feasible child immunization information source and these registries reduce reliance on parental report or medical record abstraction. Researchers seeking to link IIS data with large multi-site studies should consider acquiring IIS data, but may need strategies to overcome barriers to data completeness and linkage.


Reference Type

Journal Article

Year Published


Journal Title

Maternal and Child Health Journal


Fuller, Jill E.
Walter, Emmanuel B., Jr.
Dole, Nancy
O'Hara, Rick
Herring, Amy H.
Durkin, Maureen
Specker, Bonny
Wey, Betty