Background: Low immunization coverage may result from failure to receive vaccinations or incomplete documentation of immunizations delivered by secondary providers. Registries can be used to eliminate the problem of incomplete documentation and record scatter.
Objective: To assess the contribution of a citywide immunization registry to the assessment of practice-based immunization coverage rates.
Methods: In April 1999, we audited 858 randomly-selected medical records of children ages 18-35 months at 11 primary care practices serving a low-income, minority community in New York City. Records with MOGE documentation (4.5%) were excluded. Up-to-date (UTD) immunization status was assessed for DTP, polio, MMR, and Hib (4-3-1-3) as per the ACIP schedule. Parallel records were obtained from the New York Citywide Immunization Registry. Assessments were calculated with medical record data only and with both medical record and registry data.
Results: Medical records showed that 61.1% of the children were UTD. Registry data indicated that 46% of the children had received immunizations from other providers. Inclusion of registry data increased coverage by 10% to 71.3% (t=9.9, p<0.001). Half of the children (54.2%) received all vaccinations from their primary provider. In this group, 59.8% were UTD. The other half of the children received immunizations from both primary and secondary providers, and their coverage was 85.0% (t=8.5, p<0.001).
Conclusions: Use of multiple providers significantly increased immunization coverage rates. Without a comprehensive record of immunizations from the citywide registry, practice-based assessments significantly underestimate immunization coverage.
Learning Objectives: To identify the impact of record scatter on practice-based immunization assessments and to clarify the utility of immunization registries.
Keywords: Immunizations, Registry
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.