Immunizations

CDC and CMS-CCSQ Joint Support for Immunization Status

Thank you for opportunity to comment on this data element. The Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) emphasize the importance of patient safety being reflected in the USCDI standards. Identification of whether vaccinations are current and whether any vaccinations need to be administered using the Vaccination Event Record Type and Immunization Status data elements are vital to patient safety outcomes. CMS and CDC strongly recommend the Immunization Status (Level 2) data element in the Immunization data class be added to USCDI. This addition would promote patient safety.

CDC's Consolidated Comment for USCDI v5

** ADD THIS USE CASE TO SUBMISSION **

• "Immunizations HPV": HPV is estimated to cause 70% of oropharyngeal cancers in the United States, although it is unclear if having HPV alone is enough to cause oropharyngeal cancers, or if other factors interact with HPV to cause these cancers. Because the HPV vaccine protects against the types of HPV that can cause oropharyngeal cancers, it may also prevent oropharyngeal cancers. The United States is struggling to achieve HPV vaccination goals because HPV vaccination policies vary greatly nationwide, making it hard to implement sustainable programs. Surveillance of HPV vaccination and risk factors can help to establish associations, identify at-risk populations, and better inform clinical decision-making guidelines and interventions. These activities can increase vaccination acceptance rates and may lower HPV-associated oropharyngeal cancer prevalence and incidence.

NACCHO supports CDC's comment.

CDC's Consolidated Comment for USCDI v4

CDC continues to recommend inclusion of this high priority data element in USCDI v4.

Unified Comment from CDC

• Additional Use Cases:
• Immunization elements are a major piece of public health control and mitigation. When combined with case reports to a jurisdiction or notification to CDC, it allows the jurisdiction or CDC to see where immunizations may be lacking. Immunization information may not directly provide disparity information, but it is needed together with other disparity-related data (e.g., race, ethnicity, location) to identify vaccine breakthroughs or problems with vaccination access/coverage which may also speak to broader health disparities related to general access to medical care and services.
   
• Immunization information including date of administration is collected as part of case based surveillance for Hepatitis A, Acute Hepatitis B and Perinatal Hepatitis B to understand hepatitis transmission patterns and ensure appropriate interventions are prioritized within impacted communities.
   
• Number of stakeholders who capture, access, use or exchange this data element:  All US States and DC are funded through CDC’s Division of Viral Hepatitis flagship Notice of Funding Actions to perform surveillance activities, including collection of these data for surveillance purposes.
   
• Support for healthcare aims:  Improving patient experience of care, Improving health of populations, Reducing cost of care, Improving provider experience of care
   
• Use of data element:  Extensively used in production environments
   
• Exchange of data element: CDC Message Mapping Guides (MMG) (e.g., COVID-19) ;
• The Multiple Chronic Conditions eCare Plan project successfully tested this element at the Sep 2020 and Jan 2021 FHIR connectathons and has implemented it at the OHSU testing site.
   
• This element is used by CMS Quality Reporting and is marked Required or MustSupport in the FHIR QI Core IG
   
• CSTE supports inclusion of this measure into USCDI v3: supports information being shared with IIS across the country – should be captured for all IZ, not just children