Immunizations

Indicates whether the vaccination event is based on a historical record (e.g., second hand knowledge of the vaccination event) or was administered at the facility submitting the data.

Submitted By: Nedra Garrett / Centers for Disease Control and Prevention
Data Element Information
Use Case Description(s)
Use Case Description	Knowing whether a vaccination was administered or was a historical record is helpful when providers are evaluating a patient’s immunization status to determine when the next vaccination in a series should be given. This information helps the IIS and other health IT systems identify, prevent, and resolve duplicate vaccination events using an automated process, thus ensuring that a patient is vaccinated according to the ACIP schedule. Additionally, this information could increase vaccination rates, a Healthy People 2030 goal, by ensuring patients are vaccinated on time.
Estimated number of stakeholders capturing, accessing using or exchanging	"There are multiple stakeholders that would capture, access, use or exchange this data element or data class including: • Electronic Health Records • Immunization information systems and local and state departments of public health • Providers • Research and academic institutions, especially those running clinical trials "
Link to use case project page	https://www.cdc.gov/vaccines/programs/iis/index.html
Use Case Description	Additionally, determining whether a vaccination was administered or was a historical record is helpful when performing public health analyses. Vaccine efficacy analyses use this information to determine immunization population coverage. Statistical analyses help to identify underserved populations so that resources redirected appropriately and used efficiently.
Estimated number of stakeholders capturing, accessing using or exchanging	"There are multiple stakeholders that would capture, access, use or exchange this data element or data class including: • Electronic Health Records • Immunization information systems and local and state departments of public health • Providers • Research and academic institutions, especially those running clinical trials " AIRA: https://www.immregistries.org/ Immunization Action Collition: https://www.immunize.org/
Link to use case project page	https://www.immunize.org/
Healthcare Aims	Improving the health of populations Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s)	PHINVADs https://phinvads.cdc.gov/vads/ViewCodeSystem.action?id=2.16.840.1.114222.4.5.293
Additional Specifications	Similar information is stored in the RXA-9 field in HL7 v2. A FHIR element was added to the immunization resource: immunization.reported
Current Use	In limited use in production environments
Supporting Artifacts	Similar information has been collected in various artifacts including the HL7 v2.5.1 Implmentation Guide for Immunization Messaging, the HL7 2.8.2 Implementation Guide: Immunization Messaging, and various public heatlh reporting forms. https://www.cdc.gov/vaccines/programs/iis/technical-guidance/hl7.html
Number of organizations/individuals with which this data element has been electronically exchanged	N/A
Potential Challenges
Restrictions on Standardization (e.g. proprietary code)	None
Restrictions on Use (e.g. licensing, user fees)	None
Privacy and Security Concerns	None
Estimate of Overall Burden	The overall burden to implement this data element is low, as most healthcare IT information systems most likely have this data element stored and messaged in their system already.
Other Implementation Challenges	One possible challenge for implementation is ensuring that the correct information is captured, as depending on the timing of the administration, there could be confusion about whether the vaccination was administered or reported. For example, some EHRs would consider a vaccination event given on the same day by a provider outside of their EHR system a historical record, even though they were given on the same day, even within a matter of a few hours.