Record of vaccine administration.

Data Element
Vaccination Administration Date
Description

The date the vaccination event occurred.
Submitted By: Nedra Garrett / Centers for Disease Control and Prevention
Data Element Information
Use Case Description(s)
Use Case Description Date of vaccination is extremely important to various health care communities, especially to providers who routinely use this information to determine patient care. Providers use this information to determine if their patients were vaccinated according to schedule, if their patients need booster vaccinations, and when their patients will need to be vaccinated next. In turn, this provides patients information about their healthcare needs. Additionally, this information could increase vaccination rates, a Healthy People 2030 goal, by ensuring patients are vaccinated on time.
Estimate the breadth of applicability of the use case(s) for this data element "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 In addition to helping clinical care, date of vaccination administration helps inform decision making in public health. Date of vaccination is routinely used to determine if a vaccine preventable disease case was vaccinated properly. In fact, vaccination events missing date of administration may not be collected by providers, as providers are given guidance that only vaccinations with dates of administration are considered evidence of vaccination. Thus, some vaccinations may not be included in patient’s electronic medical records, and then sent to public health. Further, during analyses, public health practitioners often exclude vaccination administrations missing date information. By not including vaccination administrations missing date information, results from analyses could be inaccurate, depending on the number of administrations excluded. Inaccurate results could be harmful, as results help to inform communication, planning, and vaccine supply logistics.
Estimate the breadth of applicability of the use case(s) for this data element "There are mulitple stakeholders that would capture, access, use or exhange this data element or data class including:
• Electronic Health Records
• Immunization information systems and local and state departments of public health
• Vaccine Adverse Event Reporting System (VAERS)
• Providers
• Research and academic institutions, especially those running clinical trials "
Link to use case project page https://www.immregistries.org/ Immunization Action Coalition: https://www.immunize.org/
Use Case Description 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.
Healthcare Aims
  • Improving patient experience of care (quality and/or satisfaction)
  • Improving the health of populations
  • Reducing the cost of care
  • Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) LOINC:30952-6- Date and time of vaccination: https://loinc.org/30952-6/

https://loinc.org/30952-6/
Additional Specifications "Yes, this information is in various technical specifications including:
• The HL7 2.5.1 Implementation Guide for Immunization Messaging and the HL7 2.8.2 Implementation Guide: Immunization Messaging (see RXA-3)
• FHIR r4 (see immunization.occurrence)
• Clinical Decision Support for Immunizations FHIR IG
• CDC Nationally Notifiable Disease Surveillance System (NNDSS) Message Mapping Guides (MMGs) for Vaccine Preventable Diseases (VPDs)"
Current Use This data element has been used at scale between multiple different production environments to support the majority of anticipated stakeholders
Supporting Artifacts "HL7 v2.5.1 Implementation Guide for Immunization Messaging
HL7 v2.8.2 Implementation Guide: Immunization Messaging
NNDSS MMGs for VPDs
Clinical Decision Support for Immunizations FHIR IG
AIRA Functional Standards Document
CDC Endorsed Data Elements "

"HL7 v2.5.1 and v2.8.2 IGs: https://www.cdc.gov/vaccines/programs/iis/technical-guidance/hl7.html
CDC NNDSS MMGs for VPDs: https://wwwn.cdc.gov/nndss/case-notification/message-mapping-guides.html
Clinical Decision Support of Immunizations FHIR IG: http://hl7.org/fhir/uv/immds/"


https://www.cdc.gov/vaccines/programs/iis/technical-guidance/hl7.html
Extent of exchange N/A
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) N/A
Restrictions on Use (e.g. licensing, user fees) None
Privacy and Security Concerns There are privacy concerns with the use and exchange of these data elements, mainly mother’s maiden name.
Estimate of Overall Burden There should be little burden to implement this data element, as all healthcare IT already stores and messages this information.
Other Implementation Challenges N/A
ASTP Evaluation Details
Each submitted Data Element has been evaluated based on the following criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI
Criterion #1
Maturity - Current Standards		 Level 2 - Data element is represented by a terminology standard or SDO-balloted technical specification or implementation guide.
Criterion #2
Maturity - Current Use 		Level 2 - Data element is captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer.
Criterion #3
Maturity - Current Exchange		 Level 2 - Data element is electronically exchanged between more than two production EHRs or other HIT modules of different developers using available interoperability standards.
Criterion #4
Use Case(s) - Breadth of Applicability		 Level 0 - Use cases apply to a limited number of care settings or specialties, or data element represents a specialization of other, more general data elements.
Evaluation Comment This data element represents a specific type of existing USCDI data element Performance Time in the Procedures data class.

Comment

Submitted by nedragarrett_CDC on

Unified Comment from CDC

  • Additional Use Cases: 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.
     
  • 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.
     
  • 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

Submitted by nedragarrett_CDC on

There seems to be two data…

There seems to be two data elements in the Immunization Data Class in USCDI that are duplicates:

• Vaccination Administration Date
• Immunization Administered Date

Is there anyway to remove one of them? We would prefer to keep Vaccination Administration Date and have the other (Immunization Administered Date, https://www.healthit.gov/isa/uscdi-data/immunization-administered-date) removed. 

This field is for general comments on this specific data element. To submit new USCDI data classes and/or data elements, please use the USCDI ONDEC system: https://healthit.gov/ONDEC

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