Immunization Issues

Immunization Registries

Updated: November 17, 2006

Immunization registries are public health tools that facilitate high immunization coverage rates and minimize children being over immunized.

Immunization registries are confidential, computerized information systems that contain information about immunizations and children from a particular geographical area.1 Some registries include information about immunization of adolescents and adults.

These registries allow vaccine providers to monitor immunization records and to generate reminder and recall notices for children who need immunizations.

Registries consolidate immunization records scattered among different providers, making it easier to recall underimmunized children while decreasing the chances of children being given vaccines they do not need.2

According to the CDC’s 2003 Immunization Registry Annual Report—a survey of registry activity among immunization programs in the 50 states and the District of Columbia—approximately 44% of children aged 6 years or less are enrolled in a registry.3

How are children enrolled in the registry? Commonly, children are entered into the registry at birth—through a linkage with electronic birth records. Also, a health care provider can enter a child into the registry at the time of the child’s first immunization, often hepatitis B at birth.

If a registry includes all children in a given geographical area and all providers are reporting immunization information, a registry can provide a single data source for all community immunization partners.4

Parents and health care providers may find that immunization registries have a number of advantages. For example, registries can:

  • consolidate in one site all immunizations a child has received;
  • provide an accurate, official copy of a child’s immunization history for personal, day care, school, or camp entry requirements;
  • help ensure that a child’s immunizations are up to date;
  • provide reminders when an immunization is due;
  • provide recalls when an immunization has been missed;
  • help ensure timely immunization for children whose families move or switch health-care providers; and
  • prevent unnecessary (duplicative) immunizations.4

On the other hand, some people have expressed concerns regarding the privacy and confidentiality of immunization registries. For that reason, many states have created laws to protect the information in the registries. Some of these laws include:

  • penalties for improper disclosure of information;
  • provisions defining with whom immunization information can be shared (for example, providers, schools, health department); and
  • provisions allowing parents to opt out or limit access to immunization registry information.4

Additionally, the CDC’s National Immunization Program recommends that each registry have a written policy on privacy and confidentiality in place at the time of registry development.5

Registries are currently being developed in each state but to date, only approximately 30% of private providers are participating in them. Efforts are underway to increase provider participation.

As registries are used more, they will become even more helpful in assuring timely and complete immunization.