Registries:
Immunization Information Systems
States/Cities/Territories
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Questions
& Answers
about
IIS Sentinel Sites
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Contents of this page:
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Related Page
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What
are IIS Sentinel Sites?
The National Immunization Program (NCIRD) established
a group of immunization information systems
(IIS) as Sentinel Sites in 2004 from those
that receive CDC/NCIRD immunization grant funding.
These Sentinel Sites receive additional grant
funds to achieve higher standards of data quality
and routinely analyze data for programmatic
decision-making. These sites partner with NIP
in tracking patterns in immunization practices
and assessing vaccination coverage of children
in specific geographic areas.
Why
Sentinel Sites?
Public health officials have the challenging
task of determining why children are not fully
immunized and studying immunization behavior
changes over time. Each working day, tens of
thousands of children are immunized at thousands
of sites. Parents base immunization decisions
on many sources of information. Similarly,
providers’ decisions concerning recommendations
to administer or withhold immunizations can
vary with location and/or time.
Parental
acceptance of immunizations can be influenced by the media and other
events. To understand changing patterns of acceptance of immunization
soon enough to properly respond, the public health community requires
an instrument that can monitor the public’s response to events
in a timely manner; IIS, within limits, ideally suit this purpose.
The National Immunization
Survey (NIS), traditionally considered the gold standard of
immunization coverage, provides yearly estimates and reflects changes
on this time scale. At best, the NIS reflects changes on this time
scale. As a result, IIS sentinel sites have been created to respond
quickly to changing conditions and populations represented in an IIS
are usually well-understood.
No
state or local IIS is sufficiently complete yet to support routine
assessment of the coverage of an entire population. Analysis of
data from a subset of this population in a specific geographic area
using Sentinel Sites can provide valuable insights into immunization
practices and the factors influencing those practices.
How
are Sentinel Sites Selected?
IISs chosen as Sentinel Sites have been state
or large urban systems. There are two types
of sentinel sites: capacity-building and implementation
sites. Capacity-building sites primarily work
to meet data quality
Registry/IIS Certification Standards and
provide support for routine analysis of immunization
IIS data. Sites receiving capacity-building
funds collect timely and complete immunization
histories in a specific geographic area with
at least 10,000 children <6 years of age
actively participating. Implementation sites
accurately assess trends in vaccination coverage
for all children in a study population and
provide data for public health decision making.
Sites receiving implementation funds focus
on a larger population (>200,000 children
<18 years of age).
Sentinel
Sites aim to have the high data quality measures used for IIS certification:
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At least 90% of the vaccines administered
by providers entered into the IIS’s
database within 30 days of vaccine administration.
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Have 25% of the National Vaccine Advisory
Committee (NVAC) core data elements routinely
populated in their database. The aim is to
have 50% of the patient data populated with
vaccine lot number and vaccine manufacturer.
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Have data quality protocols and procedures
in place to ensure high levels of accurate
and complete vaccination histories with few
duplicate records.
What
are Sentinel Sites asked to do?
Sentinel Sites report aggregate confidential immunization coverage
data to NIP on a quarterly basis. Although data are limited to specific
geographic areas, these analyses:
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monitor ‘real time’ trends in
immunization;
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determine how events have impacted immunization
acceptance;
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answer questions concerning certain vaccines;
and
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monitor data quality, completeness, and timeliness.
Thus,
Sentinel Sites can not only increase their own understanding of
the population served but also health care providers’ ability
to address changing circumstances within their region. IISs will
also have hard data to evaluate their own performance.
Ad-hoc
requests occur when NIP determines that events
occur which might change immunization acceptance
or administration. For example, such requests
might follow warnings from professional advisory
groups or reports of vaccine shortages. Implementation sites receive ad-hoc
requests more frequently and are asked to prepare
one journal article for a peer-reviewed scientific
journal based on data from their sentinel site
population.
Sentinel
Sites receive technical consultation from NIP
and have access to information obtained from
analysis of their own data. Quarterly immunization
coverage data are consolidated, de-identified,
and returned back to sentinel sites for comparison
purposes.
See profiles
of current Sentinel Sites.
Who
to contact?
For more information on IIS
Sentinel Sites, contact Diana Bartlett at zxd5@cdc.gov.
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