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Countermeasure Tracking Systems

Countermeasure and Response Administration System

Increasing the Ability of Public Health to Track and Manage Medical Countermeasures

The Centers for Disease Control and Prevention (CDC) Countermeasure and Response Administration (CRA) is an emergency preparedness and response system. It is useful during any public health event where administered vaccine doses are tracked, pharmaceuticals and medical material are dispensed, or community mitigation measures are implemented. CRA is one of the four components of the CDC Countermeasure Tracking Systems (CTS) program.


During a public health emergency, public health agencies need to manage information about the event and check availability of medical countermeasures and know who has received them. Medical countermeasures include pharmaceuticals, vaccines, other medical material, and non-medical interventions such as personal protective equipment. After the affected population has received medical countermeasures, public health agencies need to monitor the countermeasures’ effectiveness or identify any adverse results. Finally, following an event, public health agencies need to analyze information about the event to better prepare for future emergencies. The CDC Countermeasure and Response Administration (CRA) system allows public health personnel to manage administration and tracking activities within their jurisdictions to support a full range of all-hazards events. CRA tracks vaccine administration and medical countermeasure dispensing at both the individual level and in total during a public health event.

The primary objective of the system is to increase the ability of all levels of public health to track and manage medical countermeasures. In addition, CRA supports CDC’s cross-jurisdictional reporting by providing flexible methods for accepting data from other systems or by extracting summarized data.

CRA began with the CDC Pre-event Vaccination System (PVS) that CDC implemented nationwide to track and monitor the administration of smallpox vaccine as part of the National Smallpox Preparedness Program. Building from this success and by using local, state, and CDC input, CDC expanded CRA for national, state, and local use. It was used to track vaccine doses administered during the initial weeks of the 2009 H1N1 vaccination campaign.

System Capabilities

CRA’s advanced capabilities play a critical role in an emergency response by tracking vaccinations and other medical countermeasures, providing data on dispensing of pharmaceuticals or medical equipment, and managing information on treatments and community mitigation measures.

Key system capabilities include:

  • management of multiple simultaneous events and countermeasures,
  • custom event creation and configuration,
  • flexible data entry screens for information about doses administered and dispensed,
  • individual or total data collection,
  • data extracts for jurisdictional reporting, and
  • synchronization of data from off-line deployments.

CRA is a Web-based application deployed centrally at CDC that uses CDC’s secure data access method. It is Internet accessible by using any standard Web browser and is free of charge to users. In addition, CRA may be deployed offline on a stand-alone basis to support jurisdictional operations.

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What is the CRA system and what does it do?

The CRA system is an emergency preparedness and response system. It is useful during any public health event where administered vaccine doses are tracked, pharmaceuticals and medical material are dispensed, or community mitigation measures such as social distancing are implemented. CRA supports analysis of pharmaceutical safety, coverage, and effectiveness during an event, toward improved patient outcomes. CRA is a flexible all-hazards system that reduces the need for development of new applications each time there is a new event requiring a public health response. CRA is one of the four components of the CDC Countermeasure Tracking Systems (CTS) program.


How do I get started with CRA?

If you are interested in using the CDC CRA application, the CRA team can provide you with the steps necessary to get started. For assistance, e-mail

What security measures are in place to protect the data that is submitted to CDC?

As a government agency, CDC is bound by federal law that dictates specific information security rules and processes that must be followed. To comply with these rules, CRA uses the CDC Secure Access Management Services (SAMS) system for electronic authentication. SAMS provides secure access to applications within the CDC environment and functions as the authentication gateway to CRA as well as the other CTS applications.  SAMS is the next-generation replacement for CDC’s legacy Secure Data Network (SDN) portal and does not use digital certificates.

What if I have my own CRA system; how does it relate to CDC’s CRA application?

CDC is extremely supportive of partners using their own systems. If planning to use your own CRA system, please note that CDC may request that partners report data in the event of a declared public health emergency.


How can I use CRA to report data to CDC during a public health event?

CRA offers three options for submitting aggregate counts to CDC:

  • OPTION 1: For project areas collecting data via an existing immunization information system (IIS), aggregate counts may be submitted via three standard data exchange formats (pipe-delimited, XML, and HL7). Please refer to the CRA Data Exchange Specification: Influenza Aggregate Report, which provides information about electronically reporting data to CDC through CRA. During a public health event where data about aggregate doses administered are reported to CDC for monitoring and tracking purposes, this information will be reported via the CDC CRA system.
  • OPTION 2: For project areas collecting data manually, data may be entered directly via the CRA aggregate reporting screen by using a Web browser.
  • OPTION 3: For project areas using the CDC CRA application to collect patient-level information, selected data elements will be automatically calculated and aggregated.


How do you account for the Health Insurance Portability and Accountability Act of 1996 (HIPAA) policy requirements for personal information privacy and ensure compliance?

The HIPAA privacy rule permits disclosure to public health authorities without further authorization. Covered entities are permitted to disclose Protected Health Information to public health authorities without patients’ authorization as defined at 45 C.F.R § 164.501 and as used in 45 C.F.R. § 164.512(b), Standards for Privacy of Individuality Identifiable Health Information, promulgated under HIPAA.

CRA supports collection of unidentified individual/patient information. During data entry, a unique identifier is assigned to each individual/patient record, allowing capture and retrieval of information without using identifying information. Project areas may use this feature and are not required to capture personally identifiable information (PII).

For more information, e-mail

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