Core Data Elements For IIS Functional Standards v4.0

The CDC endorsed data elements represent the data elements that are needed by an IIS to record patient demographics and vaccination events to meet the IIS Functional Standards v4.0. An IIS should store the CDC endorsed data elements listed below if the elements are sent from an external information system and meet the IIS’s data quality criteria. This list does not include all data elements external information systems such as EHRs, vital records, practice management or billing systems are expected to send to an IIS. The list may not include all data elements an IIS produces, stores or sends. Data elements may be derived and architectural solution may differ among IIS.

Definitions of the CDC endorsed data elements below can be found at:

CDC Endorsed Data Element DefinitionsCdc-excel

Patient Demographic Data Elements
Date of history of vaccine preventable disease
Ethnicity
History of disease/titer
Mother’s name: first
Mother’s name: middle
Mother’s name: last
Mother’s name: maiden last
Patient address: county of residence
Patient address: city
Patient address: country
Patient address: state
Patient address: street
Patient address: zip code
Patient alias name: first
Patient alias name: middle
Patient alias name: last
Patient birth order
Patient birth state
Patient date of birth
Patient e-mail address
Patient gender
Patient ID
Patient ID: type
IIS Patient ID
Patient multiple birth indicator
Patient name: first
Patient name: middle
Patient name: last
Patient primary language
Patient status indicator-provider level
Patient status-jurisdiction level
Patient telephone number
Patient telephone number type
Protection Indicator1
Protection indicator effective date1
Reminder recall status1
Reminder recall status effective date1
Race
Responsible person name: first
Responsible person name: middle
Responsible person name: last
Responsible person relationship to patient
Vaccination Event Data Elements
Vaccination Data Elements
Contraindications/precautions
Contraindications/precautions observation date
Dose level eligibility
Exemptions/refusals date
Exemptions/refusals reason
Vaccination administration date
Vaccine dose volume
Vaccine dose volume units
Vaccination event record type (administered/historical)
Vaccine funding source (dose level public/private indicator)1ꞎꞎ
Vaccine expiration date
Vaccine lot number
Vaccine manufacturer name
Vaccine product
Vaccine route of administration2
Vaccine site of administration2
IIS vaccination event ID1
Vaccination event ID1
Vaccine information statement2
Vaccine information statement given date2

Provider Data Elements
Vaccine ordering provider (person)
Vaccine administering provider suffix
Vaccine administering provider (person)

Facility Identifier Data Elements
Administered at location1
Sending organization1
Responsible organization1

1Data element is new for IIS Functional Standards v4.0.

2Data element should be captured in the IIS if the IIS is used as the primary vaccination event record (e.g., mass vaccination clinic).

Definition: the program that should pay for a given immunization, based on the characteristics of the patient and the type of vaccine administered. Eligibility is captured for each dose.

ꞎꞎDefinition: the funding source of the vaccine administered. Identifies the administered vaccine as publically funded, privately funded, or with other jurisdiction specific funding.

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Page last reviewed: November 21, 2018