KEYWORDS:
Bioterrorism
Registry
Monitoring Immune Status
BACKGROUND:
Planning defense against possible bioterrorism attacks presents challenges of early detection and reporting of possible cases, knowing immune levels in the population, and monitoring of prophylactic immunizations.
OBJECTIVE:
Population based immunization registries can serve a vital role in tracking persons who are protected either by immunizations or history of natural illness. Some registries may also be able to identify persons who refused vaccination, those who suffered adverse effects, and those who eventhough vaccinated, did not develop effective immunity.
METHOD:
Southern California Kaiser Permanente's Immunization Tracking System (KITS) covers over three million current members plus previous members. Implemented in 1995, KITS now contains over 23 million immunizations, including non-Kaiser administered immunizations from previous providers and schools. Immune titers are also recorded wherever available. At the beginning of the Pre-Event Smallpox Vaccination project, KITS was modified to accept successful recording and monitoring of the smallpox vaccination and "take" responses for smallpox or other mass immunizations. (KITS already recorded vaccine batch information and comments for adverse events, as well as patient demographic information.)
RESULT:
Kaiser Permanente employees were first to be offered the smallpox vaccine. Their reactions were monitored daily, and entered into KITS. At seven to ten days, the immune status was entered as "immune", "not immune", or "DKA" (did not keep appointment). The latter allows for follow-up to attempt to bring the patient back to be assessed. Persons who received their smallpox immunization elsewhere or previously, for whom "take" data is not available, only had the immunization event entered.
CONCLUSION:
Cost-effective modifications can be made to existing registries to enable them to play a vital role in defense against possible bioterrorism.
LEARNING OBJECTIVES:
How to cost-effctively modify registries to be of value in defense against possible bioterrorism.
Back to Episode II: the Range of Registry Roles in Pre-Event Vaccination for Smallpox (PVS) and Beyond
Back to The 2003 Immunization Registry Conference (October 27-29, 2003)