KEYWORDS:
Immunization registry, urban, tracking

BACKGROUND:
The Child Health Network Immunization Project (CHNIP) provided services to an 18 zip code area of Detroit to improve immunization coverage of children 0-35 months of age. One strategy employed was to provide data entry into a statewide immunization registry.

OBJECTIVE(S):
To examine the impact of closing urban primary care clinics as measured from a statewide immunization registry.

METHOD(S):
Data entry technicians entered all documented immunizations of children 3-36 months of age attending a primary care clinic prior to its closing in January, 2000 into the Michigan Childhood Immunization Registry (MCIR). Subsequently, MCIR records for the CHNIP service area were reviewed. The percent age-appropriate up-to-date according to the ACIP schedule (UTD) was calculated at time of closure and twelve months later.

RESULT(S):
474 children at least 3 months of age on 2/01/2000 were included in this review. For those children 3-12 months of age at time of closure (n=62), UTD as reported in MCIR fell from 53.2% at closing to 14.5% 12 months after closure.

CONCLUSIONS(S):
Evidence in MCIR of continued immunization activity, for children affected by the closure of an urban clinic, was lacking. Two explanations for these findings are suggested. First, these children went to other providers for immunizations who did not report to MCIR or, second, these children did not receive immunizations. The first might account for some of the drop noted, but the majority of the children in question most likely had a disruption in their immunization and well child visit schedule as a result of this clinic’s closure. Results support renewed efforts to increase provider education to use MCIR as well as tracking efforts to assume continuity of service during periods of health system’s closure and contraction.

LEARNING OBJECTIVES:
To illustrate when an immunization registry might provide added value to assuring provision and continuity of care.