KEYWORDS:
Immunization registry, CASA

BACKGROUND:
Since 1997, an immunization registry has been available to providers in Detroit-area primary care clinics. This population-based registry collects data on all vaccines administered to infants and children in Michigan and enables providers from public, private and managed care organizations to retrieve immunization histories at the point-of-service and perform clinic-level assessments.

OBJECTIVE(S):
To compare clinic immunization coverage levels calculated using data from medical charts and an immunization registry using CASA methodology.

METHOD(S):
5 CASA reviews were conducted over a 6-month period of time at 3 urban clinics. Data from the Michigan Childhood Immunization Registry (MCIR) for this defined set of children was obtained and also entered into CASA. Coverage levels will be compared for each data source using the CASA format.

RESULT(S):
893 children 0-36 months were included in this comparison. Immunization coverage ranged from 38-62% for the 4:3:1:3:3 series at age 24 months. The number of immunizations and hence the coverage level is expected to be greater using registry data. Clinics will still need to monitor the percent of immunizations provided in their office.

CONCLUSIONS(S):
Data from immunization registries can be used to assess and enhance clinic-level immunization coverage similar to CASA. Results support on-going efforts to maintain provider commitment to using registries not only for point-of-service look-up, but also as a means of understanding the complete immunization delivery system for their patients.

LEARNING OBJECTIVES:
To illustrate when an immunization registry can replace chart-based methodologies for measuring clinic coverage levels.