BACKGROUND:
NIS is one of the world's largest public health surveys. It consists of 78 individual, random-digit-dial surveys for the 50 states, the territories, and 28 cities/counties, known as immunization action plans (IAPs). Some of the current local IAPs are no longer appropriate because of tremendous demographic changes that have occurred and because some local jurisdictions consistently have high up-to-date rates. NIS resources can be better used to measure rates in the largest, fastest-growing regions in the country.

OBJECTIVE:
To re-assess the process for making measurements of immunization rates in new local IAPs in the face of limited resources; and to redefine the concept of urban areas and develop a process for including these jurisdictions in the NIS.

METHOD:
In 2004, CDC/NIP and NACCHO convened a taskforce of 8 local public health agencies and one state health department to develop a process for 1) rotating local IAPs onto and off NIS on 2-year cycles; 2) developing an evaluation process for including new IAPs and rotating off current IAPs; 3) collecting and tabulating local demographic profiles; and 4) standardizing the roatation process for future surveys.

RESULT:
As a pilot, 5 new local jurisdictions were rotated on NIS 2005 and 5 current IAPs were rotated off.

CONCLUSION:
Rotating new jurisdictions onto the NIS can help us better characterize national immunization rates. The health officers in new IAP jurisdictions would find great use for those data to know how they compare to other similarly situated jurisdictions. NIS is the only way that many local jurisdictions can afford to get county-specific immunization coverage data.

LEARNING OBJECTIVES:
Participants will understand 1) the need to measure immunization rates in rapidly changing local jurisdictions; 2) the proposed two-year rotation process; and 3) the guidelines used to select IAPs selected to rotate on and off in any given year.