Learning Objectives for this Presentation:
By the end of the presentation participants will be able to describe the benefits of conducting accountability for Vaccine for Children (VFC) doses through an immunization registry.

Background:
New York City Department of Health and Mental Hygiene's (DOHMH) VFC program distributes 2.6 million vaccine doses a year to over 1,500 providers at a cost of $56 million. Before September 2006, all providers were required to submit self-generated, hard-copy, aggregate doses administered reports (DARs) to account for their vaccines. This resulted in duplicative reporting since providers were also mandated to report all childhood immunizations to the registry. In 2006, DOHMH began accounting for vaccines by generating DARs based on vaccine doses reported to the registry for all providers.

Objectives:
To increase the accountability of VFC vaccines, reduce paperwork for providers and VFC staff, and increase Citywide Immunization Registry (CIR) completeness.

Methods:
In the fall of 2005, DOHMH staff developed a database linking VFC and CIR databases. In January 2006, DOHMH notified providers that beginning September 2006 only CIR generated DARs would be accepted; 90% of shipped doses shipped must be reported to ensure full VFC shipments. Initial CIR generated DARs were given to providers in June 2006 with follow up DARs sent in September.

Results:
The percent of providers reporting > 90 of VFC doses shipped increased from 21% in May 2006 to 27% in October 2006. Over the same time period, the percent of all VFC dose shipped and reported to the CIR increased from 74% to 85%. From January 2006 to September 2006, 2.1 million immunizations were reported to the CIR, an increase of 900,000 (77%) from the previous year.

Conclusions:
Conducting VFC accountability through an immunization registry not only provides a verifiable method of vaccine accountability, but also results in more efficient data processing, and a substantial increase in registry completeness.