Improving Reporting and IIS-Based Coverage by Conducting VFC Accountability Through an IIS: The New York City Experience

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 Information System (IIS).

Background:
In September 2006, the New York City Department of Health and Mental Hygiene began conducting VFC accountability through its IIS. Doses Administered Reports (DAR) comparing doses distributed to doses reported to the IIS are sent to all NYC's 1800 providers quarterly. Full shipment of the order is granted only if the provider reports to the IIS 90% or more of the doses received.

Objectives:
To assess the impact of conducting IIS based VFC accountability, and giving feedback on UTD coverage based on IIS and AFIX on further improving reporting and increasing coverage rates.

Methods:
Beginning June 2007, all providers began receiving quarterly reports that included their DAR, 4:3:1:3:3:1 (4 DTaP, 3 Polio, 1 MMR, 3 Hib, 3 Hepb and 1 Varicella) coverage for their 2-year olds based on the IIS, as well as their coverage by chart review if an AFIX visit was conducted in the past 2 years.

Results:
In one year, the percent of providers reporting more than 90% of doses received increased from 27% to 44%, and the VFC doses accounted for in the IIS increased form 84% to 94%. IIS based UTD coverage increased from 36% to 43%. For the last 2 mailings, 80 providers have requested lists of their children not UTD for recall or/and to add missing immunizations to the IIS, further improving immunization coverage and completeness of the IIS.

Conclusions:
IIS generated DARs have resulted in improving reporting to the IIS and allowed us to also enhance feedback to include coverage rates. Coverage rate feedback does not only further improve completeness of the IIS but also results in recall of under-immunized children and improved UTD rates in NYC.