Accounting for H1N1 Vaccine Using the New York City Immunization Information System

Background: The New York City (NYC) Immunization Information System (IIS), the Citywide Immunization Registry (CIR), was established in 1997 and currently includes 3,983,057 patients and 44,730,839 immunizations.  The CIR is used to account for vaccines distributed through its Vaccines for Children Program (VFC) based on reporting by providers of doses administered to individual patients.  All NYC providers are required by law to report to the CIR all immunizations administered to patients < 19 years; reporting of immunizations administered to adults ≥ 19 years is voluntary, with the patient’s written consent. Reporting of adult immunizations has been very low compared to childhood immunization reporting.

Objectives: To extend the use of CIR to account for H1N1 vaccines distributed to NYC facilities, including those vaccinating adults only, based on reporting of doses administered to individual patients.

Methods: All providers were notified to register with the CIR to obtain H1N1 vaccine and that reporting to CIR of individual doses administered would be required (consent was suspended for reporting H1N1 doses administered to adults).  Facilities not already registered (i.e., those vaccinating adults only) were assigned a CIR facility code and VFC PIN (if not enrolled in VFC).  CIR codes and PINs were matched, enabling comparison of H1N1 doses distributed to doses reported.  Facilities reporting >50% of doses distributed were automatically re-supplied when H1N1 vaccine was in short supply.

Results: A total of 2,784 facilities were newly registered from 8/23/09 – 12/11/09 (nearly 150% increase over the 1900 facilities already registered).  As of 12/11/09, ~ 2.2 million H1N1 doses were distributed to 2,977 facilities and 325,397 H1N1 doses were reported to the CIR.

Conclusions:The CIR facilitated accountability for H1N1 vaccines distributed in NYC and helped target re-supply efforts during the shortage. H1N1 vaccine efforts were useful in expanding participation in the CIR by adult providers.