The Importance of Expanded QA to Ensure Proper Recall of Children for Multiple School-Based H1N1 Mass Vaccination Clinics

Background: Riverside County partnered with multiple school districts and child care providers to provide H1N1 vaccinations.  The California Immunization Registry (CAIR) software was used to document all doses of H1N1 vaccine given.  It was important to identify correctly which children at each site needed a second dose of vaccine.  Therefore, accuracy of CAIR data entry was critical.

Setting: Riverside County, CA

Population: Children at multiple school districts and child care sites who required two doses of H1N1 vaccine.

Project Description: Because Riverside County’s mass vaccination campaign had six clinic teams pulling from one inventory, operation codes were assigned to ensure that children vaccinated at a particular site would be recalled to that location.  QA checks were implemented to ensure that children were assigned to the appropriate clinic with the correct date of service.  Registry staff needed to provide a count of how many children needed a second dose along with a list of names to the school. Both the registry and the partner agency worked to notify parents of the second clinic dates.  After the first school-based clinic data entry was completed, only 18 children out of 1200 were identified as needing a second dose of vaccine.  Additional QA checks were implemented immediately.  These included manually reviewing all records, comparing Daily Activity Reports with the records entered to verify correct date of service, and comparing Daily Activity Reports with the recall lists to ensure appropriate identification of children needing a second dose of H1N1.

Results/Lessons Learned: The expanded QA on the school-based clinic revealed additional data entry errors that were quickly corrected.  As a result, more than 800 children who needed a second dose of H1N1 were identified.  The additional QA steps became standard operating procedures for all subsequent clinics. As the number and frequency of the school-based clinics increased, additional changes were incorporated to ensure children would be recalled to the correct clinic location.