How ready was the US vaccination infrastructure and network of immunization information systems for COVID-19 vaccination campaigns: Recommendations to strengthen the routine vaccination program and prepare for the next pandemic

Figures & data

Figure 1. The flow of vaccine information in COVID-19 vaccination campaigns through the immunization information systems to end users: health care providers, state and local public health authorities, parents and the public.

Table 1. Recommendations to support vaccination data users under routine administration and public health emergencies.

Health-care providers	State, local, and federalpublic health authorities	Parents and general public
RECOMMENDATION 1. Invest financially.
Specifically, invest long-term financial outlays to support automated electronic data exchange connections between providers and immunization information systems to help ensure accurate consolidated records for patients.	Invest resources in ongoing long-term needs, such as workforce development and technology infrastructure, to support data exchange, data use, and program operations.	Identify and invest in long-term resources to support access to complete vaccination records for individuals and parents.
	RECOMMENDATION 2. Expand provider electronic data exchange by establishing an incentive program to promote provider connections to the IIS for systems, including pharmacy and long-term care systems, to standardize interoperability.
	RECOMMENDATION 3 (To federal authorities). Conduct a systematic review of IIS reporting mechanisms of vaccination data to the federal level to improve the quality, type, and efficiency of reporting by state and local jurisdictions.

Table 2. Needs of state and local public health authority for workforce development and technological systems modifications.

Public health workforce with expertise to:

Communicate with the public Manage vaccine logistics Onboard providers to the IIS Clean, analyze, present data (e.g., dashboard) Respond to consumer requests (e.g., records requests, customer service, help desk support) Manage outbreak response activities

Funding for technology modifications and enhancements to:

Purchase or migrate to cloud-hosted systems (which expands operating and memory capacity of a system) Upgrade existing connections from unidirectional to bidirectional Ensure data integrity and quality enhancements, including updates to software and user interfaces Automate data requests Develop and modify functionalities, such as vaccine scheduling, ordering, inventory management, and bidirectional reporting; modifications to vaccine clinical decision support (e.g., evaluation and forecasting) Mass vaccination management Implement public-facing applications