Intersection of Policy and Immunization Information Systems (IIS)

Abstract Background: Immunization information systems (IIS) are confidential, population-based computerized databases that record vaccination doses administered to persons residing within a given geopolitical area. They play a pivotal role in achieving equitable and high vaccine uptake. In the United States (US), they are implemented and managed at the state and local level, creating variability in IIS policies. Methods: We conducted a legal assessment of relevant IIS statutes and administrative codes across all 50 states, the District of Columbia, Philadelphia, and New York City. Where relevant, laws were cross-checked or supplemented with state and local health department resources. Comparisons to previous legal studies were used to evaluate trends in IIS laws over time. Results: The compilation of these laws provides an updated overview of the diverse inter- and intra-state policies within the US that govern the capabilities and implementation of IIS. The findings of this study show that while progress has been made in improving the policies to enable and enhance IIS, gaps in IIS data collection, limited interoperability with local and national health information systems, and inconsistent access to IIS to view or utilize records, limits the full potential of IIS. Conclusions: Findings from this study help shine a light on the evolution of IIS policy over the last two decades, serve as a comprehensive benchmark for future analyses, and may help policy stakeholders who are exploring amending jurisdictional IIS laws.