By Dr. Michael Martin
As Virginia continues to combat the public health challenges of COVID-19, the distribution of vaccines in the commonwealth provides a long-needed glimmer of hope.
The complex COVID-19 vaccine distribution process underscores the importance of accurate immunization histories and records. While Virginia had the foresight years ago to invest in an immunization registry for individuals, families, medical providers and public health researchers, recent action by the General Assembly has strengthened the statewide database of vaccine history and distribution. To keep our communities healthy even after the pandemic, all health care providers that administer vaccines, starting in January 2022, will participate in the Virginia Immunization Information System.
VIIS is a free, statewide, digital immunization registry that records reported vaccination doses distributed by health care providers to individuals, thus increasing the ability to appropriately react to vaccine-preventable disease outbreaks. Vaccine registry systems like VIIS are incredibly helpful for improving the public health response to outbreaks of diseases like measles, Hepatitis A, H1N1, and now COVID-19. By sharing the data with the state, appropriate resources can be deployed to counteract outbreaks and help increase community immunization rates. Currently, the Virginia Department of Health reports that 2.1 million children are under-immunized.
VIIS is a simple system — Virginia residents receive vaccinations from a variety of different places, including pediatricians, family providers, hospitals, workplaces, pharmacies, public health departments, urgent care locations and more. These vaccine providers send the patient’s vaccination records to VIIS, which in turn provides access of the records to authorized users, including patients and health care providers. For example, if a college student seeks medical care at the student health center, the care provider will be able to see what vaccines the student is missing if the student’s regular health care provider used VIIS. For outpatient clinics and practices, VIIS helps manage vaccine inventory and minimize waste.
Families tracking childhood immunizations also benefit from the use of VIIS. Children will receive dozens of shots during the first years of their lives to protect them from infectious diseases like hepatitis, pertussis, tetanus and measles. If a family moves across the commonwealth or simply gets a new health care provider, VIIS serves as a central database to reference past immunization information and ensure that records are not misread or lost.
Immunization registries also reduce over-immunization rates by providing a central source of accurate immunization records to health care providers rather than rely on the printing and inaccurate copying of records that leads to errors. The Virginia Department of Health reports that 21 percent of children are over-vaccinated due to inadvertent duplicate immunizations because of incorrect information shared with providers. We need to close the gap between under-immunization and over-immunization.
VIIS is a safe system with multiple layers of security that reflect the federal, state, local and territorial laws that protect the confidentiality of information. VIIS records conform to the same confidentiality and privacy rules as other parts of a patient’s medical record. Importantly, VIIS respects the individual’s right to opt out and maintain control of what information is shared or not shared.
Up until now, participation in VIIS has remained voluntary for most providers who vaccinate. Thus, large gaps in information undermined the reliability and usefulness of the system and prevented Virginia from fully realizing VIIS’s full potential. Fortunately, the General Assembly passed House Bill 2061, which requires that all health care providers administering vaccines participate in VIIS. This legislation is especially timely as Virginia continues to navigate COVID-19 vaccine distribution and seeks to accurately track the immunization of Virginians as a part of the commonwealth’s recovery from the pandemic, particularly with an eye on equity.
As a pediatrician, every day I immunize a child I am reminded that vaccines are one of the greatest public health protections we possess. Even now, vaccines are likely the strongest weapon we have against COVID-19. With the passage of HB 2061, more providers will be using VIIS which will help ensure that Virginia can effectively combat the COVID-19 pandemic and all future pandemics.
Dr. Michael Martin is the president of the Virginia Chapter of the American Academy of Pediatrics and member of the Steering Committee of ImmunizeVA.