The future of immunization registries

The first smallpox vaccine given 200 years ago by Edward Jenner marked the beginning of an unparalleled approach to disease prevention. Because of vaccines, smallpox has been eradicated, polio eradication is close to becoming a reality, and eliminating measles is a realistic goal for the Americas by the Year 2000. Provisional data from 1995 indicate that the United States had the lowest number of cases of vaccine-preventable diseases ever reported for seven diseases, and vaccine coverage levels are now the highest ever recorded in the United States. Yet, today about a million 2-year-old children in the United States need one or more doses of vaccines to be fully protected. Local and state immunization registries will become the cornerstone of our future immunization delivery system that will assure that every child is immunized on schedule. When the registries become fully functional, all children will be enrolled from birth. Parents can be reminded automatically when immunizations are due and can be recalled when they are overdue. Providers will easily determine the immunization needs of their patients, old or new at the time of each visit, wherever a child interacts with the health care system, be it a doctor's office, public health clinic, emergency room, or elsewhere. Programs like the one for Women, Infants, and Children (WIC) will have access to accurate immunization records. Changes in immunization schedules can be rapidly incorporated into software and disseminated. No longer will immunization assessments at the office level have to be done manually. Public health officials will have a simple, quick, inexpensive method to assess immunization coverage in their communities, and to identify groups at risk for underimmunization. Local registries can be interconnected, and information on immunization coverage can be shared with local and state agencies. This can expedite and lower the cost of monitoring immunization coverage at every level. Much progress has occurred in making immunization registries a reality. Much more needs to be done, and there are still critical barriers to overcome. Nevertheless, the progress, as detailed in this supplement, is dramatic and gives us great hope for the future, a future in which more and more infectious diseases will be conquered through the use of more and better vaccines delivered to the populations in need through an efficient system facilitated by immunization information systems.