Vaccination Event Record Type

Record of vaccine administration.

Data Element

Description

Indicates whether the vaccination event is based on a historical record (e.g., second hand knowledge of the vaccination event) or was administered at the facility submitting the data.

Submitted By: Nedra Garrett / Centers for Disease Control and Prevention
Data Element Information
Use Case Description(s)
Use Case Description	Knowing whether a vaccination was administered or was a historical record is helpful when providers are evaluating a patient’s immunization status to determine when the next vaccination in a series should be given. This information helps the IIS and other health IT systems identify, prevent, and resolve duplicate vaccination events using an automated process, thus ensuring that a patient is vaccinated according to the ACIP schedule. Additionally, this information could increase vaccination rates, a Healthy People 2030 goal, by ensuring patients are vaccinated on time.
Estimate the breadth of applicability of the use case(s) for this data element	"There are multiple stakeholders that would capture, access, use or exchange this data element or data class including: • Electronic Health Records • Immunization information systems and local and state departments of public health • Providers • Research and academic institutions, especially those running clinical trials "
Link to use case project page	https://www.cdc.gov/vaccines/programs/iis/index.html
Use Case Description	Additionally, determining whether a vaccination was administered or was a historical record is helpful when performing public health analyses. Vaccine efficacy analyses use this information to determine immunization population coverage. Statistical analyses help to identify underserved populations so that resources redirected appropriately and used efficiently.
Estimate the breadth of applicability of the use case(s) for this data element	"There are multiple stakeholders that would capture, access, use or exchange this data element or data class including: • Electronic Health Records • Immunization information systems and local and state departments of public health • Providers • Research and academic institutions, especially those running clinical trials " AIRA: https://www.immregistries.org/ Immunization Action Collition: https://www.immunize.org/
Link to use case project page	https://www.immunize.org/
Healthcare Aims	Improving the health of populations Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s)	LOINC:30952-6- Date and time of vaccination: https://loinc.org/30952-6/ PHINVAD Immunization Information Source https://phinvads.cdc.gov/vads/ViewCodeSystem.action?id=2.16.840.1.114222.4.5.293
Additional Specifications	This information is in various technical specifications including: • The HL7 2.5.1 Implementation Guide for Immunization Messaging and the HL7 2.8.2 Implementation Guide: Immunization Messaging (see RXA-3) • FHIR r4 (see immunization.occurrence) • Clinical Decision Support for Immunizations FHIR IG • CDC Nationally Notifiable Disease Surveillance System (NNDSS) Message Mapping Guides (MMGs) for Vaccine Preventable Diseases (VPDs)
Current Use	In limited use in production environments
Supporting Artifacts	Similar information has been collected in various artifacts including the HL7 v2.5.1 Implmentation Guide for Immunization Messaging, the HL7 2.8.2 Implementation Guide: Immunization Messaging, and various public heatlh reporting forms. https://www.cdc.gov/vaccines/programs/iis/technical-guidance/hl7.html
Extent of exchange	N/A
Potential Challenges
Restrictions on Standardization (e.g. proprietary code)	None
Restrictions on Use (e.g. licensing, user fees)	None
Privacy and Security Concerns	None
Estimate of Overall Burden	The overall burden to implement this data element is low, as most healthcare IT information systems most likely have this data element stored and messaged in their system already.
Other Implementation Challenges	One possible challenge for implementation is ensuring that the correct information is captured, as depending on the timing of the administration, there could be confusion about whether the vaccination was administered or reported. For example, some EHRs would consider a vaccination event given on the same day by a provider outside of their EHR system a historical record, even though they were given on the same day, even within a matter of a few hours.

ONC Evaluation Details Each submitted Data Element has been evaluated based on the following criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI
Criterion #1 Maturity - Current Standards	Level 2 - Data element is represented by a terminology standard or SDO-balloted technical specification or implementation guide.
Criterion #2 Maturity - Current Use	Level 2 - Data element is captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer.
Criterion #3 Maturity - Current Exchange	Level 2 - Data element is electronically exchanged between more than two production EHRs or other HIT modules of different developers using available interoperability standards.
Criterion #4 Use Case(s) - Breadth of Applicability	Level 2 - Use cases apply to most care settings or specialties.

Comment

Submitted by nedragarrett_CDC on 2024-10-03

Vaccination Event Record Type

The inclusion of the "Vaccination Event Record Type" in USCDI v6 will improve the precision and uniformity with which immunization information is managed across various healthcare platforms. This element introduces a standardized method for documenting vaccination occurrences, which is essential for achieving interoperability of data—a foundational aspect that supports thorough patient care and enhances safety measures.

Integration of the "Vaccination Event Record Type" into health records allows clinicians to evaluate patient’s immunization histories more accurately, ensuring timely administration of vaccines according to established protocols. This uniformity is essential for optimizing patient outcomes and maintaining adherence to vaccination guidelines. By establishing a clear and consistent understanding if the vaccination was administered or historical, it can reduce the risks associated with incorrect vaccination dosing—critical for patient safety—and decreases the administrative burden of reconciling records.

From a public health standpoint, "Vaccination Event Record Type" is invaluable for effective disease surveillance and management. It facilitates tracking of immunization information within populations, enabling swift responses to public health emergencies. During mass immunization campaigns against diseases like influenza or COVID-19, a standardized record type streamlines reporting processes, minimizes errors, and informs equitable vaccine distribution based on precise community needs.

Additionally, this data element is foundational for research by providing high-quality data essential for assessing vaccine effectiveness and safety. Researchers can utilize this information to draw informed conclusions that influence future vaccine development and policymaking.

In summary, incorporating "Vaccination Event Record Type" into USCDI version 6 promises substantial improvements in healthcare quality through enhanced data precision and reliability. It strengthens public health surveillance systems and response mechanisms while prioritizing patient safety. Consequently, its inclusion is not merely beneficial but critical for advancing healthcare delivery and safeguarding public health at both individual and population levels.

Submitted by BLampkins_CSTE on 2024-09-30

CSTE Comment - v6

CSTE supports inclusion of this data element in USCDI V6. Please see previously submitted CSTE comments for additional recommendations.

Submitted by rdillaire on 2024-09-30

CMS-CCSQ Support Vaccination Event Record Type for USCDI v6

Data Element: Vaccination Event Record Type (Level 2)

Recommendation: Add the Vaccination Event Record Type data element to Final USCDI v6.
Rationale: The Vaccination Event Record Type data element provides critical information about whether a vaccination has ever been administered, planned, or reported. The current Immunizations data element is insufficient to identify whether the vaccination is based on the historical record or was administered at the facility submitting the vaccination record. By adding Vaccination Event Record Type for immunizations, ASTP/ONC can also ensure data elements necessary to determine whether vaccinations are current, and whether any vaccinations need to be administered. Since this information helps improve accuracy of vaccine reporting, it can benefit many existing CMS vaccination quality measures. It can already be exchanged via HL7 v2.5.1 and 2.8.2 IGs.

Submitted by BLampkins_CSTE on 2024-04-15

CSTE Comment - v5

CSTE agrees with CDC and continues to strongly recommends that Vaccine Administration Date and Vaccination Event Record Type be included in USCDI v5. Both elements are required for immunization exchange and always have been. Each year, IIS respond to CDC’s annual report (IISAR). At the end of calendar year 2019, IIS records contained vaccine administration date 99.9% of the time with only 1 IIS reporting less than 100%. With these lacking from USCDI v5 draft, it would be possible to list only the immunization code a patient received, but not the date the patient received the dose or if the vaccination event originated in the source system. Vaccine Administration Date enables accurate record evaluation (e.g., were doses given at the proper age and at a proper interval) while Vaccination Event Record Type enable accurate inventory decrementing by public health and aids in vaccine matching/deduplication.

Submitted by yale-coredQMRoadmap on 2024-01-29

CDC and CMS-CCSQ Joint Support for Vaccination Event Record Type

Thank you for opportunity to comment on this data element. The Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) emphasize the importance of patient safety being reflected in the USCDI standards. Identification of whether vaccinations are current and whether any vaccinations need to be administered using the Vaccination Event Record Type and Immunization Status data elements are vital to patient safety outcomes. CMS and CDC strongly recommend the Vaccination Event Record Type (Level 2) data element in the Immunization data class be added to USCDI. This addition would promote patient safety.

Submitted by nedragarrett_CDC on 2024-04-15

CDC's comment for USCDI Draft v5

CDC would like to underscore the importance of the "Vaccination Event Record Type" as a data element for v5 of USCDI, aiming to standardize vaccine event categorization across healthcare systems. This element facilitates accurate scheduling of subsequent vaccinations, addresses duplicate record issues, and supports real-time monitoring of vaccination trends, particularly beneficial during mass vaccination campaigns like those for influenza or COVID-19. Its inclusion is advocated for its potential to elevate care standards, improve data accuracy, and empower effective public health surveillance and response.

Submitted by nedragarrett_CDC on 2023-10-03

CDC's comment on behalf of NACCHO for USCDI v5

Support - The standardization of this data element will enhance LHDs ability to use and analyze this data. It will reduce the data preparation burden and thus enable more LHDs to use this type of data to inform decision-making.

Submitted by nedragarrett_CDC on 2023-09-19

CDC's comment on behalf of CSTE for USCDI v5

CSTE agrees with CDC and continues to strongly recommends that Vaccine Administration Date and Vaccination Event Record Type be included in USCDI v5. Both elements are required for immunization exchange and always have been. Each year, IIS respond to CDC’s annual report (IISAR). At the end of calendar year 2019, IIS records contained vaccine administration date 99.9% of the time with only 1 IIS reporting less than 100%. With these lacking from USCDI v4 it would be possible to list only the immunization code a patient received, but not the date the patient received the dose or if the vaccination event originated in the source system. Vaccine Administration Date enables accurate record evaluation (e.g., were doses given at the proper age and at a proper interval) while Vaccination Event Record Type enable accurate inventory decrementing by public health and aids in vaccine matching/deduplication.

Submitted by nedragarrett_CDC on 2023-09-15

CDC's Consolidated Comment for USCDI v5

The "Vaccination Event Record Type" is a proposed essential data element for inclusion in the v5 USCDI, designed to enhance the quality and consistency of immunization data management across healthcare systems. This data element allows for the standardized categorization of vaccine events, significantly contributing to data interoperability across disparate health information systems. DefiningDefining a consistent framework for categorizing vaccination events enables healthcare professionals to accurately determine when subsequent vaccinations should be administered, thereby promoting adherence to recommended vaccination schedules and improving patient care. This element is critical for resolving duplicate vaccination records, a common issue that can lead to patient safety concerns and administrative burdens. The "Vaccination Event Record Type" is also pivotal for public health management, enabling efficient, real-time tracking and monitoring of vaccination trends at a population level. This facilitates timely and informed responses to emerging vaccination patterns, vaccine uptake rates, and potential adverse events following immunization. For instance, in mass vaccination campaigns, such as those for influenza or COVID-19, having a standardized record type can streamline reporting, minimize errors, and ensure that vaccines are effectively distributed and administered based on actual need. Moreover, this data element can play a crucial role in research, supporting robust and high-quality data sets for vaccine effectiveness and safety analysis. Therefore, we strongly advocate for including the "Vaccination Event Record Type" in the USCDI v5 due to its potential to significantly elevate the standard of care, improve data accuracy and reliability, and empower robust public health surveillance and response mechanisms.

** ADD THIS USE CASE TO SUBMISSION **

"Immunizations HPV": HPV is estimated to cause 70% of oropharyngeal cancers in the United States, although it is unclear if having HPV alone is enough to cause oropharyngeal cancers, or if other factors interact with HPV to cause these cancers. Because the HPV vaccine protects against the types of HPV that can cause oropharyngeal cancers, it may also prevent oropharyngeal cancers. The United States is struggling to achieve HPV vaccination goals because HPV vaccination policies vary greatly nationwide, making it hard to implement sustainable programs. Surveillance of HPV vaccination and risk factors can help to establish associations, identify at-risk populations, and better inform clinical decision-making guidelines and interventions. These activities can increase vaccination acceptance rates and may lower HPV-associated oropharyngeal cancer prevalence and incidence.

Submitted by yale-coredQMRoadmap on 2023-04-17

CMS-CCSQ/CDC Joint USCDIv4 Priority Vacc. Event Record Type

The immunization data element provides critical information about whether a vaccination has ever been administered, planned or reported. The current immunization data element is insufficient to identify whether the vaccination is based on the historical record or was administered at the facility submitting the vaccine. By adding vaccine event record type for immunizations, ONC can also ensure data elements necessary to determine whether vaccinations are current, and whether any vaccinations need to be administered.

Immunizations

Data Element

Comment