Barriers to IIS; Immunization Information Systems; Immunization of children – Reporting; Physicians; Private Providers


Community-Based Learning | Medicine and Health | Pediatrics | Public Health


One of the goals of Healthy People 2010 is to increase the proportion of children less than 6 years of age with two or more vaccinations recorded in a fully operational population-based immunization information system to 95%. In 2008, we piloted the Nevada web-based immunization information system (WEBIZ) in a large private pediatric clinic in north-west Las Vegas. Our objectives were: (1) to determine compliance with the recommendation that all vaccine providers report immunization activities to the WEBIZ without a state mandate and (2) to determine perceived barriers to compliance and suggestions on how to overcome expressed barriers. We documented the number of newly created and updated immunization records as outcome measures of compliance following initial training, ongoing technical support and feedback to the clinic staff on the use of WEBIZ. We found low compliance with the recommendation to document immunization activities and clinic staffs were more likely to document immunization activities when there is an established record in WEBIZ compared to when a new record had to be created by the staff. Our survey of participating clinic staff, identified time to create new records as the most common reported barrier to compliance with recommendation. We concluded that without a state mandate, compliance with the recommendation would remain low and that documentation of hepatitis B birth dose in WEBIZ, thus creating an initial record, could potentially reduce barriers to compliance with recommendation to document immunization activity in WEBIZ.