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What are IIS Sentinel Sites?
The National Center for Immunization and Respiratory Diseases (NCIRD) established a group of Immunization Information Systems (IIS) as Sentinel Sites in 2004 from those that received CDC/NCIRD immunization grant funding. These Sentinel Sites receive additional grant funds to achieve higher standards of data quality in their IIS and routinely analyze data for programmatic decision-making. These sites partner with NCIRD to track patterns in immunization practices and assess vaccination coverage among children less than 19 years of age in their sentinel site geographic regions.
Members of the IIS Sentinel Site Project, 2008-2012 include:
Arizona Department of Health Services
Kathy Fredrickson, MS, MPH
Lisa RasmussenColorado Department of Public Health and Environment Immunization Program
Elaine Lowery, JD, MA, MSPH
Kellyn Pearson, RN, BSN, MSN, CPNPMichigan Department of Community Health
Therese Hoyle
Kyle Enger, MPHMinnesota Department of Health
Karen E. White, MPH
Emily J. Peterson-StaufferNorth Dakota Department of Health
Molly Sander, MPH
New York City Department of Health and Mental Hygiene
Vikki Papadouka, PhD, MPH
Michael Andreas Hansen, MPHOregon Immunization Program, Public Health Division, DHS
James A. Gaudino, Jr., MD, MS, MPH
Mary Beth Kurilo, MPHWisconsin Immunization Program
Thomas Maerz
Gerald Gabor
Why Sentinel Sites?
Public health officials at all levels have the challenging task of determining why children are not fully immunized and studying immunization behavior changes over time. The IIS Sentinel Site project promotes the population-based analysis of IIS data and IIS data quality improvement for immunization program evaluation and to assist in disease surveillance activities.
The National Immunization Survey (NIS), traditionally considered the gold standard of immunization coverage, provides yearly estimates of coverage for 19-35 month old children and reflects changes on this time scale. IIS sentinel sites can provide vaccination coverage assessment at the state and local level within weeks and for a younger and older population (i.e., children less than 19 years of age).
Few state or local IIS are sufficiently complete to support routine vaccination coverage assessment of its entire population. However, reliable coverage assessment can occur from a subset of this population, in a specific geographic area using IIS Sentinel Sites, that has the majority of its vaccine providers and children enrolled and submitting data. These sites can provide valuable insights into immunization practices and the factors influencing those practices. Some IIS Sentinel Sites (e.g., New York City and North Dakota) have chosen to include their entire city or state in this project to assess their entire IIS geographic area.
How are Sentinel Sites Selected?
IIS chosen as Sentinel Sites have been state or large urban systems. There are two types of sentinel sites: capacity-building and implementation sites. All sites primarily work to meet data quality Registry/IIS Certification Standards and provide support for routine analysis of IIS data. Sites receiving funds collect timely and complete immunization histories in a specific geographic area of contiguous zip codes or census tracts that are usually subsets of the statewide IIS database.
At a minimum, sites need to have:
- At least 85% vaccine provider sites enrolled in the IIS;
- At least 85% of the children less than 19 years of age are participating in the IIS (participation is defined as a child having at least two doses of vaccine recorded in the IIS);
- At least 70% of the doses administered from this sentinel site area should be submitted to and processed by the IIS within 30 days of vaccine administration.
Sites funded at the capacity-level have at least 20,000 children less than 19 years of age with at least two immunizations recorded in the IIS database compared to implementation sites which have more than 200,000 children younger less than 19 years of age with at least two immunizations recorded in the IIS database.
Sentinel Sites also aim to have the high data quality measures used for IIS certification:
- At least 90% of the vaccines administered by providers entered into the IIS's database within 30 days of vaccine administration.
- Have at least 25% of the National Vaccine Advisory Committee (NVAC) core data elements routinely populated in their database. The aim is to have 50% of the patient data populated with vaccine lot number and vaccine manufacturer.
- Have data quality protocols and procedures in place to ensure high levels of accurate and complete vaccination histories with few duplicate records.
What are Sentinel Sites asked to do?
Sentinel Sites report aggregate confidential immunization coverage data to NCIRD on a quarterly basis. Although data are limited to specific geographic areas, these analyses:
- Monitor 'real time' trends in immunization;
- Determine how events have impacted immunization acceptance;
- Answer questions concerning certain vaccines; and
- Monitor IIS data quality, completeness, and timeliness.
Thus, Sentinel Sites can not only increase their own understanding of the population served but also health care providers' ability to address changing circumstances within their region. IIS will also have hard data to evaluate their own performance.
Ad-hoc requests occur when NCIRD determines that events occur which might change immunization acceptance or administration. For example, such requests might follow warnings from professional advisory groups or reports of vaccine shortages. Implementation sites may receive ad-hoc requests more frequently and are asked to prepare one journal article annually for a peer-reviewed scientific journal based on IIS data, ideally from their sentinel site geographic area.
Sentinel Sites receive technical consultation from NCIRD and have access to information obtained from analysis of their own data. Quarterly immunization coverage data are analyzed and returned back to sentinel sites for comparison purposes.
See profiles of current Sentinel Sites.
Who to contact?
For more information on IIS Sentinel Sites, contact Diana Bartlett at zxd5@cdc.gov.
Content last reviewed on June 5, 2008
Content Source: National Center for Immunization and Respiratory Diseases