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H H S Department of Health and Human Services
U.S. Department of Health and Human Services
Health Information Technology and Quality

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How do I support the submission of electronic data to immunization registries?

The EHR Incentive Program Final Rule describes the following specific objective and measure for submission of immunization data to immunization registries and immunization information systems:

Objective for Eligible Professionals and Hospitals:

  • Capability to submit electronic data to immunization registries (now called immunization information systems-IIS) and actual submission according to applicable law and practice. (Laws and practices are defined by the state in which the eligible professional or hospital provides services. Please refer to state public health agencies for more information.)


  • Perform at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries or IISs and follow up submission if the test is successful (unless none of the IISs to which the eligible professional or hospital submits such information has the capacity to receive the information electronically). (Please check with these entities for further information.)


  • Any eligible professional or hospital who administers no immunizations during the EHR reporting period.

Electronic exchange of immunization data is used by providers and state and local governmental public health agencies to collect and manage vaccination data within a particular geographic area. Immunization Information Systems can be used to generate vaccination reminders and recall notices, consolidate vaccination records from multiple providers, and provide official vaccination forms and assessments.

Currently, some existing EHRs can send and receive immunization data to and from public health agencies. However, others only have the ability to send information or have no capability to electronically share data.  Even with a certified EHR, the exact data elements, periodicity of reporting, and method of sending data to a governmental public health agency will vary from jurisdiction to jurisdiction.  You will need to check with the public health agency in your jurisdiction to confirm these details.   

As discussed in the introduction to this module, submission of electronic data to immunization registries is a menu set objective in the EHR Incentive Program Final Rule. When deciding whether or not to pursue this menu option, it will be  important for providers to know which state and local governmental public health agencies have immunization information systems and can send and receive HL7 messages.  Most state and many local public health agencies maintain an immunization information system.   Technical assistance on HL7 messaging and submission of immunization data can be provided by your Regional Extension Center (REC) or through your vendor. ONC-ATCBs should also be able to provide further information about HL7 messaging. Even if a public health agency does have this capability, providers considering this objective may also want to reach out to their state and local governmental public health agencies to assess their readiness to receive data.

Related Resources:

Guide to Immunization-related Electronic Data Exchange go to exit disclaimer– A practical guide to setting up data exchange for an immunization registry.
AIRA Technical Assistance Resource Center for ISS go to exit disclaimer– A user friendly webpage developed to provide peer-to-peer technical assistance to immunization information system project staff in key programmatic, operational and technical areas.
Diabetes Management and Meaningful Use go to exit disclaimer– Presentation by Elizabeth Molina-Ortiz of the Institute for Family Health, on patient registries for diabetes management and their use for meeting the EHR Incentive Program’s requirements.
Immunization Information Systems State Registry Staff Main & Technical Contacts – Phone and email contact information of state registry staff.  

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