| **National      Center for       Health Statistics               Division of Data       Services               6525 Belcrest Road       Hyattsville, MD       20782-2003       (301)458-4636 **

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**Frequently    Asked Questions by Vaccination Providers**

Why are vaccination providers asked to complete **Immunization History Questionnaires?**To where should completed **Immunization History Questionnaires be sent?**Is it necessary to **fill out the entire form?**Who at the CDC can **answer questions** about the NIS Provider    Study?How is **parental consent** for collecting vaccination    information obtained?What should be done in cases    where the **provider does not know the child or does not have    vaccination records** for the child? 

Click here to view the **cover letter** for vaccination    providers requested to participate in the National Immunization Survey Provider Study.

**Why are vaccinations providers asked to complete    immunization history questionnaires?**    We have discovered that sources of vaccination information from doctors and clinics are    the most up-to-date and comprehensive and that the quality of the study's results is much    improved by combining the information given by households with that given by these medical    providers. It is important that we obtain the most reliable information possible about    children's vaccinations so that we can provide the public with reliable estimates.

**To where would completed immunizations history questionnaires be    sent?**    A pre-paid, addressed envelope was included in the packet of materials along with the    request for information about the child's immunizations. If you do not have the envelope,    the address is:    Victor Coronado, M.D.    National Immunization Survey    National Immunization Program    Centers for Disease Control and Prevention    P.O. Box 5517    Chicago, Illinois 60680-8817    If it is more convenient, you may fax the information to our toll-free number:    1-800-867-1905.  

**Is it necessary to fill out the entire    form?**    If you prefer, you may attach a photocopy of the child's immunization history to the    questionnaire and just complete the items on the second page.

**Who can answer questions about the NIS provider study?**    If you have any questions or comments about the materials being requested, please call    (800) 886-4993. If you would like additional information about the National Immunization    Survey, please **e-mail Ms. Vicki    Huggins** with Abt Associates, the contractor for data collection. Your    participation in the National Immunization Survey is greatly appreciated.

**How is parental consent for collecting    vaccination information obtained?**    During the telephone interview, an NIS interviewer asks the parent or guardian of a study    child for permission to contact the child's vaccination provider and collect vaccination    information.  If consent is given, the telephone interviewer documents the obtaining    of consent. This documentation is supplied to the vaccination provider when the    request is made to complete an Immunization History Questionnaire for a child.

**What should    be done in cases where the provider does not know the child or does not have vaccination    records for the child?**    The first item on the front page of the questionnaire (see below) allows you to indicate    this. Please check the appropriate option and return the form so that we do not send you a    second request for the information. If you know the current location of records for this    child, there is a space to write that information at the bottom of the second page of the    questionnaire.    1. Which of the following best describes your records of immunization for this child?    (Check only one box.)    1 a. Have immunization record    for this child. (Go to question 2 below.)    2 b. Have provided care to this    child, but do not have his/her immunization record. (Go to question 2 below.)    4 c. Have no record of providing    care to this child. (Return questionnaire to CDC as instructed above.)    5 d. Other (Explain):    _______________________________

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This page last reviewed March 24, 2000

**U.S.    DEPARTMENT OF HEALTH AND HUMAN SERVICES****Centers    for Disease Control and Prevention**    National Center for Health Statistics    Division of Data Services     Hyattsville, MD    20782-2003    (301) 458-4636 |
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