Section IX. 2017 Immunization Information Systems Annual Report (IISAR)

What is the Immunization Information Systems Annual Report (IISAR)?

The IISAR is an annual survey that assesses immunization program performance in developing, maintaining, and 

enhancing Immunization Information Systems for a given calendar year. It is a reporting requirement for the 64 

immunization programs that receive funding under section 317b of the Public Health Service Act.

A brief note on methods

•

•

The IISAR is a self-reported, self-validated survey administered by CDC and answered by immunization program

awardees. CDC may contact you with questions after submission in order to continue data validation.

Data are collected prior to Census estimates are released for the year of the survey. For this reason, we include

Census estimates in the survey for the year prior to provide preliminary estimates for some measures. These

preliminary estimates are revised when the final Census data are released, approximately in June/July each year

for the prior years’ data. CDC provides preliminary estimates on the IISAR to ensure the estimates are

concordant with the program and past years’ data.

Changes in 2017

The IISAR underwent significant revisions in 2017 to address the new Functional Standards for IIS available at: 

https://www.cdc.gov/vaccines/programs/iis/func-stds.html. While there are many new questions, there are some old 

questions that have subtle logic guidance changes. Please be sure to carefully review the logic guidance in all sections in 

order to respond to their new specifications as accurately as possible.

Instructions

• All awardees that conduct IIS activities in their state/city/territory are required to complete this report.

• All awardees with IIS in transition are required to complete questions 1 through 7 and should consult with their

IISSB Project Officer to discuss completing other data elements on the questionnaire.

• Items in italics are completed by CDC; awardees only need to respond to questions that are NOT italicized.

• Throughout the IISAR questionnaire, age ranges are described as from age X through Y months/years. This

terminology is consistent with language used by the Advisory Committee on Immunization Practices and

indicates the lower and upper age limits for who should be included in data collection. In all cases, age X is the

lower bound and age Y is the upper bound. For example, adolescents aged 11 through 17 years should include

adolescents at least 11 years old and less than 18 years of age. Those younger than 11 years, or 18 years or

older, would not be included in this group.

• Submission of the final Immunization Information Systems Annual Report must be done by the Immunization

Program Manager or their designee.

• Only one Annual Report will be accepted per awardee. If awardees receive information from other regions or

counties in their jurisdiction, the awardee must compile the information into one Annual Report.

• The Annual Report is due on March 30, 2018; the year of performance is calendar year 2017. CDC IISSB staff will

contact each IIS after March 30 with questions and/or comments about the report and data submitted for

calendar year 2017. After March 30, 2018, the submission data will be corrected and revised. Any revised

submissions from awardees should correct issues with the submitted data as of March 30 ONLY. When

submitting revisions, do NOT submit additional 2017 data that were uploaded AFTER the March 30 cutoff date.

• Please contact Terence Ng, CDC/NCIRD/IISSB (contractor) at VFK5@cdc.gov or Lauren Shaw, CDC/NCIRD/IISSB at

ILV6@cdc.gov if you need clarification on a question or answer choice.

Resources
• For additional guidance on Patient Active/Inactive Status in Immunization Information Systems, see the AIRA

guide here: https://www.immregistries.org/resources/FINAL_AIRA_PAIS_Guide_FullFormat.pdf

• For additional guidance on using dates to calculate a period of time, the Clinical Decision Support for

Immunization (CDSi): Logic Specification for ACIP Recommendations can be referenced here:

https://www.cdc.gov/vaccines/programs/iis/cdsi.html 
CONTACT INFORMATION AND SCOPE OF IIS

Logic Guidance:

Q.1 – Q.5 are required to be completed by all awardees, including those with IIS in transition or temporarily inactive. 

List ONLY government employee contacts in Q.3 and Q.4. 

1. Awardee_______________________

2. Name of person(s) submitting this report_______________________

3. Programmatic IIS contact person (a manager or administrator who coordinates IIS activities): 

a. First Name: _______________________ e. Phone:________________ f. Ext: _______

b. Last Name: _______________________ g. Email:____________________________

c. Title: ____________________________

d. Affiliation:________________________

h. Check if contact person for questions about this report

4. Technical IIS contact person (coordinator of IIS software and/or hardware) : 

Check if same as programmatic contact (if yes, autopopulate a-g)

a. First Name: _______________________ e. Phone:________________ f. Ext: _______

b. Last Name: _______________________ g. Email:____________________________

c. Title: ____________________________

d. Affiliation:________________________

h. Check if contact person for questions about this report

5. There is no IIS in production in this state/city/territory. (If yes, block out entire report)
Age Groups

Logic Guidance: 

6. Which age groups are included in your IIS? Select one: 

a) Birth through 6 years of age

b) Birth through 18 years of age

c) All ages, including adults

d) Other (specify)______________

The IISAR has been programmed to match the age groups below. Some questions are only relevant for defined age 

groups. Therefore, the number of required questions may be reduced depending on which age groups are included in 

your IIS.

When determining if an age group is included in your IIS, consider the age range that your IIS is authorized to collect 

regardless of the completeness of data captured for that age group.
ESSENTIAL INFRASTRUCTURE STANDARDS

FUNCTIONAL STANDARD 1: The IIS contains complete and timely demographic and immunization data for 

children, adolescents, and adults residing or immunized within its jurisdiction. 

1.1 The IIS establishes a record in a timely manner from sources such as vital records or birthing 

hospitals for each child born in its jurisdiction or that resides in its jurisdiction at the date of birth.

1.2 The IIS identifies records created from vital records. 

1.3 The IIS contains a complete consolidated demographic record and vaccination history for every 

child, adolescent, and adult currently residing in the jurisdiction.

1.4 The IIS assures that all participating provider sites submit vaccination records and demographic 

information to the IIS in a timely fashion.

1.5 The IIS ensures that submitted vaccination and demographic data are processed and viewable in a 

timely manner.

1.6 The IIS assures the receipt, processing, and storage of demographic and vaccination data elements 

as endorsed by CDC.

1.7 The IIS periodically reviews the data elements endorsed by CDC and updates the IIS accordingly.

Timeliness of Birth Records in IIS

Logic Guidance:

• For newborns born January 1 through December 31, 2017

• Other birth record source includes birthing hospitals, perinatal or newborn screening programs.

• Day 0 refers to the date of birth.

• Days listed refer to calendar days.

• Reported numbers of newborn records established from Vital Records and other record sources should be mutually 

exclusive. 

• When determining whether a record was established by Vital Records or other birth record sources, consider which 

source the birth record was established by FIRST. Therefore, regardless of whether a birth record is later established 

by Vital Records, if it was first established by Other Record sources, consider it established by Other Record Sources. 

Only consider a record established by Vital Records if it was established in the IIS by Vital Records FIRST.

• In this section:

Use the table below to identify newborns to include in the assessment:

Newborns who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider 

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address is unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization information for an extended 

period of time

X 
o Note that the “extended period of time” could be defined differently by 

each IIS

Deceased

• Deceased at the time of query X 

7. For children born January 1 through December 31, 2017 in the IIS’s jurisdiction, what number had a record 

established in the IIS within the following days after birth:

a. Number of 

children with 

record 

established 

from vital 

records

b. Number of 

children with 

record 

established from 

sources other 

than vital 

records

Percentage of 

children with 

records 

established in 

the specified 

timeframe (autocalculated)

≤30 days a. b. c. (a+b)/(m+n)

>30 days - ≤45 days d. e. f. (d+e)/(m+n)

>45 days - ≤60 days g. h. i. (g+h)/(m+n)

>60 days j. k. l. (j+k)/(m+n)

Total (auto-calculated) m.-- n.--
Timeliness of vaccination records in IIS

Logic Guidance

• The period of timeliness corresponds to the time between the date of administration of the vaccine dose indicated

on the vaccination record and the date the vaccination record was posted to production in the IIS.

• Age at which vaccine is administered should be determined as of the date of vaccine administration during

CY2017.

• Depending on the date of birth, vaccines administered to an individual may fall within two different age ranges.

o Example: Vaccines administered to a child born on November 25, 2010 would be included in the “0 through 6”

age range if administered before November 25, 2017, since the child would be 6 years and one day before their

7th birthday. Vaccines administered on or after November 25, 2017 would be included in the “0 through 18”

age range because they were administered when the child then turned 7 years old.

• Timeframes listed refer to calendar days.

• In this section:

Use the table below to identify individuals to include in the assessment:

Vaccination records for individuals who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a

provider organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period

of time

o Note that the “extended period of time” could be defined differently

by each IIS

X 

Deceased

• Deceased at the time of query X 

After identifying individuals in the table above, use this table to determine the appropriate vaccination records

to include in the assessment:

General vaccination inclusions/exclusions Include Exclude

Vaccinations administered in CY2017 for all persons in the IIS X

Doses that were administered before January 1, 2018, including those recorded after 

December 31, 2017 X 

All doses (valid and invalid) X

H1N1 vaccines administered and demographic records belonging to those with only 

an H1N1 vaccination record X 

Travel vaccines (yellow fever, typhoid, etc.) See: 

wwwnc.cdc.gov/travel/page/yellowbook-home

X 

Historical vaccinations X

Non-vaccine products (e.g. immune globulins, PPD) X
8. In 2017, was your registry able to capture the date the vaccination record was posted to production? Yes/No

For vaccinations administered in CY2017 to all persons in the IIS, list the number of vaccine doses reported to the IIS 

within the following time frames:

Number of 

vaccine doses 

administered 

to children 

aged 0 through 

6 years (i.e. 

non-historical) 

during CY2017

Number of 

vaccine doses 

administered 

to persons 

aged 0 through 

18 years (i.e. 

non-historical) 

during CY2017

Number of 

vaccine doses 

administered 

to persons of 

all ages 

(lifespan) (i.e. 

nonhistorical) 

during 

CY2017

Percentage 

of doses 

reported for 

children aged 

0 through 6 

years for the 

specified 

timeframe 

(autocalculated)

Percentage of 

doses 

reported for 

persons aged 

0 through 18 

years for the 

specified 

timeframe 

(autocalculated)

Percentage of 

doses 

reported for 

persons of all 

ages 

(lifespan) for 

the specified 

timeframe 

(autocalculated)

≤3 days a b c p (a/m) q (b/n) r (c/o)

>3 days–

≤14 days

d e f s (d/m) t (e/n) u (f/o)

>14 days–

≤30 days

g h i v (g/m) w (h/n) x (i/o)

>30 days j k l y (j/m) z (k/n) aa (l/o)

Total 

(autocalculated)

m n o
Newborn Population Capture

Logic Guidance: 

• For newborns born January 1 through December 31, 2017

• If a patient record comes to the IIS through other birth record sources, but is later verified by Vital Records, consider

the patient record to have come from Vital Records.

• If a patient record comes to the IIS through other birth record sources ONLY, consider the patient record to have

come from other record sources.

• In this section:

Use the table below to identify newborns to include in the assessment:

General demographic inclusions/exclusions Include Exclude

Newborns who currently are known to reside in your jurisdiction at the time of query, 

regardless of residence at the time of birth. X

After identifying newborns in the table above, use this table to further identify newborns to include in the 

assessment: 

Newborns who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of time

o Note that the “extended period of time” could be defined differently by each

IIS

X 

Deceased

• Deceased at the time of query X 

9. Number of children in the jurisdiction born from January 1 through December 31, 2017 (2017 Census data)

10. Number of patient records created in your IIS from Vital Records for children born from January 1 through 

December 31, 2017 who resided in your jurisdiction at the time of query._____________

11. Number of patient records created in your IIS from sources other than Vital Records for children born from January 

1 through December 31, 2017 who resided in your jurisdiction at the time of query. _______________

a. Percentage of children in the IIS born from January 1 through December 31, 2017 with records created in the

IIS from all sources (Q.10+Q.11/Q.9) 
Enrollment in IIS (0–6 years, 0–18 years, lifespan)

Logic Guidance: 

• Q.13: For individuals born from January 1, 2011 through December 31, 2017

• Q.15: For individuals born from January 1, 1999 through December 31, 2017

• Q.17: For individuals born on or before December 31, 2017

Enrollment:

• In this section:

Use the table below to identify individuals to include in the assessment:

Individuals who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of time

o Note that the “extended period of time” could be defined differently by each

IIS

X 

Deceased

• Deceased at the time of query X 

After identifying individuals in the table above, use this table to further identify individuals to include in the 

assessment: 

General demographic inclusions/exclusions Include Exclude

Demographic records belonging to those with only an H1N1 vaccination record X

12. Number of individuals aged 0 years through 6 years in the jurisdiction at the time of query (2017 Census data)

13. Number of individuals aged 0 years through 6 years (born from January 1, 2011 through December 31, 2017) in both

in your jurisdiction AND in your IIS__________

a. 0–6 years enrollment: Percentage of individuals aged 0 years through 6 years in both your jurisdiction AND in

your IIS (Q.13/Q.12)

14. Number of individuals aged 0 years through 18 years in the jurisdiction at the time of query (2017 Census data)

15. Number of individuals aged 0 years through 18 years (born from January 1, 1999 through December 31, 2017) in both 

in your jurisdiction AND in your IIS__________

a. 0–18 years enrollment: Percentage of individuals aged 0 years through 18 years in both your jurisdiction AND

in your IIS (Q.15/Q.14) 
16. Number of individuals of all ages in the jurisdiction at the time of query (2017 Census data)

17. Number of individuals of all ages (born on or before December 31, 2017) in both in your jurisdiction AND in your

IIS__________

a. Lifespan enrollment: Percentage of individuals of all ages in both your jurisdiction AND in your IIS

(Q.17/Q.16) 
Child Participation in IIS (aged 4 months through 5 years)

Logic Guidance: 

• For children born from January 1, 2012 through August 31, 2017

Enrollment among children: 

• In this section:

Use the table below to identify children to include in the enrollment assessment:

Individuals who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of time

o Note that the “extended period of time” could be defined differently by each

IIS

X 

Deceased

• Deceased at the time of query X 

After identifying children in the table above, use this table to further identify children to include in the assessment:

General demographic inclusions/exclusions Include Exclude

Children enrolled in the IIS, even if they only have travel vaccines, non-vaccine products, or 

no vaccines in the vaccine record X 

Participation among enrolled children: 

• In this section:

After identifying children for enrollment using the tables above, use this table to further identify children with the

following vaccinations:

General vaccination inclusions/exclusions Include Exclude

All doses (valid and invalid) administered before January 1, 2018, including those recorded in 

the IIS after December 31, 2017 X 

Travel vaccines (yellow fever, typhoid, etc.) See:

wwwnc.cdc.gov/travel/page/yellowbook-home

X 

Non-vaccine products (e.g. immune globulins, PPD) X

18. Number of children aged 4 months through 5 years in the jurisdiction at the time of query (2017 Census data)

19. Number of children aged 4 months through 5 years (born from January 1, 2012 through Aug 31, 2017) in both in

your jurisdiction at the time of query AND in your IIS__________
a. Child enrollment: Percentage of children aged 4 months through 5 years in both your jurisdiction at the time 

of query AND in your IIS (Q.19/Q.18) 

20. Number of children in Q.19 (children born from January 1, 2012 through Aug 31, 2017 that are both in your 

jurisdiction at the time of query AND in your IIS) that have 2 or more vaccine doses recorded in your IIS (Healthy 

People 2020 objective) __________

a. Child participation: Percentage of children aged 4 months through 5 years in your jurisdiction at the time of 

query and IIS that have 2 or more vaccine doses recorded in your IIS (Q.20/Q.18)
Adolescent Participation in IIS (aged 11 through 17 years)

Logic Guidance — Adolescent participation in IIS

• For adolescents born from January 1, 2000 through December 31, 2006

Enrollment among adolescents: 

• In this section:

Use the table below to identify adolescents to include in the enrollment assessment:

Individuals who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of

time

o Note that the “extended period of time” could be defined differently by

each IIS

X 

Deceased

• Deceased at the time of query X 

After identifying adolescents in the table above, use this table to further identify adolescents to include in the 

assessment: 

General demographic inclusions/exclusions Include Exclude

Adolescents enrolled in the IIS, even if they only have travel vaccines, non-vaccine 

products, or no vaccines in the vaccine record X 

Demographic records belonging to adolescents with only an H1N1 vaccination record X

Participation among enrolled adolescents: 

• In this section:

After identifying adolescents for enrollment using the tables above, use this table to further identify adolescents

with the following vaccinations:

General vaccination inclusions/exclusions Include Exclude

All doses (valid and invalid) administered before January 1, 2018, including those recorded

in the IIS after December 31, 2017

X

Adolescent doses ONLY if they were administered from age 9 through 17 years. Only

include: Tdap/Td, HPV, meningococcal (any serotype), seasonal influenza, pneumococcal,

HepA, HepB, polio, MMR, and varicella 

(www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html#printable) 

X

Doses administered to adolescents before the adolescent’s 9th birthday X

H1N1 vaccines administered X
Travel vaccines (yellow fever, typhoid, etc.) See: 

wwwnc.cdc.gov/travel/page/yellowbook-home

X

Non-vaccine products (e.g. immune globulins, PPD) X

21. Number of adolescents aged 11 through 17 years in your jurisdiction at the time of query (2017 Census Data)

22. How many adolescents aged 11 through 17 years (born from January 1, 2000 through December 31, 2006) are both

in your jurisdiction at the time of query AND in your IIS? ______________

a. Adolescent enrollment: Percentage of adolescents aged 11 through 17 years that are both in your jurisdiction

at the time of query AND in your IIS (Q.22/Q.21)

23. How many adolescents in Q.22 (adolescents born from January 1, 2000 through December 31, 2006 that are both in

your jurisdiction at the time of query AND in your IIS) have 2 or more adolescent vaccine doses administered from

age 9 through 17 years recorded in your IIS? (Healthy People 2020 objective) ______________

a. Adolescent participation: Percentage of adolescents aged 11 through 17 years in your jurisdiction at the time

of query and IIS that have 2 or more adolescent vaccine doses recorded in your IIS (Q.23/Q.21)
Adult Participation in IIS (aged 19 years and older) 

Logic Guidance — Adult Participation in IIS

• For adults born on or before December 31, 1998

Enrollment among adults: 

• In this section:

Use the table below to identify adults to include in the enrollment assessment:

Individuals who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of time

o Note that the “extended period of time” could be defined differently by

each IIS

X 

Deceased

• Deceased at the time of query X 

After identifying adults in the table above, use this table to further identify adults to include in the assessment:

General demographic inclusions/exclusions Include Exclude

Adults enrolled in the IIS, even if they only have travel vaccines, non-vaccine products, or no 

vaccines in the vaccine record X 

Demographic records belonging to adults with only an H1N1 vaccination record X

Participation among enrolled adults: 

• In this section:

After identifying adults for enrollment using the tables above, use this table to further identify adults with the

General vaccination inclusions/exclusions Include Exclude

All doses (valid and invalid) administered before January 1, 2018, including those recorded in 

the IIS after December 31, 2017 X 

Adult doses ONLY if they were administered from age 19 years and older. Only include:

seasonal influenza, Tdap/Td, varicella, HPV, zoster, MMR, pneumococcal, meningococcal

(any serotype), HepA, and HepB 

https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule.pdf

X 

Doses administered to adolescents before 19 years of age X

H1N1 vaccines administered X

Travel vaccines (yellow fever, typhoid, etc.) See: 

https://wwwnc.cdc.gov/travel/page/yellowbookhome

X 

Non-vaccine products (e.g. immune globulins, PPD) X

following vaccinations:
24. Number of adults aged 19 years and older in your jurisdiction at the time of query (2017 Census data)

25. How many adults aged 19 years and older (born on or before December 31, 1998) are both in your jurisdiction at the

time of query AND in your IIS?

a. Adult enrollment: Percentage of adults aged 19 years and older that are both in your jurisdiction at the time

of query AND in your IIS (Q.25/Q.24)

26. How many adults in Q.25 (born on or before December 31, 1998 who are both in your jurisdiction at the time of

query AND in your IIS) have 1 or more adult vaccine dose(s) administered at 19 years and older recorded in your IIS?

_____________

a. Adult participation: percentage of adults aged 19 years and older in your jurisdiction at the time of query and

IIS that have 1 or more adult vaccine dose(s) recorded in your IIS (Q.26/Q.24) 
4:3:1:3:3:1:4 Series Coverage (for children aged 19 through 35 months) 

Logic Guidance:

• For children born from January 1, 2015 through May 31, 2016

• Coverage is defined as the number of individuals in a certain age group who received a vaccination(s) divided by the

Census-based estimate of persons in that age group in your jurisdiction. Jurisdiction is defined as the area that

contains the population of children residing in geographic location covered by the IIS.

• In this section:

Use the table below to identify children to include in the assessment:

Children who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of time

o Note that the “extended period of time” could be defined differently by

each IIS

X 

Deceased

• Deceased at the time of query X 

After identifying children using the tables above, use this table to further identify children with the following 

vaccinations:

General vaccination inclusions/exclusions Include Exclude

Both valid and invalid doses. X

Doses administered before January 1, 2018, including those recorded after December 31, 

2017 X 

The 4:3:1:3:3:1:4 series includes 4 or more DTaP/DTP/DT, 3 or more Polio, 1 or more MMR, 

3 or more Hepatitis B, ≥3 or ≥4 of Hib*, 1 or more Varicella†, and 4 or more pneumococcal 

containing vaccine).

*When calculating Hib doses, include children who received 4+ Hib-containing vaccine

doses (includes any type of Hib vaccine, including Hib, unspecified formulation) or 2 HibOMP doses (manufactured by Merck; includes PedVaxHib and Comvax) followed by ≥1 Hib

dose of any type.

† When counting Varicella, only include those who received 1 or more dose of Varicella. Do 

not count history of disease.

X 

All Doses
27. Number of children aged 19 through 35 months in your jurisdiction at the time of query (2017

Census data) --

28. NIS 4:3:1:3:3:1:4 series coverage percentage for children aged 19 through 35 months (2017

NIS data) --

29. How many children born during January 1, 2015 through May 31, 2016 that are in your

jurisdiction at the time of query have received the complete 4:3:1:3:3:1:4 series?

a. Coverage – percentage of children aged 19 through 35 months in the population

that have completed the 4:3:1:3:3:1:4 series (Q.29/Q.27)

Q.29/Q.27

(Autocalculated)

b. NIS–IIS Point Estimate Difference (2017 data) – NIS 4:3:1:3:3:1:4 series coverage

percentage minus IIS 4:3:1:3:3:1:4 series coverage percentage (Q.28 – Q.29)

Q.28 – Q.29

(Autocalculated) 
Adolescent Immunization Coverage (for adolescents aged 13 through 17 years) 

Logic Guidance — Adolescent Immunization Coverage in IIS

• For adolescents born from January 1, 2000 through December 31, 2004

• Coverage is defined as the number of individuals in a certain age group who received a vaccination(s) divided by

the census-based estimate of persons in that age group in your jurisdiction. Jurisdiction is defined as the area that

contains the population of adolescents residing in the jurisdiction covered by the IIS.

• In this section:

Use the table below to identify adolescents to include in the assessment:

Adolescents who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of

time

o Note that the “extended period of time” could be defined differently by

each IIS

X 

Deceased

• Deceased at the time of query X 

After identifying adolescents using the tables above, use this table to further identify adolescents with the 

following vaccinations:

General vaccination inclusions/exclusions Include Exclude

Both valid and invalid doses X

Tdap/Td vaccines X

Any DT/DTP/DTaP-containing vaccines* given at or after age 7 years

*Doses reported as DT/DTP/DTaP-containing that were administered at or after age 7

years could reflect misreported Tdap doses.

X 

Doses administered before January 1, 2018, including those recorded after December 31, 

2017 X 

Doses administered at any time before the adolescent’s 18th birthday X

All Doses

30. Number of adolescents aged 13 through 17 years in your jurisdiction at the time of query

(2017 Census data)

--

31. NIS Tdap/Td coverage percentage for adolescents aged 13 through 17 (2017 NIS data) --
32. How many adolescents aged 13 through 17 years (born from January 1, 2000 through

December 31, 2004) that are both in your jurisdiction at the time of query AND in your IIS

have at least one dose of Tdap/Td?

a. Coverage — Percentage of adolescents aged 13 through 17 years in the population

that have at least one dose of Tdap/Td. (Q.32/Q.30)

Q.32/Q.30

(Autocalculated)

b. NIS–IIS Point Estimate Difference (2017 data) – NIS Tdap/Td coverage percentage

minus IIS Tdap/Td coverage percentage (Q.31 – Q.32)

Q.31 – Q.32

(Autocalculated)
Adult Influenza Coverage (aged 18 and older)

Logic Guidance — Adult Influenza Coverage in IIS

• For adults born on or before December 31, 1999

• For the half flu vaccination season of July 1, 2017 – December 31, 2017

• Coverage is defined as the number of individuals in a certain age group who received a vaccination(s) divided by

the census-based estimate of persons in that age group in your jurisdiction. Jurisdiction is defined as the area that

contains the population of adults residing in the jurisdiction covered by the IIS.

• In this section:

Use the table below to identify adults to include in the assessment:

Adults who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of time

o Note that the “extended period of time” could be defined differently by

each IIS

X 

Deceased

• Deceased at the time of query X 

After identifying adults using the tables above, use this table to further identify adolescents with the following 

vaccinations:

General vaccine inclusions/exclusions Include Exclude

Both valid and invalid doses X

Doses of adult influenza administered on or after July 1, 2017 X

Doses administered before January 1, 2018, including those recorded after December 31, 

2017 X 

Doses administered at any time on or after the adult’s 18th birthday X

Doses of influenza administered to a patient during the 2017 half flu vaccination season 

before the patient’s 18th birthday X 

All Doses

33. Number of adults 18 years or older in your jurisdiction at the time of query (2017 Census

data)

--

34. BRFSS influenza coverage percentage for adults 18 years or older (2017 BRFSS data) --
35. How many adults aged 18 years or older (born on or before December 31, 1999) that are

both in your jurisdiction at the time of query AND in your IIS have at least one dose of adult

influenza vaccine administered during the 2017 half flu vaccination season (July 1, 2017 –

December 31, 2017) at the age of 18 or older?

a. Coverage — Percentage of adults aged 18 years or older that have at least one dose

of adult influenza administered during the 2017 half flu vaccination season (July 1,

2017 – December 31, 2017) (Q.35/Q.33)

(Q.35/Q.33)

(Auotcalculated)

b. BRFSS–IIS Point Estimate Difference (2017 data) – BRFSS influenza coverage

percentage minus IIS influenza coverage percentage (Q.34 – Q.35)

Q.34 – Q.35

(Autocalculated)
Data Elements — Vaccination Records

Logic Guidance: Data Elements — Vaccination Records

• These questions pertain to all vaccinations administered from January 1, 2017 through December 31, 2017, for:

Children aged 0 through 6 years, born from January 1, 2011 through December 31, 2017

Individuals aged 0 years through 18 years born from January 1, 1999 through December 31, 2017

All individuals (lifespan) aged 0 and above, born on or before December 31, 2017

• Please fill in the following on each data element field included in your IIS database.

• In this section:

Use the table below to identify individuals to include in the assessment:

Vaccination records for individuals who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of time

o Note that the “extended period of time” could be defined differently by

each IIS

X 

Deceased

• Deceased at the time of query X 

After identifying individuals in the table above, use this table to determine the appropriate vaccination records to 

include in the assessment:

General vaccination record inclusions/exclusions Include Exclude

H1N1 vaccines administered and demographic records belonging to those with only an 

H1N1 vaccination record

X 

Travel vaccines (yellow fever, typhoid, etc.) See: 

https://wwwnc.cdc.gov/travel/page/yellowbookhome home

X 

Historical vaccinations X

Non-vaccine products (e.g. immune globulins, PPD) X

36. What is the number of vaccination records in the IIS for vaccines administered in CY2017 to children born from

January 1, 2011 through December 31, 2017? _________________________

37. What is the number of vaccination records in the IIS for vaccines administered in CY2017 to individuals born from

January 1, 1999 through December 31, 2017? _________________________

38. What is the number of vaccination records in the IIS for vaccines administered in CY2017 to individuals born on or

before December 31, 2017? _________________________

o

o

o
Vaccination data elements

Vaccines administered in 2017 

to children aged 0–6 years 

with field populated with data

Vaccines administered in 

2017 to individuals aged 0–

18 years with field populated 

with data

Vaccines administered in 

2017 to all individuals 

(lifespan) with field 

populated with data

39. Vaccine Product Type Administered 

Logic guidance: Vaccine Type can refer to 

CVX, CPT, or NDC. If a record is populated 

with an acceptable value for any of these 

product type codes, consider the field 

populated.

a. #

b. % (Autocalculated w/Q.36)

c. #

d. % (Autocalculated w/ Q.37)

e. #

f. % (Autocalculated w/ Q.38)

40. Vaccination Administration Date 

Logic guidance: if the value for administration 

date is in the future or not a real date, 

consider the field not populated.

a. #

b. % (Autocalculated w/Q.36)

c. #

d. % (Autocalculated w/ Q.37)

e. #

f. % (Autocalculated w/ Q.38)

41. Vaccine Manufacturer Name 

Logic guidance: if the value for manufacturer

is “unknown,” consider the field not 

populated. 

a. #

b. % (Autocalculated w/Q.36)

c. #

d. % (Autocalculated w/ Q.37)

e. #

f. % (Autocalculated w/ Q.38)

42. Vaccine Lot Number

Logic guidance: if the value is unacceptable 

for your IIS (e.g. vaccine type, “N/A”, 

“Missing”), consider the field not populated.

a. #

b. % (Autocalculated w/Q.36)

c. #

d. % (Autocalculated w/ Q.37)

e. #

f. % (Autocalculated w/ Q.38)
Vaccination data element for VFC/awardee program vaccine eligibility at the dose level

Logic Guidance: Vaccination data element for VFC/awardee program vaccine eligibility at the dose level

• If VFC/awardee program vaccine eligibility is stored in the IIS at the dose level (i.e. a VFC/awardee program vaccine

eligibility status is assigned to and stored for every administered dose recorded in the IIS), answer ‘field present’

and complete questions b and c. This is true if the eligibility status is collected and stored by the IIS for each

uniquely administered dose, or if eligibility is collected at the vaccination event/visit level (i.e. for all vaccinations

administered during a single vaccination event) and is translated by the IIS to the dose level (e.g. the eligibility

status for the event is recorded as VFC-Medicaid and the IIS assigns this status to a vaccination record indicating

DTaP administered during the visit but not to a vaccination record indicating yellow fever vaccine administered

during the same visit). If VFC / awardee program eligibility is stored in the IIS at the vaccination event/visit level

and not translated by the IIS to each unique administered dose, answer ‘no field’ present.

• For this question only, please limit to doses administered from January 1 through December 31, 2017 to 0–18 year

olds (date of birth January 1, 1999 through December 31, 2017) as only this age group is eligible for VFC.

o Note: If your registry is not authorized to serve individuals of this entire age range, respond to the question

with individuals your registry is authorized to serve.

• A provider is counted as VFC provider if enrolled as such during the entire calendar year

• In this section:

Use the table below to identify individuals to include in the assessment:

Vaccination records for individuals who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of time

o Note that the “extended period of time” could be defined differently by

each IIS

X 

Deceased

• Deceased at the time of query X 

After identifying individuals in the table above, use this table to determine the appropriate vaccination records to 

include in the assessment:

General vaccination record inclusions/exclusions Include Exclude

H1N1 vaccines administered and demographic records belonging to those with only an 

H1N1 vaccination record X 

Travel vaccines (yellow fever, typhoid, etc.) See: 

https://wwwnc.cdc.gov/travel/page/yellowbookhome

X 

Historical vaccinations X

Non-vaccine products (e.g. immune globulins, PPD) X
Vaccination data element Field status 

(check one) VFC providers only

43. VFC/Awardee Program Vaccine 

Eligibility at Dose Level

Examples: 

• Not VFC eligible

• VFC eligible — Medicaid

• VFC eligible — Uninsured

• VFC eligible — American 

Indian/Alaskan Native

• VFC eligible — Underinsured 

(FQHC/RHC/Provider with delegated 

authority)

• Eligible for a non-VFC funding source 

(e.g., state or locally defined)

a.  Field 

present 

 No field

b. # numerator (number of vaccination records 

with vaccine date of administration from 

January 1 through December 31, 2017, 

administered to persons aged 0 through 18 

years (DOB January 1, 1999 through December 

31, 2017), by VFC providers only with this field 

populated with data) 

c. # denominator (number of vaccination 

records administered to persons aged 0 through 

18 years (DOB January 1, 1999 through 

December, 31, 2017) by VFC providers only in 

the IIS in 2017) 

d. Autocalculated percent 

vaccination records with 

vaccine date of administration 

from January 1 through 

December 31, 2017 

administered to persons aged 0 

through 18 years with field 

populated with data (Q.43b/c)
Data Elements - Patient Records

Logic Guidance: Data Elements – Patient Records

• For children with date of birth from January 1 through December 31, 2017

• Please fill in the following on each data element field included in your IIS database.

• In this section:

Use the table below to identify newborns to include in the assessment:

Newborns who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider 

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of time

o Note that the “extended period of time” could be defined differently by each 

IIS

X 

Deceased

• Deceased at the time of query X 

Patient-level data elements Field Status (check one)

Number of child records with date 

of birth from January 1 through 

December 31, 2017, with field 

populated with data

Percentage of child records with date 

of birth from January 1 through 

December 31, 2017 with field 

populated with data. Denominator 

derived from Q.10+Q.11 (autocalculated)

44. Patient Name

Logic guidance: if the value is

unacceptable for your IIS

(e.g. “Baby Boy”), consider

the field not populated.

a. First Name 

 Field present

 No field

b. Last Name 

 Field present

 No field

c. #

d. #

e. Q.44/(Q.10+Q.11)

f. –

45. Patient Date of Birth

Logic guidance: if the value

for birthdate is in the future 

or not a real date, consider 

the field not populated.

a.  Field present

 No field b. # c. --

46. Patient Gender

Logic guidance: if the value

for gender is “unknown,” 

consider the field not

populated. If the value is

“other”, consider the field to

be populated.

a.  Field present

  No field b. # c. --
TIONAL STANDARD 8: The IIS exchanges data with health information systems in accordance with current 

interoperability standards endorsed by CDC for message content, format, and transport.

47. Address (Street, City, 

State, ZIP code) 

Logic guidance: if there is 

more than one address listed 

per child, only include one per 

child record, such as the most 

recent. 

Consider Street to be 

populated if the field is 

populated with the patient’s 

P.O. Box number. 

a. Street:

 Field present

 No field

b. City:

 Field present

 No field

c. State:

 Field present

 No field

d. ZIP code: 

 Field present

 No field

e. # Street

f. # City

g. # State

h. # ZIP code

i. – 

j. – 

k. – 

l. – 

48. Mother’s Name

Logic guidance: If Mother’s 

Name can be determined 

from Responsible Person 

Name elements, do so and 

consider it having Mother’s 

First and/or Last Name field/s 

present. Count any 

Responsible Person Name 

information for mothers 

toward Mother’s Name fields. 

a. First Name

 Field present or derived

 No field

b. Last Name

 Field present or derived

 No field

c. # Mother’s First Name 

d. # Mother’s Last Name

e. – 

f. – 

49. Patient Telephone 

Number 

Logic guidance: refers to the 

telephone number of either 

the patient or the 

parent/responsible person

a.  Field present  No field b. # c.--

50. In 2017, my IIS stored or derived all CDC-endorsed data elements. Yes/No

Notes for Functional Standard 1 Please provide any relevant notes or comments for data provided for 

Functional Standard 1.
FUNCTIONAL STANDARD 8: The IIS exchanges data with health information systems in accordance with 

current interoperability standards endorsed by CDC for message content, format, and transport.

8.1 The IIS supports the Simple Object Access Protocol (SOAP) standard Interface, Web Services 

Definition Language (WSDL), or other transport solutions as endorsed by CDC. 

8.2 The IIS receives submissions and returns acknowledgements consistent with the current CDCendorsed HL7 Implementation Guide.

8.3 The IIS receives queries from, and sends responses to, health information systems consistent with 

the current CDC-endorsed HL7 Implementation Guide.

Logic Guidance 

Q.52–54:

• In order for testing to be considered independent, it must be conducted by an external entity (e.g., the American 

Immunization Registry Association) OR, the testing must be conducted through testing tools developed by the 

National Institute of Standards and Technology.

Q.53 and Q.54: 

• “Conformance” indicates that the IIS passed all tests and met all standards, except where any deviation is as a 

result of documented state or local policy. Any deviations as a result of other factors does not meet the definition 

of conformance.

51. In 2017, did your IIS support the SOAP Standard Interface 1.2 specification, Web Services Definition Language 

(WSDL) in production, as endorsed by CDC? Yes/No

52. If yes to Q.51, was your IIS’s message transport functionality independently tested? Yes/No

53. If yes to Q.52, did your IIS pass tests demonstrating conformance in the following areas (select all that apply): 

a. Connectivity Yes/No

b. Submit Single Message Yes/No

c. Security Fault Yes/No

54.

HL7 v2.5.1 Release 1.5 Standard Messages

Message Type 

Received

The IIS received and 

processed the 

following message 

types (in production) 

during 2017

The ability to 

receive this message 

type has been 

independently 

tested

The IIS has been independently determined to be able 

to receive the following message types that conform 

to the HL7 v2.5.1 release 1.5 standard. Any observed 

deviation from the national standard is a necessary 

result of documented state or local policy

QBP a.  Yes  No b.  Yes  No c.  Yes  No

VXU d.  Yes  No e.  Yes  No f.  Yes  No

Message Type 

Sent

The IIS sent the 

following message 

types (in production) 

during 2017

The ability to send 

this message type 

has been 

independently 

tested

The IIS has been independently determined to be able 

to send the following message types that conform to 

the HL7 v2.5.1 release 1.5 standard. Any observed 

deviation from the national standard is a necessary 

result of documented state or local policy
ACK g.  Yes  No h.  Yes  No i.  Yes  No

RSP j.  Yes  No k.  Yes  No l.  Yes  No

Notes for Functional Standard 8 Please provide any relevant notes or comments for data provided 

for Functional Standard 8.
FUNCTIONAL STANDARD 9: The IIS ensures and promotes user access to immunization records for clinical 

decision-making.

9.1 The IIS has policies and procedures for recruiting and enrolling immunization providers in the IIS.

9.2 The IIS actively engages immunization providers to recruit and enroll them in the IIS.

9.3 The IIS ensures enrolled immunization providers have access to a patient’s immunization record in 

the IIS at the time immunization services are delivered.

Provider Site Participation 

Logic Guidance 

• Provider Site: A provider organization that provides vaccination services and that maintains permanent records 

(excluding temporary or mobile immunization clinics, health fairs, etc.). 

• All provider sites enrolled in VFC as of December 31, 2017 should be counted as a VFC site.

• In this section:

Use the table below to identify provider sites to include in the assessment:

General provider site inclusions/exclusions Include Exclude

All provider sites enrolled in your IIS, regardless of age group served by those sites or your 

IIS

X

All provider sites enrolled in the IIS as of December 31, 2017 X

Provider sites that only enrolled to provide emergency vaccines such as during pandemic 

response scenarios.

Example: Exclude a community center that only enrolled due to the 2010 H1N1 influenza 

pandemic and does not provide other immunizations. However, include a pediatrician that 

enrolled due to the 2010 H1N1 influenza pandemic if they also continue to provide routine 

immunizations.

X

Provider Sites

VFC Sites Non-VFC Sites

55. Number of provider sites in your jurisdiction as of December 31, 2017 a. --

56. Number of provider sites in your jurisdiction enrolled in your IIS as of 

December 31, 2017

a. b.

57. Number of enrolled provider sites reporting data to your IIS at least once 

from July 1, 2017 – December 31, 2017

a. b.

c. Percentage of VFC provider sites that reported data to your IIS at least 

once from July 1, 2017 – December 31, 2017 (auto-calculated) Q.57a/Q.55a 

d. Percentage of all VFC provider sites and enrolled non-VFC provider sites 

who reported data to your IIS at least once from July 1, 2017 – December 

31, 2017 (auto-calculated) 

(Q.57a + Q.57b)/(Q.55a + Q.56b)

Notes for Functional Standard 9 Please provide any relevant notes or comments for data provided for 

Functional Standard 9.

FUNCTIONAL STANDARD 10: The IIS forecasts pediatric, adolescent, and adult immunizations in a manner 

consistent with Advisory Committee on Immunization Practices (ACIP) recommendations.

10.1 The IIS uses Clinical Decision Support (CDS) functionality that can be updated to reflect new or 

revised ACIP recommendations. 

10.2 The IIS displays and sends an evaluated immunization history that adheres to ACIP 

recommendations for each vaccination event.

10.3 The IIS displays and sends a forecast that adheres to ACIP recommendations, with status indicators 

for each vaccine and vaccine family.

10.4 The IIS CDS functionality is updated for the IIS in a timely fashion after new ACIP recommendations 

are incorporated into the CDC Clinical Decision Support for immunization (CDSi) resources published 

on the CDC website.

Logic Guidance

• Answer “yes” for the questions below only if all of the CDC-published CDSi test cases in each category were run and 

the IIS produced the result specified for each test case (except for cases where results intentionally differed from 

the test cases due to policies described in the questions below).

58. In 2017, my IIS used CDC-endorsed methods to ensure that evaluations and forecasts produced by my IIS were 

consistent with ACIP age-based vaccination recommendations (excluding risk factors, contraindications, and 

immunities); any deviations from ACIP recommendations exist because of documented state and local policy, for the 

following age groups:

a. 0–6 years Yes/No

b. 0–18 years Yes/No

c. All ages (lifespan) Yes/No

59. In 2017, my IIS used CDC-endorsed methods to ensure that evaluations and forecasts produced by my IIS were 

consistent with ACIP vaccination recommendations, including risk factors, contraindications, and immunities; any 

deviations from ACIP recommendations exist because of documented state and local policy, for all ages (lifespan)

including: 

a. Risk factors Yes/No

b. Contraindications Yes/No

c. Immunities Yes/No

60. CDC released CDSi version 3.5 on August 25, 2017, which included updates for the 2017–18 influenza seasonal 

recommendations. How long did it take for your IIS to implement all of the influenza guidance for evaluation and 

forecasting into production?

a. 30 days or less

b. 31–60 days

c. Greater than 60 days
d. The IIS has not been updated with the CDSi functionality to reflect the September 2, 2016 (Version 3.1) CDSi

recommendations for influenza.

Notes for Functional Standard 10 Please provide any relevant notes or comments for data provided for 

Functional Standard 10.
FUNCTIONAL STANDARD 11: The IIS manages patient status at the provider organization and jurisdiction 

levels.

11.1 The IIS maintains patient “active” or “inactive” status (PAIS) at the provider site level. 

11.2 The IIS assigns patient PAIS to an individual at one or more jurisdictional levels.

11.3 The IIS user can update PAIS through the user interface or via HL7 message. 

11.4 The IIS user can generate a roster of active patients from the IIS for a provider site.

11.5 The IIS assigns PAIS to a patient for a provider site based on information in the IIS. 

Data Elements – Patient Status Indicators

Logic Guidance: Data Elements – Patient Status Indicators

• For individuals age 0–18 years with date of birth from January 1, 1999 through December 31, 2017 

o Note: If your registry is not authorized to serve individuals of this entire age range, respond to the question 

with individuals your registry is authorized to serve.

• In this section:

Use the table below to identify individuals to include in the assessment:

Individuals who are considered... Include Exclude

Active

• Residence in jurisdiction is confirmed or received an immunization from a provider 

organization within the jurisdiction and address is unknown

X 

Inactive, outside jurisdiction

• Does not reside in the jurisdiction X 

Unknown, no address – no vaccination

• Address in unknown and IIS has never received vaccination information X 

Unknown, no activity for extended period of time

• Has not received demographic and/or immunization for an extended period of 

time

o Note that the “extended period of time” could be defined differently by 

each IIS

X 

Deceased

• Deceased at the time of query X 

After identifying individuals in the table above, use this table to further identify newborns to include in the 

assessment: 

General demographic inclusions/exclusions Include Exclude

Demographic records belonging to those with only an H1N1 vaccination record X

Patient-level data elements Field Status (check one)

Number of patient records with 

date of birth from January 1, 1999 

through December 31, 2017, with 

field populated with data 

Percentage of patient records 

with date of birth from January 

1, 1999 through December 31, 

2017 with field populated with 

data. Denominator from Q.15 

(auto-calculated)
61. Patient status indicators

at the provider site 

level: 

Definition: A field to denote 

the status of a patient. 

Examples: 

• Active

• Inactive – No longer a 

patient

• Inactive – Lost to followup

• Inactive – Unspecified

• Deceased

NOTE: If the patient has 

more than one patient status 

indicator in your IIS (e.g. for 

multiple provider sites), 

include the patient in the 

numerator if they have at 

least one active or inactive 

status indicated in their 

record.

a.  Field present 

 No field b. # c. Q.61b/(Q.15) 

62. In 2017, did the IIS automatically assign PAIS to an individual at one or more jurisdictional levels based on the 

address of residence in the IIS? Yes/No

63. In 2017, did the IIS set the status of an individual to permanently inactive/deceased based on any information 

submitted to the IIS? Yes/No

64. In 2017, by which mechanism(s) could an IIS user update PAIS? Check all that apply: 

a. Direct user interface

b. HL7 message

65. In 2017, did the IIS generate a roster of active patients for a provider site from the IIS? Yes/No

66. In 2017, did the IIS automatically assign PAIS to a patient for one or more provider levels based on information in the 

IIS (e.g., based on which provider administered the most recent vaccinations)? Yes/No

Notes for Functional Standard 11 Please provide any relevant notes or comments for data provided for 

Functional Standard 11.
FUNCTIONAL STANDARD 12: The IIS supports vaccine product recall activities.

12.1 The IIS creates a list of patients who received recalled vaccine. 

12.2 The IIS creates a list of provider sites that received recalled vaccine.

12.3 The IIS user can generate a list of patients or provider sites that received recalled vaccine.

67. In 2017, could the IIS create a line list report of patients who received recalled vaccine based on query parameters 

(e.g. vaccination date, lot number, provider site, etc.)? Yes/No

68. In 2017, could the IIS create a line list report of provider sites that received recalled vaccine based on query 

parameters (e.g. shipment date, lot number, etc.)? Yes/No

69. In 2017, could the IIS user create a line list report of patients or provider sites that received recalled vaccine based 

on query parameters? Yes/No

Notes for Functional Standard 12 Please provide any relevant notes or comments for data provided for 

Functional Standard 12.
FUNCTIONAL STANDARD 13: The IIS supports reporting and investigation of vaccine adverse events.

13.1 The IIS has policies and procedures in place that support vaccine adverse event investigation. 

13.2 The IIS provides IIS-related training, access, and support to adverse event investigators.

13.3 The IIS refers IIS users to appropriate resources for VAERS support.

Logic Guidance

• “Not Applicable” refers to instances in which no investigations occurred during 2017. 

70. In 2017, did vaccine adverse event investigators in your jurisdiction routinely use IIS data? Yes/No/Not Applicable

71. In 2017, did you have a link to the Vaccine Adverse Event Reporting System (VAERS) form in your IIS for users to 

access? Yes / No

Notes for Functional Standard 13 Please provide any relevant notes or comments for data provided 

for Functional Standard 13.
FUNCTIONAL STANDARD 14: The IIS supports public health response during disease outbreaks.

14.1 The IIS has policies and procedures in place that support vaccine-preventable disease investigation 

and control. 

14.2 The IIS provides training, access, and support for disease investigators.

14.3 The IIS provides access to IIS data to support vaccine-preventable disease investigation and control.

14.4 The IIS provides access to IIS data to support perinatal hepatitis B prevention efforts.

72. In 2017, did the IIS have the capability to create vaccination coverage and line list reports based on user-defined 

query parameters (e.g. a patient age group/DOB range, list of specific individuals, geographic area, recipients of 

specific vaccines, etc.) to support vaccine preventable disease investigation and control? Yes/No

Logic Guidance

• “Not Applicable” refers to instances in which no investigations occurred during 2017. 

73. In 2017, did disease investigators in your jurisdiction routinely use IIS data? Yes/No/Not Applicable

74. In 2017, did Perinatal HepB investigators in your jurisdiction routinely use IIS data? Yes/No/Not Applicable

Notes for Functional Standard 14 Please provide any relevant notes or comments for data provided 

for Functional Standard 14.
FUNCTIONAL STANDARD 15: The IIS supports immunization-related efforts in school settings.

15.1 The IIS has policies and procedures in place that support school staff access and use of IIS data to 

assess student compliance with school immunization requirements.

15.2 The IIS has policies and procedures in place that support the use of IIS data for state and local school 

reporting requirements. 

15.3 The IIS has policies and procedures in place that support the use of IIS data for identifying schoolaged students who are at risk during vaccine-preventable disease outbreaks.

15.4 The IIS actively engages with stakeholders to support immunization-related efforts in school settings.

Logic Guidance

• Include public schools that are subject to school entry requirements by age or grade in your jurisdiction. 

• Use kindergarten entry requirements, requirements for 6 year old children, etc. when defining elementary schools. 

• Use 6th grade entry requirements, requirements for 12 year olds, etc. when defining middle schools. 

• If a school serves age ranges encompassing both elementary and middle schools, it is acceptable to count the 

school twice for the public elementary school count and the public middle school count.

o Example: A school serves kindergarten-age children through 13 year old children. This school would be 

included in counts for public elementary schools and public middle schools.

75. Select all methods by which your IIS supported immunization-related efforts in elementary or middle school settings

during 2017: 

a. By providing online access to school staff Yes/No

b. By sending individual immunization records to schools upon request Yes/No

c. By having an electronic connection to the school system Yes/No

d. By generating compliance reports by school Yes/No

e. By supporting schools in identifying school-age students at risk during vaccine-preventable disease

outbreaks Yes/No

f. Other (specify) _____________

76. Can your IIS calculate the percentage of public elementary schools in your jurisdiction that used the IIS as the 

primary source of immunization data to support immunization-related business requirements (e.g. assess student 

compliance with school immunization requirements, support state and local school reporting requirements, identify 

school-aged students who are at risk during vaccine-preventable disease outbreaks)? Yes/No 

77. In 2017, how many public elementary schools were in your jurisdiction? ______________

78. In 2017, how many public elementary schools use the IIS as the primary source of immunization data to support 

immunization-related business requirements (e.g. assess student compliance with school immunization 
requirements, support state and local school reporting requirements, identify school-aged students who are at risk 

during vaccine-preventable disease outbreaks)? ______________

a. Percentage of public elementary schools in your jurisdiction that used IIS data (Q.78/Q.77)

79. Can your IIS calculate the percentage of public middle schools in your jurisdiction that used the IIS as the primary 

source of immunization data to support immunization-related business requirements (e.g. assess student 

compliance with school immunization requirements, support state and local school reporting requirements, identify 

school-aged students who are at risk during vaccine-preventable disease outbreaks)? Yes/No

80. In 2017, how many public middle schools were in your jurisdiction? ______________

81. In 2017, how many public middle schools in your jurisdiction that used the IIS as the primary source of immunization 

data to support immunization-related business requirements (e.g. assess student compliance with school 

immunization requirements, support state and local school reporting requirements, identify school-aged students 

who are at risk during vaccine-preventable disease outbreaks)? ______________

a. Percentage of public middle schools in your jurisdiction that used IIS data (Q.81/Q.80) 

Notes for Functional Standard 15 Please provide any relevant notes or comments for data provided for 

Functional Standard 15.
FUNCTIONAL STANDARD 16: The IIS supports immunization-related efforts in childcare settings. 

16.1 The IIS has policies and procedures in place that support childcare staff access and use of IIS data to 

assess student compliance with childcare immunization requirements.

16.2 The IIS has policies and procedures in place that support the use of IIS data for state and local 

childcare reporting requirements. 

16.3 The IIS has policies and procedures in place that support the use of IIS data for identifying children in 

childcare who are at risk during vaccine-preventable disease outbreaks.

16.4 The IIS actively engages with stakeholders to support immunization-related efforts in childcare 

settings.

82. Select all methods by which your IIS supported immunization-related efforts in childcare settings during 2017:

a. By providing online access to childcare staff Yes/No

b. By sending individual immunization records to childcare settings upon request Yes/No

c. By having an electronic connection to the childcare system Yes/No

d. By generating compliance reports by childcare setting Yes/No

e. By supporting childcare settings in identifying children at risk during vaccine-preventable disease outbreaks

Yes/No

f. Other (specify) _____________

83. Can your IIS calculate the percentage of state-licensed childcare settings in your jurisdiction that used the IIS as the 

primary source of immunization data to support immunization-related business requirements (e.g., assess student 

compliance with childcare immunization requirements, support state and local childcare reporting requirements, 

identify children in childcare who are at risk during vaccine-preventable disease outbreaks)? Yes/No

84. In 2017, how many state-licensed childcare settings were in your jurisdiction? ______________

85. In 2017, how many state-licensed childcare settings in your jurisdiction used the IIS as the primary source of 

immunization data to support immunization-related business requirements (e.g., assess student compliance with 

childcare immunization requirements, support state and local childcare reporting requirements, identify children in 

childcare who are at risk during vaccine-preventable disease outbreaks)? ______________

a. Estimated percentage of state-licensed childcare settings in your jurisdiction that used data (Q.85/Q.84)

Notes for Functional Standard 16 Please provide any relevant notes or comments for data provided for 

Functional Standard 16.
FUNCTIONAL STANDARD 18: The IIS provides predefined and ad hoc assessment and coverage reports that 

users can generate without assistance from the IIS.

18.1 The IIS produces Assessment, Feedback, Incentive, and eXchange (AFIX) assessments that adhere to 

published CDC AFIX operational and technical guidelines. 

18.2 The IIS assists with identification of under-immunized populations. 

18.3 The IIS enables immunization stakeholders to generate vaccination coverage assessments for 

populations they serve (e.g., schools, health plans, health departments).

86. In 2017, did at least one Assessment Feedback Incentive and eXchange (AFIX) visit conducted in the past calendar 

year use IIS-generated assessments that adhere to published CDC AFIX-IIS assessment requirements? Yes/No

87. In 2017, did the IIS generate vaccination coverage assessments for geographic sub-jurisdiction-level areas (e.g. 

county, ZIP code, region, etc.) to identify under-immunized populations? Yes/No

Logic Guidance

• If the report can only be generated by looking up each patient record individually, select “No” for Q.88.

88. In 2017, did the IIS have the capability to create vaccination coverage assessments and line list reports based on 

user-defined query parameters (e.g. a patient age group/DOB range, geographic area, recipients of specific vaccines, 

etc.) for a sub-population defined by the immunization stakeholder (i.e. a list of specific individuals)? Yes/No

Notes for Functional Standard 18 Please provide any relevant notes or comments for data provided for 

Functional Standard 18.
FUNCTIONAL STANDARD 19: The IIS supports reminder and recall activities. 

19.1 The IIS supports the maintenance of complete and accurate contact information for individuals with 

records in the IIS.

19.2 The IIS identifies individuals in the IIS who have not received one or more age-appropriate 

vaccinations or vaccination series.

19.3 The IIS generates reminder and recall data by age, vaccine, vaccine series, reference date, IIS-defined 

geographic area, and provider site.

19.4 The IIS generates or supports more than one method of reminder and recall notification from the IIS 

or from third-party systems.

19.5 The IIS excludes individuals from reminder and recall outputs upon request.

89. In 2017, were external sources (e.g., SmartyStreets, GIS) of address data used to verify/correct the formatting of 

addresses in your IIS (e.g., changing “ROAD” to “Rd”)? Yes/No

90. In 2017, were external sources (e.g., U.S. Postal Service, Lexis-Nexis) of residential addresses used to verify whether 

patients currently reside at the addresses listed in their IIS record, or to update the record to reflect the current 

address? Yes/No

Logic Guidance

Q.92:

• Answer “yes” if IIS data were used to support reminder and/or recall messages regardless if messages were 

generated by third-party systems or the IIS itself.

• If age-based reminder and/or recall messages were generated for any individuals within a listed age range, answer 

“yes” for that age range, even if the entire age range was not included.

91. At least once in 2017, did any provider or the immunization program use the IIS to generate age-based reminder 

and/or recall messages for any individuals who were not up-to-date for their vaccinations? Yes/No

92. If yes to Q.91, which of the following age groups did providers or the immunization program use the IIS to generate 

age-based reminder and/or recall messages for?

a. 0–6 years 

 

 

Yes/No

b. 7–18 years Yes/No

c. ≥19 years Yes/No

d. My IIS was used to generate reminder/recall messages, but cannot determine the age of the individuals 

 Yes/No

93. In 2017, did your IIS exclude individuals from reminder and recall outputs upon request by a parent, guardian, or 

individual? Yes/No
Notes for Functional Standard 19 Please provide any relevant notes or comments for data provided for 

Functional Standard 19.
FUNCTIONAL STANDARD 20: The IIS provides immunization records to individuals with appropriate 

authentication. 

20.1 The IIS has policies and procedures in place and facilitates access to official immunization records for 

individuals, parents, or custodial guardians.

Logic Guidance:

• An “official immunization record” refers to an immunization record that is acceptable for business functions 

including school entry and travel.

94. In 2017, could individuals, parents, and custodial guardians obtain an official immunization record from the IIS... 

(select all that apply)

a. Through their healthcare provider? Yes/No

b. Through a provider-managed patient portal that interfaces with the IIS? Yes/No

c. Directly from the IIS through a consumer access portal? Yes/No

d. Directly from the IIS or Immunization Program without a consumer access portal (e.g. fax, mail, walk-in 

paper record, etc.)? Yes/No

Notes for Functional Standard 20 Please provide any relevant notes or comments for data provided for 

Functional Standard 20.
FUNCTIONAL STANDARD 22: The IIS reliably exchanges information electronically with IISs in other 

jurisdictions consistent with the current CDC-endorsed HL7 Implementation Guide.

22.1 The IIS has memoranda of understanding, interagency agreements, or other documented 

authorization to request and receive immunization information from other IISs.

22.2 The IIS can query another IIS for an immunization history.

22.3 The IIS sends patient demographic and vaccination records to IISs in other jurisdictions for patients 

who reside in those jurisdictions.

95. In 2017, did your IIS send at least one QBP message in production to another jurisdiction's IIS, consistent with the 

CDC-endorsed HL7 Implementation Guide v. 2.5.1? Yes/No

96. In 2017, if your IIS sent patient demographic and vaccination records to IIS in other jurisdictions, list all of these 

jurisdictions: [Free text box, open ended no text limit]

97. In 2017, if your IIS received patient demographic and vaccination records from IIS in other jurisdictions, list all of 

these jurisdictions: [Free text box, open ended no text limit]

Notes for Functional Standard 22 Please provide any relevant notes or comments for data provided 

for Functional Standard 22.
FUNCTIONAL STANDARD 23: The IIS supports vaccine management and quality assurance functions for VFC 

and state and local vaccine programs.

23.1 The IIS captures provider site Master Data in accordance with VTrckS data exchange specifications. 

23.2 The IIS maintains a list of vaccines available for ordering consistent with the most current Federal 

Vaccines List.

23.3 The IIS supports vaccine ordering for provider sites enrolled in VFC and state and local vaccine 

programs.

23.4 The IIS provides the status of vaccine orders placed in the IIS to provider sites.

23.5 The IIS supports provider site enrollment in VFC and state and local vaccine programs.

23.6 The IIS supports the collection of the Provider Profile data for provider sites enrolled in VFC and state 

and local vaccine programs.

23.7 The IIS supports the tracking of VFC eligibility at the dose level for every administered dose of 

publicly purchased vaccine ordered, administered, and reported to the IIS.

98. In 2017, did the IIS capture provider site Master Data in accordance with VTrckS data exchange specifications?

Yes/No

99. In 2017, did the IIS maintain a list of vaccines available for ordering consistent with the most current federal vaccines 

list? Yes/No

100. In 2017, did the IIS support vaccine ordering for provider sites enrolled in VFC and state and local vaccine 

programs? Yes/No

101. In 2017, did the IIS provide the status of vaccine orders placed in the IIS to provider sites? Yes/No

102. In 2017, did the IIS support provider site enrollment in VFC and state and local vaccine programs? Yes/No

103. In 2017, did the IIS support the collection of the provider profile data for provider sites enrolled in VFC and state 

and local programs? Yes/No

Notes for Functional Standard 23 Please provide any relevant notes or comments for data provided for 

Functional Standard 23.
FUNCTIONAL STANDARD 24: The IIS supports data exchange with the national Vaccine Tracking System 

(VTrckS).

24.1 The IIS exports provider Master Data, inventory data, and order data to VTrckS.

24.2 The IIS imports provider site shipment data from VTrckS. 

24.3 The IIS inventory is populated automatically through receipt of vaccine shipment data from VTrckS 

or by provider site acknowledgement of receipt.

24.4 The IIS exports vaccine return and wastage data to VTrckS.

104. In 2017, did the IIS import provider site shipping data from VTrckS? Yes/No

105. In 2017, was the IIS inventory populated automatically through receipt of vaccine shipment data from VTrckS or by 

provider site acknowledgement of receipt? Yes/No

106. In 2017, did the IIS export vaccine return and wastage data to VTrckS? Yes/No

Notes for Functional Standard 24 Please provide any relevant notes or comments for data provided for 

Functional Standard 24.
FUNCTIONAL STANDARD 25: The IIS supports provider site level vaccine inventory management and 

reconciliation according to VFC and state and local immunization program requirements.

25.1 The IIS provides access to the IIS vaccine inventory functionality for all provider sites that receive 

publicly purchased vaccine.

25.2 The IIS organizes and indicates vaccine inventory by any combination of NDC, lot number, expiration 

date, and public private indicator for vaccine inventory managed in the IIS. 

25.3 The IIS allows provider sites to record information about inventory they receive (e.g., vaccine orders 

or incoming transfers).

25.4 The IIS automatically decrements administered doses (not historical doses) from active inventory.

25.5 The IIS supports the reconciliation of expected inventory in the IIS with the provider site’s actual 

physical inventory. 

25.6 The IIS documents reductions in vaccine inventory (e.g., outgoing vaccine transfers, returns, 

wastage, and other). 

25.7 The IIS supports the printing of packing slips for vaccines being returned to the distributor.

25.8 The IIS supports the management of provider site inventory by fund type.

107. In 2017, did the IIS organize and indicate vaccine inventory by any combination of NDC, lot number, expiration date 

and public private indicator for vaccine inventory managed in the IIS? Yes/No

108. In 2017, did the IIS allow provider sites to record information about inventory they receive (e.g., vaccine orders or 

incoming transfers)? Yes/No

109. In 2017, did the IIS automatically decrement administered doses (and not historical doses) from the current 

inventory? Yes/No

110. In 2017, for each provider site, did the IIS: (Select all that apply)

a. Display the expected inventory for the reconciliation period (i.e. since the last reconciliation)? Yes/No

b. Require providers to report actual physical inventory? Yes/No

c. Require documentation describing discrepancies between expected and actual inventory? Yes/No

111. In 2017, did the IIS document reductions in vaccine inventory (e.g., outgoing vaccine transfers, returns, wastage, 

and other)? Yes/No

112. In 2017, did the IIS support the printing of a packing slip for vaccines being returned to the distributor? Yes/No

113. In 2017, did the IIS allow the management of provider site inventory by fund type? Yes/No

Notes for Functional Standard 25 Please provide any relevant notes or comments for data provided for 

Functional Standard 25.
FUNCTIONAL STANDARD 26: The IIS provides data or produces reports for VFC and state and local 

immunization programs.

26.1 The IIS produces reports or data that estimate, by patient age, the number of doses of publicly 

purchased vaccine each provider site will administer during the upcoming year.

26.2 The IIS produces reports or data that estimate, by patient age, the aggregate number of publicly 

purchased vaccines all providers will administer during the upcoming year.

26.3 The IIS produces reports or data that detail publicly purchased vaccine doses administered by a 

provider site. 

26.4 The IIS produces reports or data that support vaccine inventory management and accountability for 

purposes other than ordering and reconciliation. 

26.5 The IIS produces accountability reports or data that support the vaccine ordering process.

114. In 2017, did the IIS produce reports or data that... (select all that apply) 

a. Estimate, by patient age, the number of doses of publicly purchased vaccine each provider site will 

administer during the upcoming year? Yes/No

b. Estimate, by patient age, the aggregate number of publicly purchased vaccines all providers will administer 

during the upcoming year? Yes/No

c. Detail publicly purchased vaccine doses administered by a provider site? Yes/No

d. Support vaccine inventory management and accountability for purposes other than ordering and 

reconciliation? Yes/No

115. In 2017, did the IIS produce accountability reports or data that support the vaccine ordering process? Yes/No

Notes for Functional Standard 26 Please provide any relevant notes or comments for data provided for 

Functional Standard 26.