National Center for Immunization and Respiratory Diseases (NCIRD) 

Immunization Information Systems (IIS) 

Strategic Plan

Executive Summary

Summary of IIS Strategic Plan v1.3 

finalized on November 30, 2013

Last Reviewed February 2016
Centers for Disease Control and Prevention 

National Center for Immunization and Respiratory Diseases

Table of Contents

1 Introduction....................................................................................................................... 3

1.1 Overview .................................................................................................................... 3

1.2 Strategic Plan Development Approach.................................................................... 3

2 Current State..................................................................................................................... 4

2.1 IIS Description and Accomplishments..................................................................... 4

2.2 Challenges ................................................................................................................. 4

3 Future State....................................................................................................................... 5

3.1 Vision ......................................................................................................................... 5

3.2 Goals .......................................................................................................................... 5

3.3 Strategic Initiatives.................................................................................................... 6

3.4 Next Steps and Further Information......................................................................... 6

List of Tables

Table 1: IIS Strategic Plan Focus Areas..................................................................................... 3

Table 2: Summary of IIS Challenges, by Strategic Plan Focus Area .......................................... 4

Table 3: NCIRD’s IIS Goals........................................................................................................ 5

Table 4: IIS Strategic Initiatives.................................................................................................. 6

IIS Strategic Plan v1.3 – Executive Summary 2 
Centers for Disease Control and Prevention 

National Center for Immunization and Respiratory Diseases

1 Introduction

1.1 Overview

In November 2013, the Centers for Disease Control and Prevention (CDC) National Center for 

Immunization and Respiratory Diseases (NCIRD) released its Immunization Information Systems 

(IIS) Strategic Plan to guide NCIRD’s future IIS-related investment decisions. NCIRD developed 

the IIS Strategic Plan with input from the IIS community and identified 18 initiatives in five key 

focus areas to help the IIS community to achieve the Plan’s goals. To assist with refining and 

prioritizing these initiatives—as well as keeping the Plan aligned with the evolving IIS 

environment—NCIRD created an intergovernmental IIS Executive Board. The Board reviewed the 

proposed IIS Strategic Plan and provided input to the final version. 

1.2 Strategic Plan Development Approach

NCIRD developed the IIS Strategic Plan with input from a broad cross-section of the IIS 

community, including: 

• 24 immunization community stakeholders, including IIS managers and representatives from 

CDC, other federal agencies, universities and NGOs focused on health IT, informatics and 

immunization information management,

• Subject matter experts (including a member of the Health IT Standards Committee and an 

expert on state-level SOA and HIE architecture),

• IIS stakeholders at the federal and state level during the NCIRD-sponsored Immunization 

Blue Ribbon Panel on May 16-17, 2013, and

• Other documentation and research to identify key challenges and trends. 

Based on its findings, NCIRD outlines five IIS Strategic Plan Focus Areas (see Table 1). 

Table 1: IIS Strategic Plan Focus Areas

Name Description

Nationwide 

Leadership

Vision, strategy, policy, standards, accountability, and shared services developed for sharing on a 

nationwide basis by NCIRD and the IIS community (including state and local immunization 

programs) working with HHS and other federal agencies, the Executive Office of the President 

and Congress.

Sustainability Long-term funding and resources to maintain immunization information management on a 

nationwide scale. 

Provider 

Services

Services for immunization providers in support of data exchange with IIS and clinical decision 

support at the point of care.

Public Health 

Services

Services for public health officials and organizations in support of immunization programs, 

informatics, surveillance and coverage.

Interoperability

/ Data 

Management

Data exchange across the information immunization management ecosystem, including data 

quality and technical and semantic interoperability services developed in collaboration with state 

and local partners.

The Plan organizes IIS-related accomplishments, challenges, goals, and strategic initiatives to 

these five Focus Areas. 

IIS Strategic Plan v1.3 – Executive Summary 3 
Centers for Disease Control and Prevention 

National Center for Immunization and Respiratory Diseases

2 Current State

2.1 IIS Description and Accomplishments 

As a repository, the IIS is a centralized system of record of immunizations for residents of the 

jurisdiction that it supports—storing data such as patient name, demographics, immunization 

administration date, dosage, type, etc. The purpose of the IIS is to consolidate immunization 

information from providers into one database to provide an accurate immunization assessment and 

eliminate the use of manual vaccine administration logs. The IIS can also be thought of as software 

that provides services to users related to the data in the database. An IIS transforms immunization 

data into usable information and is an integral part of the “immunization information supply chain.” 

Examples of services provided by many of today’s IIS include:

• Identifying populations at high risk for vaccine-preventable diseases to target interventions 

and resources efficiently,

• Combining immunization information from different sources into a single record,

• Providing official immunization records for school, day care, and camp entry requirements,

• Protecting the privacy of all users, including children, families, and providers,

• Reminding families when an immunization is due or has been missed,

• Helping providers and parents determine when immunizations are due to ensure children 

get only the vaccinations they need, and

• Exchanging immunization information with healthcare providers to ensure timely 

immunizations, consolidation of records, and efficient workflows. 

Immunization programs have become adept at locating multiple funding sources for IIS. This 

situation is both a challenge and an accomplishment. According to 2010 data, most of the IIS 

funding (55%) comes from CDC / NCIRD, some from the States (almost 18%), and the rest (27%) 

from multiple sources, including local, private, in-kind, CMS/MMIS, CMS/HITECH, HRSA, other 

federal programs, and emergency preparedness.

1

2.2 Challenges 

Table 2: Summary of IIS Challenges, by Strategic Plan Focus Area

Focus Area High-Level Challenges

• Policies and standards to support immunization management are not coordinated nationwide 

across all immunization stakeholders.

• There is no overriding nationwide consent policy for interstate data exchange.

• There is no nationwide policy for interstate data exchange.

Sustainability • There is no IIS line item in VFC or section 317 funding programs. State-level support of IIS is 

variable and although CDC-provided Prevention and Public Health Fund awards have 

helped, these funds are short in duration and cannot be used to support ongoing operations

to maintain the IIS technology and appropriately-skilled staff to support it. 

1 Source: Presentation by Dr. Chesley Richards, former Director, NCIRD Immunization Services Division at the 

Immunization Blue Ribbon Panel on May 16, 2013.

IIS Strategic Plan v1.3 – Executive Summary 4 

 

Nationwide

Leadership
Centers for Disease Control and Prevention 

National Center for Immunization and Respiratory Diseases

Focus Area High-Level Challenges

Provider 

Services

• Some IIS integration standards for providers and EHR-S vendors are applied in a variable 

way across jurisdictions due to local statutes and business rules.

• Immunization-centric data, functionality, usability and interoperability standards are applied in 

a variable way data collection at the point of care. 

Public Health 

Services

• Some sectors of the immunization information management community lack knowledge, skills 

and roles in the areas of informatics, epidemiology, economics, computer science, and IT. 

• Some IIS functions are redundant while others are variable across jurisdictions due to local 

statutes and business rules.

• Some IIS interoperability standards for immunization programs and IIS vendors are 

implemented in a variable way across jurisdictions due to local statutes and business rules.

• Methods/standards for analyzing IIS data (e.g., developing coverage rates) vary from IIS to 

IIS, resulting in potential misinterpretation by public health officials and scientists.

Interoperability

/ Data 

Management

• Challenges remain to ensure immunization data in IIS is complete, accurate and acquired in 

a timely manner.

3 Future State

3.1 Vision 

Any vision for the future of immunization information management must be subordinate and 

aligned to the vision for nationwide immunization management, which is: “A nation without vaccinepreventable disease, disability, and death.”2

In support of the nationwide immunization vision, NCIRD, in consultation with various stakeholders 

and subject matter experts, proposes this vision for immunization information management:

“Real time, consolidated immunization data and services for all ages are available for 

authorized clinical, administrative, and public health users, and consumers, anytime 

and anywhere.”3

3.2 Goals 

NCIRD interpreted the future state vision to create a long-term goal aligned to each Focus Area 

(see Table 3). The team also created near- and mid-term goals to help define the outcomes and 

metrics for near-, mid-, and long-term initiatives. 

Table 3: NCIRD’s IIS Goals

Focus Area Long-Term Goal

Nationwide 

Leadership

There is a nationwide immunization and immunization information management program 

vision, strategy, policy and metrics.

Sustainability

Local, state and nationwide immunization information management programs have sufficient

funding and resources such as informaticians, epidemiologists, economists, business 

analysts, contracts specialists, engineers, and information technologists.

Provider Services Providers transmit immunization event data automatically and receive consolidated patient 

history and clinical decision support within the same application.

2 Source: The vision statement used by the CDC’s Global Immunization Strategic Framework 2011–2015 here. 3 Source: Paraphrased from a vision proposed by Dr. Chesley Richards, former Director, Immunization Services Division 

within NCIRD, during opening remarks for the Immunization Blue Ribbon Panel, May 16, 2013.

IIS Strategic Plan v1.3 – Executive Summary 5 

 
Centers for Disease Control and Prevention 

National Center for Immunization and Respiratory Diseases

Focus Area Long-Term Goal

Public Health 

Services

IIS collect and display real-time, accurate immunization coverage analytics for all ages and 

vaccine inventory status for the jurisdiction to support all immunization program functions and 

public health use, and immunization clinical decision support is available as an IIS service.

Interoperability / 

Data Management

Data exchange among immunization information management systems is automatic and 

transparent regardless of location.

3.3 Strategic Initiatives 

NCIRD, with input from the IIS Executive Board, developed 18 strategic initiatives to help drive 

implementation of the IIS Strategic Plan. 

Table 4: IIS Strategic Initiatives 

Focus Area Strategic Initiatives

Nationwide 

Leadership

1. Nationwide Immunization Information Management Vision and Strategy 

2. Nationwide Immunization Information Management Policy and Metrics 

Sustainability

3. IIS - IIS and EHR - IIS Cross-jurisdictional Data Exchange Policy 

4. IIS Value, Funding and Cost Optimization 

5. Immunization Program Capacity Management Plan 

6. Shareable and Transportable Immunization Services 

Provider Services

7. Nationwide Immunization EHR Interoperability Standards 

8. Nationwide Immunization Provider Workflow and Services Standards 

9. Immunization-centric EHR Certification 

10. Provider-accessible Immunization Data Entry and Clinical Decision Support Service 

11. IIS Services Validation 

Public Health 

Services

12. Data Analytics 

13. IIS Service Catalog and Sharing Mechanism 

14. Nationwide Immunization Program Workflow and Services Standards 

Interoperability / 

Data Management

15. Nationwide Interstate and Intrastate Interoperability Standards 

16. Data Quality Services 

17. Nationwide Consolidated Patient Immunization History Standards 

18. Consumer-accessible Immunization Clinical Decision Support Service 

The IIS Strategic Plan also identifies NCIRD functions and current/past projects relevant to each 

proposed initiative, as well as proposed metrics, a strategic roadmap, and potential stakeholder 

groups. Finally, the Plan lists short- and long-term recommendations for implementation. 

3.4 Next Steps and Further Information 

NCIRD plans to engage the IIS Executive Board on a quarterly basis to request input and provide 

updates to the IIS Strategic Plan’s implementation. NCIRD will carefully consider their input, and 

will produce periodic summaries of ongoing updates to the operational version of the IIS Strategic 

Plan to share with internal and external stakeholders. 

For any questions or concerns regarding this Executive Summary or to request a copy of the full 

IIS Strategic Plan document, please contact NCIRD at IISExecutiveBoard@cdc.gov. 

IIS Strategic Plan v1.3 – Executive Summary 6