Using MIIC to Measure Child Immunization Rates
The Minnesota Immunization Information Connection (MIIC) immunization registry is a valuable source of real-time childhood immunization assessment rates for health care providers, counties, and the state. Updated 4/12
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Achieving and maintaining high childhood immunization rates is an ongoing public health challenge essential to the continued control of vaccine preventable disease. It is important that children receive all recommended immunizations in their first two years of life since vaccine preventable diseases are often more serious in young children.
National and state immunization goals call for 90% coverage rates among young children for individual recommended vaccines and 80% coverage for the series of recommended immunizations. See the Childhood Immunization Schedule for more information on what vaccines are recommended at what ages.
MIIC can be used to monitor provider-based and population-based coverage rates for the recommended childhood vaccines. For both types of rates MIIC identifies the percent of two-year olds (children age 24 to 35 months) who are up to date by their second birthday for the following:
- 4 or more doses of Diphtheria, Tetanus, and Pertussis-containing vaccine,
- 3 or more doses of Polio vaccine,
- 1 or more doses of Measles, Mumps, Rubella vaccine,
- Complete Haemophilus influenzae type b,
- 3 or more doses of Hepatitis B,
- 1 or more Varicella vaccine, and
- Complete PCV.
Within the MIIC application, providers can use the assessment report feature to produce childhood immunization rates specific to their patient population. This assessment can be conducted at any time by MIIC users.
The assessment feature in MIIC produces three related reports: an Immunization Assessment Summary, a Single Antigen Graph, and a Patient Not Up to Date List. Providers can use the reports to monitor immunization rates in their patient populations and to conduct outreach to ensure age-appropriate vaccination.
Sample MIIC assessment reports are shown below:
For more information on how to produce assessment reports in MIIC, see the Child Immunization Assessment Reports MIIC User Guide document.
Like the provider-based assessment, population-based assessment also identifies the percent of two-year-olds who are up to date by their second birthday for a number of recommended immunizations. However, instead of assessing only those children associated with a specific health care provider, the entire population of children residing in a certain geographic area is assessed.
The Minnesota Department of Health conducts population-based assessment of childhood immunization rates annually by county. In order to provide the most accurate reflection of county-level immunization coverage, rates are calculated for only those children with two or more shots in MIIC.
See Childhood Immunization Coverage in Minnesota for the most recent statewide population-based rates.
The overall quality of MIIC data, including completeness, accuracy, and timeliness of entry, directly impacts the usefulness of the assessment data. Accuracy of the MIIC rates is especially affected by: provider participation in the registry, management of children who have moved or gone elsewhere, and border-state data exchange.
- Approximately 85-90% of Minnesota health care providers routinely submit immunization data to MIIC; however, not all those who do participate report every dose of vaccine administered. Review Clinic Participation in MIIC to see provider participation by county.
- When a child moves out of Minnesota, his or her MIIC record may not be updated, so the child may still be counted as unimmunized for doses that were due after the child left the state.
- Finally, data exchange with border state immunization information systems is currently limited to Wisconsin. Shots received in Wisconsin by Minnesota residents are in MIIC but there is no similar data exchange with North Dakota, South Dakota, or Iowa at this time.
Calculated MIIC rates are likely lower than true coverage rates due to these limitations.
Continued measurement of childhood vaccination levels is essential for monitoring progress towards national and state immunization goals aimed at preventing vaccine-preventable disease.