Abstract
Context: The Advisory Committee on Immunization Practices (ACIP) publishes annual recommendations for the prevention and control of seasonal influenza. Between 2011 and 2013, the ACIP recommended 2 approaches that providers could use to determine how many influenza vaccine doses children aged 6 months through 8 years should receive. One did not consider doses received prior to the 2010-2011 season; the other considered complete influenza immunization history, such as that available in immunization information system (IIS).
Objectives: To use Michigan's IIS, the Michigan Care Improvement Registry (MCIR), to compare the number of children recommended to receive 2 doses of influenza vaccine under each ACIP approach, and to determine the potential for overimmunization of Michigan children with influenza vaccine if providers do not use the data in MCIR.
Design: Cross-sectional analysis in the 2011-2012 to 2013-2014 influenza seasons.
Setting: We used the seasonal influenza and 2009 H1N1 monovalent vaccine doses in MCIR to determine the number of influenza vaccine doses children should receive using both ACIP approaches each season.
Participants: We analyzed data for more than 900 000 children aged 6 months through 8 years in each influenza season.
Main Outcome Measure: Number of children recommended 2 doses of influenza vaccine using each ACIP approach in each influenza season.
Results: Our evaluation showed that using MCIR could prevent the overimmunization with a second influenza vaccine dose for 70 323 children during the 2011-2012 influenza season, 126 076 children during the 2012-2013 season, and 81 635 children during the 2013-2014 season.
Conclusions: This is the first study to use an IIS to quantify the difference between ACIP's approaches for 2-dose influenza vaccine recommendations. The immunization history and 2-dose forecasting algorithm available through MCIR minimizes overimmunization and has potential cost-saving implications. Our study illustrates the value of a centralized repository provided by IISs to immunization providers, public health, and caregivers.