Comparisons of immunization records between a community pharmacy, a regional registry, and a health system

Abstract

Objective: Our study compared the completeness of immunization records for six vaccines between a community pharmacy database, regional immunization information system (IIS), and a health system’s electronic health record (EHR). Methods: In a community pharmacy immunization program, two pharmacists and a community pharmacy resident performed a needs assessment for six vaccines (tetanus-diphtheria-acellular pertussis vaccine for adults or diphtheria-tetanus-acellular pertussis vaccine for child and adolescents, zoster vaccine live, 13-valent pneumococcal conjugate vaccine, 23-valent pneumococcal polysaccharide vaccine, hepatitis B vaccine series, and human papillomavirus vaccine) for over 2,400 patients between August 2016 and March 2017. This is a retrospective study to review immunization records for 243 patients. Inclusion criteria included patients from the community pharmacy immunization program who also had at least one medication prescribed by an academic health system provider. Immunization records for six vaccines were collected from the community pharmacy database, regional IIS, and EHR. Results: 186 of 243 (77%) patients had additional immunization records in the regional IIS or EHR that were not found in the community pharmacy database. For those 186 patients, 108 (58%) patients had additional immunization records for 2 or more unique vaccines. In total, 378 additional immunization records were identified for the six vaccines. For all six vaccines, the regional IIS and EHR possessed more complete immunization records compared to the community pharmacy database (p < 0.05 for HPV and p < 0.001 for the remaining 5 vaccines). Conclusion: Our study showed that immunization records were more complete in a regional IIS and health system EHR compared to a community pharmacy database. If all three sources were utilized by the pharmacist during the needs assessment, the community pharmacy team would have made fewer vaccine recommendations, which would have reduced the potential for duplicate or inappropriate vaccines.