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Immunization information systems in Canada: Attributes, functionality, strengths and challenges. A Canadian Immunization Research Network study

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Abstract

OBJECTIVES: Canada does not have a national immunization registry. Diverse systems to record vaccine uptake exist, but these have not been systematically described. Our objective was to describe the immunization information systems (MSs) and non-IIS processes used to record childhood and adolescent vaccinations, and to outline the strengths and limitations of the systems and processes.

METHODS: We collected information from key informants regarding their provincial, territorial or federal organization’s surveillance systems for assessing immunization coverage. Information collection consisted of a self-administered questionnaire and a follow-up interview. We evaluated systems against attributes derived from the literature using content analysis.

RESULTS: Twenty-six individuals across 16 public health organizations participated over the period of April to August 2015. Twelve of Canada’s 13 provinces and territories (P/Ts) and two organizations involved in health service delivery for on-reserve First Nations people participated. Across systems, there were differences in data collection processes, reporting capabilities and advanced functionality. Commonly cited challenges included timeliness and data completeness of records, particularly for physician-administered immunizations. Privacy considerations and the need for data standards were stated as challenges to the goal of information sharing across P/T systems. Many P/Ts have recently implemented new systems and, in some cases, legislation to improve timeliness and/or completeness.

CONCLUSION: Considerable variability exists among NSs and non-IIS processes used to assess immunization coverage in Canada. Although some P/Ts have already pursued legislative or policy initiatives to address the completeness and timeliness of information, many additional opportunities exist in the information technology realm.

Résumé

OBJECTIFS: Contrairement à d’autres pays (comme les États-Unis et l’Australie), le Canada n’a pas de registre d’immunisation national. Il existe divers systèmes d’enregistrement du recours aux vaccins, mais ils n’ont pas été systématiquement décrits. Notre objectif était de décrire les systèmes d’information sur la vaccination (SIV) et les processus autres que les SIV utilisés pour enregistrer les vaccins administrés durant l’enfance et l’adolescence, et d’en présenter les forces et les contraintes.

MÉTHODE: Nous avons recueilli auprès d’informateurs privilégiés des données sur les systèmes de surveillance utilisés par leur organisme provincial, territorial ou fédéral pour évaluer la couverture vaccinale. Les données ont été recueillies au moyen d’un questionnaire à remplir soi-même et d’un entretien de suivi. Au moyen d’une analyse de contenu, nous avons évalué les systèmes par rapport à des attributs trouvés dans la documentation.

RÉSULTATS: Vingt-six personnes issues de 16 organismes de santé publique ont participé à l’étude entre avril et août 2015. Douze des 1 3 provinces et territoires (P/T) du Canada et deux organismes intervenant dans la prestation des services de santé des Premières Nations dans les réserves ont participé. D’un système à l’autre, on nous a signalé des différences dans les processus de collecte de données, les capacités d’établissement de rapports et les fonctions avancées. Les difficultés couramment rencontrées concernaient l’actualité et l’exhaustivité des dossiers de données, particulièrement pour les vaccins administrés par les médecins. Les questions de confidentialité et l’absence de normalisation des données ont été indiquées comme faisant obstacle au partage de l’information d’un système P/T à l’autre. Bon nombre de P/T ont récemment mis en œuvre de nouveaux systèmes et, dans certains cas, des mesures législatives pour en améliorer l’actualité et/ou l’exhaustivité.

CONCLUSION: Il existe une variabilité considérable entre les SIV et les processus autres que les SIV qui servent à évaluer la couverture vaccinale au Canada. Quelques P/T mènent déjà des initiatives législatives ou stratégiques pour aborder l’exhaustivité et l’actualité des données, mais il existe de nombreuses possibilités de faire mieux dans le domaine de la technologie de l’information.

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Author information

Authors and Affiliations

  1. Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 2V1, Canada

    Sarah E. Wilson MD, MSc, Susan Quach MSc, Shelley L. Deeks MD, MHSc, Natasha S. Crowcroft MSc, MD(Cantab), Jeffrey C. Kwong MD, MSc & Caitlin Johnson MPH

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Sarah E. Wilson MD, MSc, Shelley L. Deeks MD, MHSc, Natasha S. Crowcroft MSc, MD(Cantab) & Jeffrey C. Kwong MD, MSc

  3. Institute for Clinical Evaluative Services, Toronto, ON, Canada

    Sarah E. Wilson MD, MSc, Jeffrey C. Kwong MD, MSc & Karen Tu MD, MSc

  4. University of Alberta, Edmonton, AB, Canada

    Shannon E. MacDonald PhD, RN

  5. BC Centre for Disease Control, Vancouver, BC, Canada

    Monika Naus MD, MHSc

  6. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    Monika Naus MD, MHSc

  7. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada

    Natasha S. Crowcroft MSc, MD(Cantab)

  8. Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, MB, Canada

    Salaheddin M. Mahmud MD, MSc, PhD

  9. Hospital for Sick Children, Toronto, ON, Canada

    Dat Tran MD, MSc

  10. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada

    Jeffrey C. Kwong MD, MSc & Karen Tu MD, MSc

  11. Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Karen Tu MD, MSc

  12. Public Health Agency of Canada, Ottawa, ON, Canada

    Shalini Desai MD, MHSc

Authors
  1. Sarah E. Wilson MD, MSc
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  2. Susan Quach MSc
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  3. Shannon E. MacDonald PhD, RN
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  4. Monika Naus MD, MHSc
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  5. Shelley L. Deeks MD, MHSc
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  6. Natasha S. Crowcroft MSc, MD(Cantab)
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  7. Salaheddin M. Mahmud MD, MSc, PhD
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  8. Dat Tran MD, MSc
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  9. Jeffrey C. Kwong MD, MSc
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  10. Karen Tu MD, MSc
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  11. Caitlin Johnson MPH
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  12. Shalini Desai MD, MHSc
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Corresponding author

Correspondence to Sarah E. Wilson MD, MSc.

Additional information

Acknowledgement: This study was funded by the Canadian Immunization Research Network through a grant from the Canadian Institutes of Health Research.

Conflict of Interest: None to declare.

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Wilson, S.E., Quach, S., MacDonald, S.E. et al. Immunization information systems in Canada: Attributes, functionality, strengths and challenges. A Canadian Immunization Research Network study. Can J Public Health 107, e575–e582 (2016). https://doi.org/10.17269/CJPH.107.5679

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  • DOI: https://doi.org/10.17269/CJPH.107.5679

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