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Share: Cross-Jurisdictional Immunization Information Exchange

The Cross-Jurisdictional Immunization Information Exchange serves to improve the immunization information available to health care providers when a patient may reside in a neighboring state/jurisdiction or has relocated from another region. Most Immunization Information Systems (IIS) focus on residents in their jurisdiction and vaccinations given by providers in that jurisdiction, so gaps in immunization history can develop. This can lead to unnecessary vaccinations and missed opportunities to complete a vaccine series.

The Cross-Jurisdictional Immunization Information Exchange will eliminate those gaps through manual and automated sharing of data for patients seeing a provider in one jurisdiction who have address histories—or live in—another jurisdiction. The data exchange is secure and reliable. It was developed under the legal guidance of the nonprofit Association of State and Territorial Health Officials (ASTHO).

The Cross-Jurisdictional Immunization Information Exchange pilot includes more than 12 public health agencies around the country, most working in pairs to coordinate data exchange between a variety of underlying software platforms. In addition to the technical challenges, each trading pair had to first navigate their local legal policies regarding access to patient data—a process assisted by ASTHO’s and the American Immunization Registry Association’s legal and regulatory expertise.

Goal of the Cross-Jurisdictional Immunization Information Exchange

The Cross-Jurisdictional Immunization Information Exchange has the ultimate goal to enable participating agencies to operate under a shared-data use agreement that provides access to all U.S. states and territories, vastly improving the completeness of patient immunization records across the country.

A Successful Example

The first jurisdictions to go live with their exchange were the state of Delaware and the city of Philadelphia. On September 12, 2018, the Delaware IIS and the Philadelphia IIS performed an initial “data dump” of existing immunization records for patients with former or current addresses in each other’s jurisdictions. Philadelphia transmitted approximately 3,000 Unsolicited Vaccination Record Update (VXU) messages to Delaware that resulted in approximately 17,600 new immunizations to be created in Delaware’s IIS. Delaware, in turn, transmitted around 470 VXU messages to Philadelphia.

The exchange made Philadelphia officials aware that the city’s hepatitis B coverage rates are better than anticipated because Philadelphia now receives information on birth doses of the hepatitis b vaccine through the exchange. Ultimately, the Office of the CTO hopes to see this success scale to a national level, leading to better quality data across every IIS.

For more information about the Cross-Jurisdictional Immunization Information Exchange reach out to James.Daniel@hhs.gov.

Content created by Office of the Chief Technology Officer (CTO)
Content last reviewed on May 15, 2020