Vaccine information in ELR

It is an AOE for sure!
Riki

Won't cause errors in MA (but the surveillance database can't consume!)

Would be fine in MD.

Won't cause any issues in NH.

Won't cause any issues for Iowa.

This will not cause issues for CA as long as we are notified in advance so that we can update our system to accommodate. Although, like other states have already mentioned, our surveillance database cannot consume these data.

We go to our immunization registry for this information and not from lab messages. We do not want to receive this in any messages.

Hi everyone - do we really think labs will have complete and accurate vaccination data? With key variables that would be needed such as date of vaccination, manufacturer etc? I am not sure this is the greatest idea since ideally we would be linking cases with vaccine registry data…. And this would pose a significant burden on providers to enter data, labs to receive, store and report it, and for health depts to receive, process, and import for it to be useful.  Curious what others think (saw Nancy’s comment!) 

Annie - Agree. It dismays me whenever I see this type of request that is yet another work around from lab messages and all of the different ways states say they have to code to accommodate this. I would think that nationally AIRA would recommend getting vaccination information from the state's vaccination registry, unless you are picking up some indication from a provider recorder in case reporting (we'd still want the record from the state registry as well as the gold standard).

I agree with the comments above. We would never use these data, we would be relying on our immunization registry. It's a huge ask to expect labs to be able to supply this information, when we already have it from an approved/verified source. Not sure what's driving this?

Thanks for all your responses - here is what Krishna (NIH home testing project) shared with me:
Here’s the main goal, and a piece of data that is of interest to some key leaders in Federal government: 

In order to answer the question above, we need to match a test result with vaccination status. Are the states able to do this without a national Patient ID - how is this happening?
Riki

Hi Riki and all-
this chain of responses tells me 2 things:
1. we need a governance process to review requests, including who they are from and why. Riki - this is in no way a negative comment on what you are doing! you rock!

2. I actually emailed the CDC and asked about vaccine breakthrough and how they were determining it to ward off adding unnecessary variables in our surveillance system and get the straight story. The CDC told me they were going to determine vaccine breakthrough via analysis - they would get case info including vax hx and lab test info and do the analytic determination if it was a VB event. The determination of a VB event is not as simple as a lab/provider indicating it is.

IMHO what should be done is: AIRA/IIS/APHL work with states to see if there is a process to get COVID-19 vax info into surveillance systems OR a way to add it to reporting to CDC. CT and I'm sure many other states have a process to get that in. These processes may not be some sort of API/call out- interoperability, so the point is does a state have a method that works.
Right now we are still using the VB RedCap as we are working on migrating that info into our surveillance system. However, the second item needed is a sincere move forward with the COVID-19 MMG with all states, recognizing that we are now asking state staff to set aside other work to get that done. What is the minimally necessary info to go into the MMG right now? And if this is a priority, we can do it, but will need to tell our leadership why we are not doing something else to get this important work done. Staffing shortages still exist.

Also just my opinion, but we have to stop short cutting getting information by using labs to do this. I'm sure many states have or are working on methods to get VB, variant, and just regular COVID-19 case info to CDC. Is it possible to get this together and stop this constant pinging to make this v2 message and labs do and collect information not within their scope. I'd much rather focus on labs getting/requiring patient demographic information, ordering provider info from the orders and sending us this and complete test results than AOE+. 

Is this a topic for our Oct ELR workgroup call?

Thanks!

Also this has come up on the all state epi calls I believe, but CDC (Ben Silk and others) is working with a number of states/jurisdictions that already are able to link their immunization registry data with their case data = these jurisdictions will contribute data on a regular basis to CDC so that they can analyze the data together.  Riki, it would be helpful to know where that request/question came from at CDC since they may not know about what is going on on the epi side to address the questions around vaccine breakthroughs.  Fine to just email me offline if you want. This idea of using the labs to report vaccination data did come up a few weeks ago in some of our (CSTE's) conversations with CDC but we did say many of these same things in response and thought they had decided not to pursue.  Thanks everyone!

Thanks Annie! here is the phrase that I'm sure caught everyone's eye - I added the bold for the NIH home testing project....

 Krishna (NIH home testing project) shared with me:
Here’s the main goal, and a piece of data that is of interest to some key leaders in Federal government: 

Aha! That context is super helpful. Thank you Jason! 

Thanks Jason!

Minnesota can handle this if sent like an AOE, but would need to know for mapping so we don't reject.
Agreeing with others on AOE quality that we are receiving currently and not wishing for labs to have to add another question.