Immunization Integration Program

Your Gateway to Immunization Interoperability

Select Block Reference (Programmatic)

IIP Collaborative

The Collaborative fosters an interconnected network of immunization data exchange partners to prioritize, develop and drive the adoption of solutions to improve immunization interoperability. Learn how the IIP Collaborative is driving action in the immunization ecosystem.


  • Strengthen relationships between immunization information systems (IIS), electronic health record systems (EHRs) and other health information technology (IT), health information exchanges (HIEs), clinicians, public health and other critical partners
  • Raise awareness of the issues that challenge immunization interoperability and create resources to reduce their impact
  • Develop recommended guidance and solutions for prioritized issues
  • Drive adoption of recommended solutions that benefit the immunization ecosystem

Current Priorities

The IIP Collaborative, comprised of IIS, EHRs and other health IT, HIEs, clinicians, public health agencies, pharmacy and other critical partners, is addressing identified priorities for 2023 to improve immunization interoperability, information sharing and management including:

Regularly updating of code sets:

  • Out of sync vaccine-related code set values (e.g., NDCs for annual flu vaccine or new vaccines) between immunization data exchange partners impedes data interoperability and can prevent patients’ vaccinations from being recorded properly.
  • The Code Sets work effort launched in fall 2022 to collaborate with key partners to develop recommendations. This project seeks to develop resources to reduce:
    • The level of effort and length of time required to implement new values within vaccine-related code sets used for interoperability between IIS and other health IT systems.
    • The variation in understanding of code set values (e.g. use of specific v. generic, NOS codes) and code set metadata (e.g., “code is active”) between IIS and applications used by their trading partners (e.g., EHRs).
  • This effort builds upon the work done in AIRA’s 2020 Vaccine Code Set Considerations
  • In the spring of 2023, information will be gathered from 50,000+ individuals who currently use CDC provided vaccine code set resources in the form of an online poll. Once the poll is live a link will be provided here.
  • Contact us at to learn more about the topic, share your expertise or to participate in solution development.

Immunization Data from Pharmacies

Pharmacies play an important role in immunization - how can pharmacy systems leverage immunization data exchange standards and best practices to improve interoperability with IIS and maximize successful immunization submission.  

Submissions Prior to the Assignment of a Legal Baby Name

The first vaccination in a person’s life, hepatitis B, typically happens within 24 hours of birth.  Sometimes, the legal name has not yet been assigned  and when an HL7 immunization message is sent from the hospital to the IIS the name is often just a placeholder (e.g., BabyBoySmith). When the legal name is available, the hepatitis B record needs to be identified and updated to avoid duplicate records.

Triggers that Prompt Submission or Query Messages from EHRs to IIS

IIS usability could be improved through optimally defined and timed submission and query triggers. If health IT systems can exchange data with IIS at appropriate times based on specific criteria, patient data will be available to providers when needed during clinic workflows and unnecessary queries to the IIS can be avoided.

The IIP is always accepting  issues as trends change and new issues emerge in the immunization data exchange ecosystem.

Share Your Issue


Data validation and addressing reasons for IIS rejections:

  • Inconsistency in how data is entered at the point of registration or vaccine administration such as dates entered in the future, birth date discrepancies, or missing fields can cause IIS to reject immunization messages. Assessing data for validity, completeness and accuracy before submission facilitates successful submission and reduces the amount of rejected data that must be investigated, corrected, and resubmitted.
  • The IIP Data Validation Workgroup developed comprehensive strategies to improve successful immunization submission to IIS at the point of care including end-user training resources and a common data error template for customization by IIS. Contact us at to learn more and explore technical assistance opportunities.

Accessing bulk query data from IIS:

  • On average, IIS receives twice as many queries as submissions. Key partner groups are unable to access the data they need in a timely manner because of disparate and/or inadequate query or bulk data protocols.
  •  The IIP Collaborative Bulk Query Workgroup developed a bulk query toolkit which includes best practice guidance for bulk query options. Contact us at to learn more and explore technical assistance opportunities.

Acknowledgments Message Handling and Error Report Guidance:

The IIP Acknowledgments Workgroup developed a guidance document and implemented a pilot program to promote and validate the guidance. The workgroup convened to address variability in acknowledgment message handling among EHRs, IIS, and clinicians to improve the quality of information used for decision making.

Technical assistance opportunities are available to implement the Acknowledgments Guidance with interested partners. Email to learn about technical assistance opportunities.

Multiple Match Query Solution:

Patient Matching Brief:

  • The IIP developed an educational brief to raise awareness around patient identification and matching to support immunization information sharing and management. When published, the educational brief will serve to inform:
    • Current national patient matching strategies to emphasize the need for faster policy change
    • Implications of the current unique health identifier federal funding ban
    • Provide unbiased education as a community of experts providing insight and consensus around immunization
    • Discussion supporting patient matching strategies

Common Standard for Transport of Immunization Messages:

  • The IIP Executive Committee gained agreement on the unified adoption of a standard transport protocol to improve interoperability and information sharing among EHRs and IIS to support public health immunization goals.

Interested in using IIP guidance and solutions?

The IIP offers technical assistance and support to immunization data exchange partners who would like to implement our recommendations. Contact us at to learn more about how to engage with us to implement IIP solutions.

Approach to Prioritization

The IIP solicits immunization interoperability challenges from the broader immunization ecosystem and works with CDC to screen the issues to ensure topics are within scope not duplicative of other efforts. The IIP Executive Committee scores the issues based on criteria listed below to inform the IIP and assist the CDC Informatics and Data Analytics Branch (IDAB) to select issues to tackle.


Conduct community information gathering on each issue to:

  • Define and categorize the problem

  • Learn IIS, EHR and provider community perspectives

  • Identify existing efforts to address the issue

  • Recommend solution-based approaches to address the issue

  • Address additional considerations to each issue such as policy and technical barriers


Develop and apply screening and prioritization criteria for each issue to:

  • Assess level of impact on quality, safety and public health, impact on EHR-IIS interoperability, and information sharing

  • Leverage existing resources and ensure feasibility of achieving consensus on and developing a solution

  • Emphasize feasibility of implementing and adopting a solution

  • Ensure impact was broad and benefited key collaborator groups

  • Confirm the ability to effect change through policy and other levers

  • Align issue topics with IIP scope, goals, and objectives



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