Monitoring and reporting the US COVID-19 vaccination effort.

Immunizations are an important tool to reduce the burden of vaccine preventable diseases and improve population health.1 High-quality immunization data is essential to inform clinical and public health interventions and respond to outbreaks of vaccine-preventable diseases. To track COVID-19 vaccines and vaccinations, CDC established an integrated network that included vaccination provider systems, health information exchange systems, immunization information systems, pharmacy and dialysis systems, vaccine ordering systems, electronic health records, and tools to support mass vaccination clinics. All these systems reported data to CDC's COVID-19 response system (either directly or indirectly) where it was processed, analyzed, and disseminated. This unprecedented vaccine tracking effort provided essential information for public health officials that was used to monitor the COVID-19 response and guide decisions. This paper will describe systems, processes, and policies that enabled monitoring and reporting of COVID-19 vaccination efforts and share challenges and lessons learned for future public health emergency responses.

Current Challenges and Future Possibilities for Immunization Information Systems.

Immunizations have proven to be an important tool for public health and for reducing the impact of vaccine preventable diseases. To realize the maximum benefits of immunizations, a coordinated effort between public policy, health care providers and health systems is required to increase vaccination coverage and to ensure high-quality data are available to inform clinical and public health interventions. Immunization information systems (IIS) are confidential, population-based, computerized databases that record all immunization doses administered by participating providers to persons residing within a given geopolitical area. The key output of an IIS is high-quality data for use in targeting and monitoring immunization program activities and providing clinical decision support at the point of care. To be truly effective, IISs need to form a nationwide network and repository of immunization data. Since the early 2000s Centers for Disease Control and Prevention has made strides to help IIS move toward a nationwide network through efforts focused on improving infrastructure and functionality, such as the IIS Minimum Functional Standards, and the IIS Annual Report, a self-reported data collection of IIS progress toward achieving the functional standards. While these efforts have helped immunization programs achieve more functional standards, there is a need to shift focus from infrastructure and functionality improvements to high data quality through objective measurement of IIS performance and evaluating critical outcomes. Additionally, realizing the vision of a nationwide repository of high-quality immunization data requires tackling the many challenges that impact data quality and availability including those related to policy, data sharing, data use, aging IIS technology, sustainability, and participation in the IIS. This paper describes the current state of IIS in the United States, critical challenges impacting the quality of data in IIS, and potential components of a future IIS model to address these challenges.

Methods for characterizing fine particulate matter using ground observations and remotely sensed data: potential use for environmental public health surveillance.

This study describes and demonstrates different techniques for surface fitting daily environmental hazards data of particulate matter with aerodynamic diameter less than or equal to 2.5 microm (PM2.5) for the purpose of integrating respiratory health and environmental data for the Centers for Disease Control and Prevention (CDC) pilot study of Health and Environment Linked for Information Exchange (HELIX)-Atlanta. It presents a methodology for estimating daily spatial surfaces of ground-level PM2.5 concentrations using the B-Spline and inverse distance weighting (IDW) surface-fitting techniques, leveraging National Aeronautics and Space Administration (NASA) Moderate Resolution Imaging Spectrometer (MODIS) data to complement U.S. Environmental Protection Agency (EPA) ground observation data. The study used measurements of ambient PM2.5 from the EPA database for the year 2003 as well as PM2.5 estimates derived from NASA's satellite data. Hazard data have been processed to derive the surrogate PM2.5 exposure estimates. This paper shows that merging MODIS remote sensing data with surface observations of PM,2. not only provides a more complete daily representation of PM,2. than either dataset alone would allow, but it also reduces the errors in the PM2.5-estimated surfaces. The results of this study also show that although the IDW technique can introduce some numerical artifacts that could be due to its interpolating nature, which assumes that the maxima and minima can occur only at the observation points, the daily IDW PM2.5 surfaces had smaller errors in general, with respect to observations, than those of the B-Spline surfaces. Finally, the methods discussed in this paper establish a foundation for environmental public health linkage and association studies for which determining the concentrations of an environmental hazard such as PM2.5 with high accuracy is critical.