Journal article
Comparison of immunization information systems, electronic medical records, and self-report to ascertain RSV vaccination status among US adults aged ≥60 years, 2023–2024
Vaccine, Vol.69, 127946
01/01/2026
DOI: 10.1016/j.vaccine.2025.127946
PMID: 41275655
Abstract
Respiratory syncytial virus (RSV) vaccines were recommended for US adults aged ≥60 years in 2023. Immunization information systems (IISs) are important sources of RSV vaccination data; however, the completeness of documented RSV vaccinations in IISs is unknown.
The IVY network prospectively enrolled hospitalized adults with acute respiratory illness aged ≥60 years at 26 hospitals in 20 states during October 1, 2023–April 30, 2024. At enrollment, RSV vaccination history was abstracted from jurisdictional IISs, inpatient electronic medical records (EMRs), and through patient (or proxy) interviews with final RSV vaccination status adjudicated from all three sources. Frequencies and proportions of RSV vaccinations identified by IISs, EMRs, and self-report were compared to each other and to adjudicated RSV vaccination status using an unweighted Cohen's kappa coefficient (κ), sensitivity, and specificity. RSV vaccinations documented in IISs were compared by jurisdictional consent policies. Statistical significance was determined using Wilcoxon rank sum or Pearson's chi-squared tests, with a 2-sided P value <0.05.
Among 7219 enrolled patients, 749 (10.4 %) had received RSV vaccination adjudicated from all sources, 613 (8.5 %) RSV vaccinations were detected by IISs, 439 (6.1 %) by self-report, and 334 (4.6 %) by EMRs. Self-report had the highest frequency of missing RSV vaccination history (30.1 %). Among 4422 patients with non-missing RSV vaccination data, agreement with adjudicated RSV vaccination status was highest for self-report (κ = 0.90) followed by IISs (κ = 0.88) and EMRs (κ = 0.55). Among 6208 patients with IIS data, the sensitivity of detecting RSV vaccinations was higher in states with mandatory inclusion of vaccination data in IISs than in those that required explicit consent (92 % vs. 65 %, P < 0.001).
In this multicenter analysis, IISs detected more RSV vaccinations than self-report or EMRs, especially in jurisdictions with mandatory inclusion policies. Combining multiple data sources remains the optimal approach to ascertain RSV vaccination status in the US.
Details
- Title: Subtitle
- Comparison of immunization information systems, electronic medical records, and self-report to ascertain RSV vaccination status among US adults aged ≥60 years, 2023–2024
- Creators
- Lauren T. Vanasse - National Center for Immunization and Respiratory DiseasesBasmah Safdar - Yale UniversityWesley H. Self - Vanderbilt University Medical CenterYuwei Zhu - Vanderbilt University Medical CenterAdit A. Ginde - University of Colorado Anschutz Medical CampusIthan D. Peltan - University of UtahSamuel M. Brown - University of UtahManjusha Gaglani - Baylor Scott & White Medical Center - TempleShekhar Ghamande - Baylor Scott & White Medical Center - TempleCristie Columbus - Baylor Scott & White Medical Center - TempleNicholas M. Mohr - University of IowaKevin W. Gibbs - Wake Forest UniversityDavid N. Hager - Johns Hopkins University School of MedicineAmira Mohamed - Albert Einstein College of MedicineNicholas J. Johnson - University of WashingtonJay S. Steingrub - Baystate Medical CenterAkram Khan - Oregon Health & Science UniversityJennifer G. Wilson - Stanford University School of MedicineNida Qadir - University of California, Los AngelesSteven Y. Chang - University of California, Los AngelesChristopher Mallow - University of MiamiLaurence W. Busse - Emory UniversityJamie Felzer - Emory UniversityJennie H. Kwon - Washington University in St. LouisMatthew C. Exline - The Ohio State UniversityIvana A. Vaughn - Ford Motor Company (United States)Mayur Ramesh - Ford Motor Company (United States)Jarrod M. Mosier - University of ArizonaEstelle S. Harris - University of UtahAdrienne Baughman - Vanderbilt University Medical CenterSydney A. Cornelison - Vanderbilt University Medical CenterCassandra Johnson - Vanderbilt University Medical CenterPaul W. Blair - Vanderbilt University Medical CenterNatasha Halasa - Vanderbilt University Medical CenterNathaniel Lewis - National Center for Immunization and Respiratory DiseasesSascha Ellington - National Center for Immunization and Respiratory DiseasesRachel E. Rutkowski - National Center for Immunization and Respiratory DiseasesMarietta S. Cox - Centers for Disease Control and PreventionFatimah S. Dawood - National Center for Immunization and Respiratory DiseasesInvestigating Respiratory Viruses in the Acutely Ill (IVY) NetworkDiya Surie - National Center for Immunization and Respiratory Diseases
- Resource Type
- Journal article
- Publication Details
- Vaccine, Vol.69, 127946
- DOI
- 10.1016/j.vaccine.2025.127946
- PMID
- 41275655
- NLM abbreviation
- Vaccine
- ISSN
- 0264-410X
- eISSN
- 1873-2518
- Publisher
- Elsevier Ltd
- Grant note
- United States Centers for Disease Control and Prevention: 75D30122C14944
Funding This work was funded by the United States Centers for Disease Control and Prevention (contract 75D30122C14944 to Vanderbilt University Medical Center) .
- Language
- English
- Date published
- 01/01/2026
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9985034929302771
Metrics
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