Thread by @lisabari, Now that we have two vaccines headed for EUAs, and a goal [...]

Now that we have two vaccines headed for EUAs, and a goal to vaccinate 20M front-line responders and high risk people this winter, how will we track who got the vaccine, and ensure they come back for a second dose? Everyone talks about "infrastructure", but what do they mean?

I have some good news, and some bad news.

On the one hand, some important work has been happening behind the scenes at the CDC and at HHS OS.

On the other hand, not being able to discuss this work publicly, and the lack of explicit coordination with states is a huge problem.

First: The long-standing project from the HHS CTO's office: The Immunization Gateway. https://www.hhs.gov/cto/initiatives/public-health-innovation/immunization-gateway/index.html
This is basically exactly what is needed! Connects states, private organizations, and other entities responsible for immunizations, and allow query/response.

Immunization (IZ) Gateway

The Consumer Engagement for Immunization Information Systems (IIS) Project encourages consumer access to immunization records.

https://www.hhs.gov/cto/initiatives/public-health-innovation/immunization-gateway/index.html

But some bad news...the CTO's office has always suffered from a lack of statutory authority and integration with other, operational agencies. Great ideas, great people, needs more support from leadership and funding. And recently, it was de-facto rolled into the CIO's office.

Why does it matter? @seanessee just gave us some ideas: https://twitter.com/seanessee/status/1328727532351361025?s=20

https://twitter.com/seanessee/status/1328727532351361025?s=20

Just like every other part of our public health system across 50 states and 14 territories (yikes), investment in immunization registries has varied. There is no consistent way to track who has received immunizations, and no widely adopted "immunization gateway".

But as I mentioned, the Immunization (IZ) Gateway already exists. It's multi-stakeholder. But it's not required, and it, and the rest of the "infrastructure" to onboard IIS is missing in most cases.

We're just a few weeks/months (hopefully) from the first EUA vaccine doses being delivered to our COVID first responders. We need to make sure that those doses are traceable beyond what is available in closed EHR systems. We need de-identified data for broad public health use.

The IZ Gateway can do this.

Separately, it's time for public health infrastructure development to be front and center, in particular in a Biden administration.

And of course my addendum: Career federal employees are working 24-7 on these programs. You may not see it, but it's happening. We must get visibility and funding to their work.

Additionally (and you knew I was going to say this), community and statewide HIEs can help states get connected to their IIS and the IZ Gateway, and can fill in missing demographic information and deal with patient matching issues.

me!