Measuring the Success of the US COVID-19 Vaccine Campaign

It's Time to Invest in and Strengthen Immunization Information Systems

Jade Benjamin-Chung, PhD, MPH; Arthur Reingold, MD


Am J Public Health. 2021;111(6):1078-1080. 

Abstract and Introduction


With the recent US Food and Drug Administration approval of the Pfizer-BioNTech and Moderna SARS-CoV-2 vaccines, the United States has begun COVID-19 vaccine dissemination. The vaccination program is historic in its massive scope and complexity. It requires accurate, real-time estimates of vaccine coverage to assess progress toward achieving herd immunity. Under Operation Warp Speed, the US Centers for Disease Control and Prevention (CDC) has constructed a federal database, or "data lake," to monitor vaccine coverage nationwide and ensure that recipients receive both of the necessary doses. The data lake will be managed separately from existing state and local immunization information systems (IISs), which house vaccine data in all 50 states, five cities, the District of Columbia, and eight territories. In an open letter to the Director of the CDC in late 2020, four organizations representing immunization managers and public health officials expressed concerns about the plan to include vaccine recipients' personal identifier information in the data lake.[1] They also urged stronger coordination with IISs.

We wholeheartedly agree with both points. While some IISs have limitations, including incomplete data and poor linkage with electronic health records (EHRs), they also have a track record of success, as during the 2009 H1N1 influenza pandemic.[2,3] The current moment demands that IISs be strengthened. With enhanced IIS data quality, we can reduce health inequities and conduct more rigorous evaluations of vaccine campaigns. Given the current limitations of IISs, the planned data lake may be a necessary stopgap for the COVID-19 vaccine program. However, the pandemic has radically increased public awareness about the value of the public health enterprise. We must seize this unprecedented opportunity to achieve long-standing goals to increase funding and streamline policies for IISs.