January 23, 2019

New Hampshire has been the only state in the United States without an electronic immunization registry that is functioning to allow vaccine information to be safely stored and searchable in an electronic database.

The concept of a functional vaccine registry is to have a confidential, population-based, computerized information system that collects vaccination data of the people living in a state. This is time saving and provides a significant amount of data.

A state vaccine registry can allow providers to determine appropriate vaccines for their patients. This prevents patients from getting inappropriate vaccines at inappropriate times and delaying vaccines due to unknown immunization history. 

At a population level it gives information to improve vaccine rates in communities where rates are lower than needed to provide herd immunity and help prevent vaccine-preventable disease.  This allows for targeted education and resources where needed. A vaccine registry helps residents keep a safe, permanent record of their vaccinations. It also helps providers when new patients arrive at their clinic without records, to be able to determine the immunization status of the patient and make appropriate clinical decisions based on this information.

There is new legislation, SB179, being pushed by a pharmaceutical manufacturer to allow pharmacists to administer all adult vaccines at their locations. Given the concerns that have been raised without a state registry and the current lack of communication between pharmacists and primary care practitioners, I believe the Medical Society must vigorously oppose this bill. Patients should not be put at continued risk of receiving inappropriate vaccines at inappropriate times until New Hampshire’s vaccine registry is in place and fully operational.

Pharmacists have been inconsistent in notifying primary care practitioners when administering vaccines and inconsistent in obtaining appropriate history from the patients (from patient or by contacting the PCP for records). There are numerous reports of patients receiving inappropriate vaccines from pharmacists due to lack of knowledge of a patient’s risk factors or administering a repeat dose of a vaccine they had already received. This is totally unacceptable, inappropriate and substandard patient care.

The first priority should be to establish a functioning state vaccine registry to share information about patients and then to further discuss allowing for increased access points for administration of vaccines.

I welcome your thoughts and can be reached at tlafortune187@outlook.com.

Tessa Lafortune-Greenberg, MD
NHMS President