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August 2021 Monthly Update


Monthly Update


August 2021 in Review




Executive Director's Update


The end of summer is upon us. August was filled with meetings and conferences and an unfortunate reminder that the pandemic is still here as an unwelcome fourth wave hit most of our country. The month started with the AIRA 2021 National Meeting. It was so exciting to see each other in person and virtually for folks who attended the meeting online. Given that we’re still entrenched in the pandemic and COVID-19 vaccine response work, we weren’t sure what attendance would look like this year. It’s safe to say that it exceeded our expectations! You can find out more in the National Meeting recap article below, including the number of attendees and some fun pictures.

Right after the National Meeting, many people attended the HIMSS21 Global Health Conference & Exhibition. HIMSS21 offered the IIS community and others many different ways to engage and network with AIRA staff, including an AIRA Info Session and a presentation by AIRA staff on the Immunization Integration Program (IIP). Learn more about what’s happening with the IIP in the article below.

August rounded out with the 2021 Strategic Health Information Exchange Collaborative (SHIEC) Annual Conference. AIRA was part of a panel presentation to introduce the Immunization Data Exchange Advancement and Sharing (IDEAS) Program, which is a project with the Office of the National Coordinator (ONC) and the Association of State and Territorial Health Officers (ASTHO). AIRA, the Association of Immunization Managers, SHIEC, and others are strategic partners working with ONC and ASTHO on this important project. You can learn more about the project and the SHIEC Annual Conference in the article below.

Chances are you’ve heard about the Vaccination Credential Initiative (VCI) and SMART Health Cards at recent meetings and conferences, and your organization may be part of this work as well. National Meeting attendees got to hear from VCI about this important work and AIRA continues to gather and document common terminology and references in the Vaccine Credentials: Context and Working Definitions for IIS working guide. We will continue to update you and the guide as we learn more about vaccine credentialing solutions.

Making the rounds of hot topics are clinical trial vaccines and their addition to an IIS. AIRA is working with manufacturers and jurisdictions to develop a best practice guide for how best to capture this information for COVID-19 vaccines. If you have any questions or if you have experience adding this information to your IIS, we would welcome your thoughts and comments.

The end of summer and start of a new school year brings with it a lot of uncertainty and anxiety. Just know we’re all in this together and AIRA staff are here to help. Please don’t hesitate to reach out if you need us.

Thank you,

Rebecca Coyle, MSEd

Executive Director


AIRA 2021 National Meeting Recap

AIRA was excited to host the IIS community at the AIRA 2021 National Meeting in Portland, Oregon, and virtually on August 3–5, 2021. This year’s meeting was a hybrid event with both in-person and virtual components. The meeting was a success in so many ways. The fact that we were able to host an in-person event was a success in and of itself, but the turnout far exceeded our expectations! There were 468 total attendees—187 were in person, and 281 attended virtually. Between in-person and virtual attendees, 50 of the 64 IIS jurisdictions (78%) were represented.

In addition to our fabulous speakers and presenters, we also recognized our colleagues from across the IIS community as part of this year’s award recipients. You can find a complete list of award recipients on our website. A special, bittersweet recognition was given to Bill Brand of the Public Health Informatics Institute, who recently retired after 30 years of working in public health and IIS. Bill has been an IIS advocate who has formally worked in the IIS community and has served as an informal mentor to many of us. Thank you for your service, Bill!

In true National Meeting fashion, AIRA staff put on a hilarious, yet educational, game show that took attendees on a journey along the Oregon Trail. Just like in the original game, contestants navigated obstacles along their trek, but this modernized version included a COVID twist. Congratulations to the teams who made it to the end of the trail!


AIRA 2021 National Meeting presentations are available in the AIRA Repository. You can find presentations easily by filtering on "National Meeting Presentations" and "2021." You can also view the presentations on the National Meeting webpage. Select the full meeting agenda and click on the listed presentations of interest.


We’re already looking forward to hosting the next National Meeting, however, we don’t have dates or a location yet. We’ll share our plans as soon as we have them. We look forward to connecting with you in person again soon!

Mike Bin and Jeff Chorath

Jeffrey McIntyre and Mary Woinarowicz

Pictured: Jeff Chorath from the Washington State Department of Health attempts to identify and remove "bad data" from a jar of candy using only chopsticks and sheer skill.

Pictured: AIRA board members Jeffrey McIntyre, Mississippi State Department of Health, and Mary Woinarowicz, North Dakota Department of Health



AIRA's Participation at SHIEC

AIRA had the opportunity to attend and present at the 2021 Strategic Health Information Exchange Collaborative (SHIEC) Annual Conference on August 16–18 in Scottsdale, Arizona. During the conference, SHIEC announced it was merging with the Network for Regional Healthcare Improvement to form a new organization called Civitas Networks for Health. The merger will be official on October 1, 2021. Together, they will continue to work for community- and data-led health improvement and information exchange to tackle challenging health care issues.

Several conference sessions focused on highlighting interoperability successes during the COVID-19 vaccine response with a focus on community-centric approaches. AIRA presented as part of a panel, joining partners from the Office of the National Coordinator (ONC), the Association of State and Territorial Health Officers (ASTHO), the Association of Immunization Managers (AIM), and SHIEC to introduce the ONC Immunization Data Exchange Advancement and Sharing (IDEAS) Program.

In January 2021, ASTHO was engaged by ONC to develop and implement the IDEAS Program. The program has two primary objectives: (1) to explore and assess ways to establish and scale sharing of the COVID-19 Vaccine Reporting Specifications (CVRS) file between a jurisdiction's IIS and a health information exchange (HIE) and (2) to build on existing relationships between states and jurisdictional HIEs to promote vaccine data sharing. To ensure successful achievement of these objectives, ASTHO also engaged key immunization and HIE experts, including AIRA, AIM, SHIEC, Mathematica, and Guidehouse. AIRA looks forward to strengthening our partnerships with these organizations as we work together on this new project.


A Call to Action to Increase Adult Vaccination Coverage

The National Adult and Influenza Immunization Summit (NAIIS) issued a call to action to increase vaccination coverage among US adults. The NAIIS is co-led by the CDC’s Health and Human Services Office of Infectious Disease and HIV/AIDS Policy and the Immunization Action Coalition.

Despite documented health benefits of adult vaccination, adult vaccination coverage rates remain low in this country, and these rates have been further reduced by the COVID-19 pandemic. NAIIS members urge all health care providers to implement strategies that will improve routine vaccination of adults.

NAIIS calls on all clinicians, health care providers, and occupational health specialists to follow the National Vaccine Advisory Committee (NVAC) Standards for Adult Immunization Practice. The standards urge providers to:

  • Assess the vaccination status of patients at each clinical encounter, including providers who do not stock vaccines.
    • Use the local IIS to view patients’ prior vaccinations to support vaccine needs assessment.
  • Identify the vaccines each patient needs, then clearly recommend those needed vaccines.
  • Offer needed vaccines or strongly refer patients to another provider for vaccination.
  • Document vaccinations given, including in the local IIS.
    • Many electronic health record (EHR) systems already link to the IIS. Providers should check with their EHR administrators.
    • Providers not already using an IIS should contact their local or state immunization programs to inquire about enrolling in the IIS.
  • Measure vaccination rates of each provider’s patient panels. Make changes to clinic patient flow and take other steps to address barriers to patient vaccination.


Standards and Analytics TA Corner

The AIRA Standards and Analytics Team responds to technical assistance requests submitted by the IIS community. Here a few of the hot topics from the past month that may be helpful to your work.

Additional and booster doses in IIS
You may be wondering how additional doses of COVID-19 vaccine for immunocompromised individuals should be indicated via HL7 message versus a booster dose (if recommended). Guidance from CDC says there is no expectation to report the indication/intent for additional COVID-19 doses for immunocompromised individuals versus booster doses. For documenting via HL7, additional COVID-19 doses for immunocompromised individuals and/or booster doses should be transmitted in the same way as other vaccines recommended by the Advisory Committee on Immunization Practices (e.g., Hib vaccine boosters, high-risk pneumococcal vaccine, etc.).

Fast Healthcare Interoperability Resources (FHIR) and IIS
The FHIR standard builds on previous standards, such as HL7, to offer additional technologies to expand the ways information can be exchanged. An AIRA 2021 National Meeting presentation on the incorporation of FHIR in IIS interoperability yielded some exciting ideas for how this new technology could be used. We are interested in learning more from the IIS community, including how you use or plan to use FHIR. Please email Assiatou Diallo with a short description of your current projects. Your feedback will be used to help us draft a road map for the implementation of this new standard.

Vaccine credentials
AIRA is recruiting interoperability subject matter experts for the Standards & Interoperability Steering Committee small groups. These month-long groups develop guidance and implementation strategies on immunization topics. Upcoming topics include:

  • Creating a vaccine credential on a PDF
  • Creating a PDF response via HL7
  • Creating a PDF response via FHIR
  • Immunization history and forecast via FHIR query

If you’re interested, contact Assiatou Diallo. We also welcome future small-group topic suggestions.

Interop course
We are preparing to launch the next edition of the AIRA Interoperability Course this fall! Please contact Assiatou Diallo if you are interested in signing up.


Measurement and Improvement Updates

Is your IIS vendor product validated?
AIRA and members of the Measurement for Assessment and Certification Advisory Workgroup (MACAW) have heard from both individual IIS and IIS vendors about a desire to use results from independent testing to help IIS programs better align with national standards and inform the contracting and procurement processes. Increasingly, contract language within the IIS community needs alignment with IIS Functional Standards. All Measurement and Improvement (M&I) content areas are driven by the IIS Functional Standards and provide results that can be shared to show alignment with standards. To support this process, AIRA added an opportunity for vendors to test and validate their base product within the M&I Initiative. Participation in this process will allow individual IIS and IIS vendors to support each other in alignment with national standards. The results can be shared with current and potential IIS customers.

The Aggregate Analysis Reporting Tool (AART) will display basic and complete levels of Validation for IIS vendor-based products. As indicated in the image to the right, Validated products will have the word “Product” on the Validation badge to easily differentiate an IIS vendor product from individual IIS within AART. We recognize that testing results may differ between a base product and an installed instance of that product, depending on application configuration settings, hosting, and production environmental factors.

If you want to participate or need more information, contact Shalena Prude.

Validation badge

DAR badge

Data at Rest is now in Testing and Discovery
AIRA will measure patient and vaccination data quality from a cohort of newborns to 2-year-olds. The data quality indicators of completeness, validity, and timeliness are measured in this content area. Data at Rest Testing and Discovery will include a triangle as seen in the image to the left. This is similar to the pentagon report seen in HL7 and Clinical Decision Support Testing and Discovery.

Have questions or need help? AIRA’s technical assistance team is ready to help you understand your Aggregate Analysis Reporting Tool dashboard and results, prioritize work, and support your movement toward better alignment with standards. Don’t hesitate to contact us for technical assistance. We can quickly answer a question or dive deeper into topics, such as assisting you and your IIS technical development team with better understanding of issues and making plans to more fully align with standards. Fill out a Technical Assistance Request or contact Shalena Prude for more information.



Committee and Workgroup Updates: August Recap

Measurement for Assessment and Certification Advisory Workgroup (MACAW)

  • MACAW met on August 12.
  • Assiatou Diallo updated the workgroup on Data at Rest in Testing and Discovery.
  • The workgroup also received a demo on the new Aggregate Analysis Reporting Tool User Interface Enhancements.
  • MACAW discussed the nest steps for Data Quality Incoming (DQI)/Ongoing and received an update on the DQI Validation document.

Modeling of Immunization Registry Operations Workgroup (MIROW) Steering Committee

Standards and Interoperability Steering Committee (SISC)

  • The SISC met on August 11.
  • Mary Beth Kurilo gave an update on the AIRA 2021 National Meeting, HIMSS21 Global Health Conference & Exhibition, and the Office of the National Coordinator Electronic Health Records Reporting Task Force.
  • The SISC was polled about small group topics by Assiatou Diallo.
  • The committee also discussed the United States Core Data for Interoperability immunization data elements.
  • The next committee meeting is September 8, 2021, from 1 to 2 p.m. ET.

NOTE: Meeting minutes will capture only action items and decisions made. Recordings of the meetings can be obtained directly upon request by emailing This email address is being protected from spambots. You need JavaScript enabled to view it..


AIRA Job Opportunities

Are you interested in working for AIRA or in the IIS community? Find current job openings at AIRA and other states/jurisdictions on the Employment Opportunities and Requests for Proposals page on the AIRA website.

AIRA is looking for a Technical Assistance (TA) Analyst to ensure we’re meeting the TA needs of the IIS community. The person in this position will help operationalize AIRA’s Customer Relationship Management (CRM) system to fulfill the needs of the entire organization, coordinate internal communication between teams to help inform AIRA staff offering TA, perform data extracts and analysis from the CRM to understand trends, develop and implement processes and documentation to improve the use of the CRM throughout AIRA, oversee and manage weekly data quality monitoring, and foster relationships with AIRA members and staff. Please share this information with anyone who is interested and qualified. Send complete application packages, including an AIRA Job Application, to This email address is being protected from spambots. You need JavaScript enabled to view it. by September 17, 2021.

Opportunities for independent contractors

Sign up to get notifications of future contracting opportunities.

  • There are no opportunities at this time.


AIRA In the News - August 2021


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