This document discusses recommendations from the American Immunization Registry Association's Modeling of Immunization Registry Operations Work Group regarding decrementing inventory via electronic data exchange. It defines key concepts like storage model, dose-level eligibility, and dose-level public/private indicator. The storage model describes how vaccines are separated in storage by factors like lot number, expiration date, and fund type. Dose-level eligibility and indicator determine the funding program and public/private status of each administered vaccine dose.

1. Recommendations of the
American Immunization Registry Association (AIRA)
Modeling of Immunization Registry Operations Work Group (MIROW)
March 29, 2016
Decrementing Inventory
via Electronic Data Exchange

2. MIROW Best Practices for Decrementing Inventory via Electronic Data Exchange | 2016 9
Roster: Modeling Immunization Registry Operations
Workgroup (MIROW)
Co-Chairs:
Warren Williams, MPH
MIROW Steering Committee Co-chair
Acting Chief
Immunization Information System Support Branch
Centers for Disease Control and Prevention
Phone: (404) 639-8867
E-mail: wxw4@cdc.gov
Elaine Lowery, JD, MSPH
MIROW Steering Committee Co-chair
Public Health Consultant
AIRA
Phone: (303) 881-2440
E-mail: Elaine.Lowery@comcast.net
American Immunization Registry Association (AIRA)
Rebecca Coyle
Executive Director
AIRA
Phone: (202) 527-7000, ext. 2
E-mail: coyler@Immregistries.org
Nichole Lambrecht, MSc
Senior Project Manager
AIRA
Phone: (202) 470-0026
E-mail: nlambrecht@immregistries.org
Ketti Turcato
Coordinator
AIRA
Phone: (202)759-0186
E-mail: kturcato@immregistries.org
Business Analysis
David Lyalin, PhD
Business Analysis and Facilitation
Public Health Analyst
Immunization Information System Support Branch
Centers for Disease Control and Prevention
Phone: (404) 718-4594
E-mail: dil8@cdc.gov
Angela Lindsay, MS IT
Business Analysis and Facilitation
Business Analyst III
IHRC, Inc.
Phone: (678) 371-8523
E-mail: nai8@cdc.gov
Subject Matter Experts:
Brandy Altstadter
IWeb Support Manager
Scientific Technologies Corporation (STC)
Phone: (602) 241-1502
E-mail: brandy_altstadter@stchome.com
Jennifer Bednar
Business Analyst
Hewlett Packard Enterprise (HPE)
Phone: (512) 319-4238
E-mail: jennifer.bednar@hp.com
Danielle Hall
Planning and Research Associate
Maine Immunization Program
Phone: (207) 287-4693
E-mail: danielle.hall@maine.gov
Janet Fath, PhD
Acting IISSB Operations Team Lead
Immunization Information System Support Branch
Centers for Disease Control and Prevention
Phone: (404) 639-6070
E-mail: azf2@cdc.gov

3. 20 American Immunization Registry Association
Storage model
When the provider organization receives a vaccine shipment, the doses are quickly stored within a storage unit (i.e., a
refrigerator or freezer). Storage model describes the way vaccine stocks are physically separated from each other in
the provider organization’s storage unit. Provider organizations separate vaccine by lot number and lot number
expiration date. However, depending on the awardee’s requirements, the provider organization may also need to
separate the vaccines by fund type (e.g., separate containers for doses funded by VFC, 317, state, CHIP, and private), or
may be allowed to have less specific categories (e.g., VFC public, non-VFC public, and private). All vaccine doses
purchased by a particular program are referred to as that program’s “stock” or “inventory” (e.g., VFC public stock,
non-VFC public stock, and private stock). See the Vaccine storage models section below for more details. Separating
vaccines helps to achieve better accountability for each dose and to ensure that only patients that are eligible for a
funding program receive a vaccine funded by that particular program. In the case of the 10 doses of 317-funded
vaccine for uninsured adults, the doses would be arranged in the storage unit according to the appropriate storage
model (e.g., separate from VFC, CHIP, state, and private doses). The Vaccine storage models section of this chapter
discusses storage models in more detail.
Dose-level eligibility
Dose-level eligibility describes a patient’s eligibility for a funding program (such as VFC, 317, etc.); it is determined for
each dose administered (for details, see the MIROW 2011 IIS Collaboration with VFC and Grantee Guidelines [1.4]).
Dose-level eligibility is determined for a patient at the time of the vaccination event. In addition to indicating a patient’s
eligibility for a particular funding program, dose-level eligibility reported by a provider organization to an IIS may also
serve as a proxy (i.e., substitute, representation) for fund type.
Dose-level public/private indicator
Once the provider knows the patient’s dose-level eligibility, they select the dose of vaccine from the storage unit based
on the patient’s eligibility. When the provider documents the vaccination event, they may include the specific fund type
of the dose administered, or they may document less specific categories (e.g., VFC public, non-VFC public, and
private). These less specific categories are referred to as “dose-level public/private indicator,” since the data element
identifies if the dose administered was purchased with public or private funds. If the data element is included in the
provider organization’s EHR, it can transmit dose-level public/private indicator to the IIS through an EDE. The term
“dose-level public/private indicator” corresponds to the term “funding source” in the HL7 specifications. See Figure 2
below for an example of when inventory is stored in two stocks (public and private).
Figure 2. Dose-level public/private indicator (funding source) vs. fund type
The provider assigns the dose-level public/private indicator for each administered vaccine dose based on the stock the
particular vaccine dose was pulled from in the provider organization’s storage unit. An explanation of how a provider
determines how to separate vaccine stocks in a storage unit is in the Vaccine storage model section below. Given the
relationship between storage models and fund type, dose-level public/private indicator can be described as an
aggregated reflection of fund type at the vaccine dose-level.
Public
Dose-level Public/Private Indicator
(i.e., Funding Source)
Private
Dose-level Public/Private Indicator
(i.e., Funding Source)
VFC
Fund
Type
Private
Fund
Type
317
Fund
Type
State
Fund
Type
CHIP
Fund
Type