Vaccination Programs: Client-Held Paper Immunization Records
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) finds insufficient evidence to determine whether client-held paper immunization records increase vaccination rates. Studies reported inconsistent findings on a variety of programs.
The full CPSTF Finding and Rationale Statement and supporting documents for Vaccination Programs: Client-Held Paper Immunization Records are available in The Community Guide Collection on CDC Stacks.
Intervention
Client-held paper immunization records document an individual’s vaccination status. Clients or families use them to track status and see which vaccinations are recommended. Healthcare providers use them to determine when and where clients receive vaccinations. Records may be used alone or with more comprehensive health records.
About The Systematic Review
The CPSTF finding is based on evidence from a Community Guide systematic review completed in 2010 (7 studies, search period 1980-2009) combined with more recent evidence (1 study, search period 2009-February 2012). This updates and replaces the 2010 finding for Client-Held Paper Immunization Records.
Study Characteristics
- Studies used client-held paper immunization records as part of multicomponent efforts
- Comparison groups received one or more interventions
Summary of Results
Eight studies with 11 study arms were included.
- Overall vaccination rates increased by a median of 5.3 percentage points (6 studies with 9 study arms)
Summary of Economic Evidence
An economic review was not conducted because CPSTF did not have enough information to determine if the intervention works.
Applicability
Applicability was not assessed because CPSTF did not have enough information to determine if the intervention works.
Evidence Gaps
- How effective are activities aimed at increasing the retention and use of client-held paper immunization records for children by their parents or other caregivers?
- What is the impact of electronic health records or immunization information systems on intervention effectiveness?
Implementation Considerations and Resources
Paper immunization records may be useful when used consistently, when providers update them and parents keep track of them. Children are more likely to receive recommended vaccinations and avoid over-vaccination, especially in nontraditional settings like emergency departments.
Barriers include clients’ declining interest over time, low card retention, and healthcare providers’ concerns about time management.
Paper records will continue useful until issues of privacy, security, and quality of electronic records are resolved, and for clients on the other side of the “digital divide.”
No harms were identified.