Washington state's database of adult vaccinations is "incomplete" and "inaccurate," a group of King County doctors says, leading some to worry that the system may complicate efforts to eventually vaccinate residents for COVID-19.
The King County Medical Society says doctors can't reliably use the state's database to find out who's been vaccinated for what because reporting vaccinations to the state is optional for health care providers, not mandatory.
"During a crisis such as the current COVID-19 pandemic, we know that inefficiencies, redundancies, and delays can cost lives," leaders of the medical society wrote in a March memo to members. The King County Medical Society represents some 4,000 doctors.
The state's database, the Washington State Immunization Information System, was designed to track childhood vaccinations, but has since been expanded to capture adult vaccinations.
However, doctors with medical society say, many records of adult vaccinations are missing.
They say that's because people move around and receive vaccinations in a variety of places, including hospitals, clinics and pharmacies, and because some health care providers have older electronic medical records systems that are not connected to the state's database.
Health care workers' immunization records also remain in "silos" in individual human resources departments, and not connected to the state database, doctors with the medical society say.
"We're faxing information back and forth," said Dr. Rajneet Lamba, a doctor at EvergreenHealth in Kirkland and president of the medical society's board. "It’s surprising the amount of communication that we still do in health care using a fax machine."
Several efforts are underway to develop a COVID-19 vaccine, including a trial in Seattle. It's unclear when a vaccine may be widely available.
Lamba said he's worried the state's immunization database isn't equipped to track efforts by doctors to quickly vaccinate large numbers of people for COVID-19.
"With multiple candidate vaccines, you'd of course want to know which vaccine was given," Lamba said. "There's going to be multiple trials. Phase one, phase two, phase three. These will be different sized trials. You'll want to know who got which vaccine."
State officials, in an email responding to the doctors' concerns, said one of their top priorities is assessing whether the tracking system "is prepared to track and report on a novel coronavirus vaccine when one becomes available."
Officials also pushed back against criticisms of the database, saying, "Washington already has some of the highest rates of immunization data in our state registry."
"We appreciate that the society wants to support public health measures and immunization efforts in Washington," state officials said in a response passed along by COVID-19 response spokeswoman Barbara LaBoe. "However, nationwide there is no correlation between the amount of data in a state’s (immunization database) and whether the state has mandatory reporting."
State officials said they've already taken a step called for by the medical society: obtaining funding to connect medical records systems from individual health care providers to the state's system. State officials say $250,000 was allocated toward the effort in 2019.
But some doctors say they're still dealing with holes in the system — a problem they say has worsened as adults get more vaccines over the course of a lifetime.
"We're seeing adults who have absolutely no clue what they've had," said Dr. Francis Riedo, who leads infection control efforts at EvergreenHealth and has called for improvements to Washington's database for years.
"I'm actually in clinic every day and we're constantly looking up vaccine records," Riedo said. "We're seeing diabetics who haven't had their tetanus vaccines or their hepatitis B vaccines. We're seeing elderly people who haven’t had their flu shots, their pneumonia vaccines, their shingles vaccines. Or you start asking and they say, 'Well, I think I got it at this pharmacy.' But you don’t know that because it’s not in the Washington state database."
He also worries about health care providers losing track of who's been vaccinated for COVID-19 once a vaccine is available.
"Who's giving all these vaccines, I guarantee you, will be more than just the doctors and hospitals,” Riedo said. “It will be pharmacies and clinics everywhere. And I think it's imperative that that information be placed into the Washington State Immunization Information System database."
He added that he believes there should be a national vaccine database, but the United States has no such system.