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Philadelphia is poised for the rollout of a coronavirus vaccine, whenever it finally happens. An estimated 95% of residents already have their immunizations tracked in the city’s system, a secure database whose comprehensiveness rivals any in the U.S.
That robust vaccination registry might be why the Centers for Disease Control and Prevention in August selected Philadelphia as a pilot site for a COVID vaccine, Health Commissioner Dr. Tom Farley suggested at the time. Philly was the only city to be chosen, alongside four states, to put forth a potential distribution plan.
In the weeks since, the federal government’s plans changed — and Philly was basically un-selected, WHYY reports. Not that it was replaced by another municipality. Instead, the CDC pivoted and is now asking for vaccine distribution plans from every city and state in the country.
Still, local officials say PhilaVax, the immunization record founded in 1994, will play a key role in the coming months and years. It’s “the glue that holds our public health work together,” said Health Department spokesperson Jim Garrow.
More than 800 medical providers already report to the database, so Philly won’t have to start from scratch in tracking coronavirus vaccinations, as many government health systems might.
In the coming months, the city’s data scientists will be working to enhance the system. One important update: Tracking vaccinations across county lines, which health officials say will be essential to making sure people in the region are effectively immunized.
“There are limits to how much of the vaccine is delivered to Philadelphia,” Garrow said. “We want to make sure people are being counted across city and state lines.”
How did the city’s immunization system come to be so robust in the first place? What happens to the data there, and how will it be used to battle the pandemic? Read on for everything you need to know.
Called PhilaVax, the system is the Department of Public Health’s database of all immunizations that have been administered in the city since 1994.
Yup, each time you’ve gotten your flu shot, or a vaccine preventing HPV or tetanus, or when you’ve taken your kid to get their measles immunization — it’s all been recorded in this database. That is, so long as your healthcare provider participates in the system.
Not much. All the data is totally confidential, and you can’t even get into the system without a provider login.
After nearly three decades, the system has become highly efficient. There are roughly 800 providers that feed into the database. It’s not mandatory, but all the city’s major health centers do it, plus a ton of private practices and even school nurses.
Each time a patient is vaccinated for any illness, the provider can submit data electronically, in real time. If they prefer, they can also report manually, by mail or fax.
With this system, your personal immunization record stays up to date with the city. City officials and your doc can both keep tabs on whether you’ve gotten the necessary vaccinations, and follow up with you if there’s something you’re missing. If you’d rather not be included, you have to specifically ask your provider to opt out — something Health Department officials say is rare.
For one thing, the system makes it easy to measure the city’s total immunization rate — particularly among children, for whom up-to-date vaccines are essential.
The CDC measures vaccination rates using responses to their National Immunization Survey. Philly has it easier — the city doesn’t have to distribute such a survey, because data collection is built into the immunization process.
Also, the portal is especially helpful for doctors who are distributing vaccines that need two or more doses — which medical experts expect the coronavirus vaccine will require.
When the HPV vaccine first came out, Garrow said, this software came in handy — it helped remind doctors which of their patients had gotten one dose, but not the second. It lets health providers know to reach back out to patients who might have forgotten they need a second dose to actually develop immunity.
Added bonus: Since it’s a citywide database, if you get one dose from one health center, and the second from another, PhilaVax will know. Doctors don’t have to scramble to duplicate their efforts.
And if PhilaVax staff notice that a particular private practice or health center has high rates of missing vaccines, they’ll reach out and ask them to check in with patients.
The software was first created in 1994, after a push from the CDC to set up repositories like it all over the country. Philly got funding from the Robert Wood Johnson Foundation, and built its system.
Then, it was called KIDS, and focused on tracking immunizations for children up to 6 years old. Eventually, the system evolved to include adults too.
Philly was among the first local jurisdictions to do it. By 2000, it was among only six cities in the U.S. with such a repository. The others were Washington, D.C.; Chicago, Illinois; Houston, Texas; New York, New York and San Antonio, Texas.
It’s hard to track this number, since the repository includes records going back 26 years — including people who’ve since moved away or died. But Health Department officials do know that 95% of Philadelphians are included in the database, spread across 800 providers.
Turns out, a central data repository like this still isn’t all that common among cities. At the start of 2020, 49 states had vaccine registries — New Hampshire being the exception, and they’ve since started making one.
Then there are 14 systems operated by cities like New York and San Diego, and U.S. territories like American Samoa. Before the coronavirus hit, the CDC kickstarted the IZ Gateway — a project encouraging more localities to develop registries.
There’s a major limitation to Philly’s system: It doesn’t communicate with the state or neighboring counties. So if someone gets, say, the first round of their coronavirus vaccine outside the city — Philly’s database might not know it.
They might give them the first round all over again, give them another type of vaccine — or not be aware of their vaccination status at all.
That means for now, the task at hand for the PhilaVax team is to set up better inroads to communicate with our neighbors.
“There’s definitely a lot of thought and data work to be done to make sure that all these different systems can talk, and do so in basically a real-time fashion,” said Garrow, the Health Department spokesperson.
Having this infrastructure already in place will no doubt offer an advantage in distributing the coronavirus vaccine, whenever we get it. We’ve got leverage over the many cities and counties across the country that don’t keep unified track of vaccinations.
Meantime, the Health Department’s data scientists will be working to build a new section of the registry to keep tabs on the brand new immunization.
“It’s really adding in a whole new piece to the registry and how that registry functions,” Garrow said, “which folks who work on this are just starting to undertake.”