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Public Health Rep. 2002 Jul-Aug;117(4):386-92.

Immunization registries: costs and savings.

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Boston Public Health Commission, Communicable Disease Control Program, Boston, MA 02118, USA.



The objectives of this study were to quantify the actual costs of developing, maintaining, and operating the Boston Immunization Information System (BIIS), an electronic registry and tracking system, and to compare the registry's costs with those of performing the same functions manually.


Cost data were obtained from 23 BIIS health care sites, the city health department, and 13 control sites. Actual costs of developing and operating BIIS in 1998 and projected 1999 costs for a hypothetical expanded registry were measured. Total costs of registry-supported immunization activities were compared with the costs of similar types and volumes of manual activities.


The total annual cost of developing, maintaining, and operating BIIS in 1998 was $345,556. Annual total cost per record was $5.45 for all children aged <23 years and $10 when costs were distributed only among active users (children <8 years old). Operating BIIS saved $26,768 in 1998, compared with manual performance. The hypothetical projected total cost of an expanded BIIS in 1999 would have been $577,919, with a projected savings of $689,403 compared with manual costs.


Electronic immunization registries potentially offer an efficient tool for the delivery of immunization services. Registries can save substantial funds if their data are kept up-to-date, and if caregivers are willing and able to use the registries routinely.

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