Problem solved: How do you track adult vaccination?

Engage patientsThe problem is now we have others outside the primary care office vaccinating, including public health and very commonly pharmacists. I have no issue with whoever gives the vaccine, but I need to be told that it was given, so I can update the chart. I feel that it is mandatory (but not happening) for a fax to be sent by the pharmacy to the primary care provider when a vaccine is given so we can do so. Just giving the patient a slip of paper is fraught with hazard as most do not make it to the clinic. It’s the responsibility of the family doc to be the keeper of the patient record, so all parts of the system need to help us do so! Having said that, here are a few possible ways:Have the patient enter them as they get them (as well as putting in their old ones) in an app called CANImmunize. It is far from perfect but is a potential digital repository for patients that then can be shared with the clinician.In Ontario, give patients a yellow immunization card and have them keep track of their record. (Other provinces have similar.)Keep track of vaccines in a section of your chart (if paper), or if EMR, in a prevention section.Annual physicalsI use annual physicals as an opportunity to ask patients about their vaccination status and update any vaccines they have gotten from pharmacies. This is also a good time to talk to patients if they have any hesitations about vaccinations and address their concerns. Our clinic also has nurses that run flu vaccine days, and we send out an email blast to patients reminding them to get the flu shot. Some patients will inform us that they have already gotten their vaccine and we will update their records accordingly.Central registry?I do my best to address the patient in front of me to review the vaccines they require and offer prescriptions for those not covered. But I also realize that for me to adequately and comprehensively address all medical issues, including vaccines for all my patients, I would need to work at least 27 hours per day. My EMR shows the vaccines given when I look up each patient, but it can be difficult to be aware of those given at pharmacies and elsewhere. A central vaccine registry could be helpful, but I fear it could become an additional administrative burden for family docs also.Get patients to trackAs an ER doctor, I usually am most concerned about tetanus status—I’m quite religious about making sure patients’ tetanus is up to date (within the past 10 years) and, if not, to update it. If they don’t know, I just give it to them and let them know it’s good for 10 years. Normally I’m giving the Tdap now to cover pertussis, too, since it seems to be making a comeback. I encourage patients to make their own vaccine records to help keep track of vaccinations from pharmacies, doctors’ offices, etc. For guidance in what immunizations patients should get, I recommend the official Canadian government site. Though not perfect, it’s a good start.

Problem solved: How do you track adult vaccination?

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