Reports that the smallpox vaccine may offer protection against monkeypox has baby boomers searching for the vaccine’s distinctive scar while fielding texts about vaccination status from adult children. An increase in polio cases in New York created additional vaccine record searches. All of these, combined with people keeping track of their Covid-19 vaccinations and boosters, have more people concerned about their vaccination histories than ever before. If that sounds familiar, there are some things you can do to fill in the gaps in your memory, before you talk to your doctor about what you may need.
Physicians such as Fred Salley support maintaining vaccination records. He says that “people who received the smallpox vaccine are somewhat protected against monkeypox, so it is beneficial to have this information.” He adds that vaccination records are necessary so medical staff know, for example, which type of shingles or pneumonia vaccine was administered, so patients “can get the higher protection offered by newer vaccines.”
Until a few decades ago, immunization records were stored on paper, making them easy to lose, difficult to read, and prone to errors when moved across medical offices. Electronic records are an improvement, but they may be incomplete with consumers receiving vaccines at drug stores, drive-in clinics, and grocery stores, which maintain their own records and don’t necessarily share data. Immunization requirements continue as we age (shingles, pneumonia, etc.), so maintaining accurate records is necessary for older adults as well.
Vaccination records are collected and stored by state governments, not the federal government or any national agency. The CDC does not have vaccination record information.
Check state-run immunization information systems (IIS): These systems are confidential, population-based, computerized databases that record all immunizations administered to residents by participating providers, and they provide aggregate-level vaccination data for that population.
While aggregate population vaccination data is collected and stored in IIS systems, in most cases individual vaccination records are not automatically stored or accessible. IIS systems follow CDC's written privacy standards, including notification, choice, usage, access/disclosure, and data retention, and in most cases, users must opt in (or be opted in by parents) for individual records to be maintained.
Dig up historical data: The first place to check for vaccination records is to see what, if anything, is stored in the state’s IIS. Keep in mind that historical immunization data is often lost when a user leaves the system that maintains the records. Records are often deleted after individuals move to another state, graduate from high school or college, or change doctors. Many IIS systems delete the data of minors after they age out of the system unless they ensure that information is transferred to an adult file, although some states maintain vaccination records for life.
Keep in mind, however, that opting into a physician's office patient portal is not the same as opting into a state's IIS system, and immunization records may not be transported across portals when you change physicians. (I provided my shot records to my physician as an adult, but those records weren’t transferred with my medical files to my new physician, and my copies were lost during a natural disaster.) This is an additional problem with paper copies, they can be lost to flood, fire, frequent moves, or other reasons.
If you want to update an incomplete IIS record, you can request vaccination records from prior health care providers, local (city or regional) health departments, or your state health department. The CDC suggests checking with parents or caregivers (including reviewing stored files and baby books), previous schools or employers (including the military), physician’s offices or health clinics, and state health departments for vaccination records. You can find additional tips to locate old immunization records here. Once you locate additional records, you can ask your medical provider to update your records in your state’s IIS system.
Remember, IIS functionality varies by state: The advantage of IIS systems is they house official records that are accessible to users, and vaccination data is automatically updated as long as the user remains in-state and doesn’t opt out. However, systems in some states provide limited access to vaccination records, and most don’t contain vaccinations administered prior to the system’s release. While IIS systems are bound by CDC privacy standards, users should review their state's system and standards to decide if the advantages of accessing official vaccination data is worth individual privacy concerns.
My home state of Maryland allows users to log in and request access to their data, but my current state of Texas requires users to mail, fax, or email an official data request and then wait for a mailed paper copy of their vaccination record. In my case, that took a month.
While the Texas registry securely consolidates and stores immunization records from multiple sources (health care providers, pharmacies, public health clinics, Medicaid claims administrators, state health services, and so on) in one centralized system, it was designed so only doctors, schools, child-care centers, public health care providers, and other authorized health care organizations can directly access them, and even then only for patients who have opted in. Texas immunization records are not available to view online by the general public, including parents or legal guardians. However, many state IIS systems and pharmacies offer both online and mobile app access to your personal vaccination history.
Start from scratch: What should you do if, like me, you can’t locate your childhood vaccination records? According to the CDC, repeating vaccines isn’t ideal, but in some cases it may be appropriate. In some cases, blood tests can be performed to determine your immunity to specific illnesses and which vaccines you should get as an adult, so discuss your options with your doctor.
If you want your official vaccination record stored and updated, the most logical option is to utilize your state’s IIS system. If that system doesn’t meet your needs, there are other options as well. Salley says, “It really comes down to who is responsible for maintaining medical records, the individual or the government? It is simple for the individual to keep track of vaccines and beneficial for them to do so.”
There are a number of mobile apps (SMART Health Card, Express Scripts, and Docket Immunization Records, for example) that store official vaccination data. Plus, you can always maintain your own list of vaccination dates and locations in your phone’s notes section or in your contacts. Keep in mind however, that while user-stored records of vaccine dates and providers are helpful for reference, they are not official records. In addition to being verifiable, official vaccine documentation includes the date of administration, manufacturer, vaccine lot number, name and title of administrator, and facility address.
If you want an easy way to get started, over 20 states and many pharmacies, hospitals, and health care providers use SMART Health Cards. The app (and its digital vaccination “card”) allows you to save and share verified clinical information, including your vaccination history. With over 200 million users, the SMART Framework is openly licensed and not associated with a single organization or government entity. That means that even if your state doesn’t officially use it, you can use the app to store your vaccinations as long as your health care provider participates or is able to transfer data to the system.
SMART Cards include records of vaccines administered by participating pharmacies or health care providers and records stored in a participating state’s IIS system, so users in these participating states can access all their vaccination data. Only authorized providers can update your official vaccination record, but some states allow you to submit a copy of official vaccine documentation to update your IIS record. Keep in mind that vaccine storage systems are evolving and differ across states, and most apps only track Covid-19 vaccination data, with the potential to add additional vaccination information later.
Data security varies by app, so read the app’s data usage policy before signing up. Always try to save a copy of your official immunization data, so you’re not locked into any single service or platform.
I prefer the convenience of an official record that is automatically updated with each booster or vaccine, so I’ve opted in to my state’s IIS system. Since my state doesn’t provide web or mobile access, I may take advantage of an app such as SMART to make traveling easier. Since I couldn’t locate my vaccine history, I’ll ask my physician if I need to update any vaccinations. And I’ll email a password-protected copy of my adult kids’ vaccination records so they can access and track them as they choose.
