Costs of immunization registries: Experiences from the all kids count II projects

Background: Immunization registries are tools to improve and sustain immunization coverage rates for our nation’s preschool children. Developing a means of supporting registries over the long term requires information on costs to operate registries. Methods: To determine the annual cost per child to operate immunization registries for the 16 All Kids Count (AKC) II projects, some of the most developed registry projects in the United States, we projected a national figure for operating registries and compared the figure with a variety of potential cost offsets. Results: When the registries are fully operational, the average cost per child for the 16 AKC II projects will be $3.91 (range, $1.60 to $6.23; interquartile range, $2.91 to $4.81) per year. Conclusions: Based on the AKC study, maintaining a nationwide network of registries for children aged 0 to 5 will require an estimated $78.2 million. Cost offsets include not having to manually retrieve records for school entry, child care, change in provider, and Health Plan Employer Data Information Set reports; not having to carry out the National Immunization Survey; and prevention of overimmunization. We estimate these offsets at $113.8 million annually.