New Hampshire will soon be the only state in the nation not tracking residents' vaccinations for the flu, measles and mumps.
Today, New Hampshire and Massachusetts are the only states lacking immunization registries that track vaccinations electronically, according to the U.S. Centers for Disease Control and Prevention.
"Registries help you to better reach those children that are maybe slipping through the cracks when it comes to their immunization," CDC spokesman Thomas Skinner said.
Immunization registries are key to preventing disease outbreaks by notifying parents when their children need shots for preventable diseases, he said.
Massachusetts has created a pilot program and has legislation in the works to fund a registry. But New Hampshire has no similar plans, according to Chris Adamski, the state's public health bureau chief of infectious disease.
"We've looked at the issue many times over the years, but there's no specific funding earmarked for it," she said. "New Hampshire is one of the better states for immunization. I don't think the fact that we don't have a registry holds us back. We do have a sense of how we're doing with immunizations from a number of reliable data sources."
In 2010, 90 percent or more of New Hampshire children were vaccinated against preventable diseases, including tetanus, polio, mumps and more, she said.
The state is looking at other technology that electronically shares many types of medical information, beyond immunizations, she said.
"We have looked at bigger and broader initiatives, like Health Information Exchange," Adamski said. "There's a lot changing in the world of technology and data. A registry that might have been implemented 10 years ago might need to be updated. We want to make sure it's not something that will be outdated as we go forward."
But Dr. John Modlin, chairman of the Department of pediatrics at Dartmouth Medical School, said it's not technology holding the state back, it's the cost.
"I think there's a slim chance of it happening because vaccine registries are expensive to set up and maintain," he said.
"New Hampshire is a small state with no broad-based taxes. We have a Republican-led Legislature here and they have no interest in funding such things, no matter what the benefit may be."
But he said the state is still doing a good job immunizing the population.
"New Hampshire is among the top states in the country at achieving high levels of immunization, even without registries," he said.
"But we could do an even better job if we had registries."
In Massachusetts, legislation is pending that would provide around $2 million to run a registry by charging insurance companies fees.
The measure failed the past few years, but this time, advocates like Dr. Sean Palfrey, professor of pediatrics and public health at Boston University's School of Medicine, are optimistic.
"We've struggled and we're behind a large number of states," Palfrey said. "We started a registry about 10 years ago and then withdrew it because it wasn't accurate. It does cost money and it's difficult to roll out to practices that have a wide variety of electronic medical records."
Despite the challenges, a Massachusetts registry is now in the pilot stage, he said.
"We're in the process of trying to introduce the registry to individual practices, teach them how to use the system and learn ourselves in the process," he said. "It will help when we put the entire system out to the rest of the state. I think this time it's possible."
If the legislation passes, New Hampshire would be the only state in the nation without this type of technology.
"There are ways that this information can be gathered without use of a registry," Skinner said. "If that's what New Hampshire feels like they need to do, that's their prerogative. But, by and large, immunization rates across the country continue to go up. So that's a good sign."
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