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Vaccination Programs: Client-Held Paper Immunization Records


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a Community Guide systematic review completed in 2010 (7 studies, search period 1980-2009) combined with more recent evidence (1 study, search period 2009-February 2012). This updates and replaces the 2010 finding for Client-Held Paper Immunization Records pdf icon [PDF - 516 kB].

This review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to increasing appropriate vaccination.

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 495 kB].

The systematic review included 8 studies with 11 study arms.

  • Overall vaccination rates increased by a median of 5.3 percentage points (6 studies with 9 study arms).

Summary of Economic Evidence

An economic review of this intervention was not conducted because the Task Force did not have enough information to determine if the intervention works.


Applicability of this intervention across different settings and populations was not assessed because the Task Force did not have enough information to determine if the intervention works.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. What are evidence gaps?

  • How effective are activities aimed at increasing the retention and use of client-held paper immunization records for children by their parents or other caregivers?
  • What is the impact of electronic health records or immunization information systems on intervention effectiveness?

Study Characteristics

  • Included studies used client-held paper immunization records as part of multicomponent efforts. Comparison groups received one or more interventions.