Case Synopsis

With the implementation of mandatory reporting of all immunizations in the Northwest Territories (NWT) in 2012, the Department of Health and Social Services’ (DHSS) Disease Registry Unit was working toward the implementation of a new immunization registry similar to those implemented across the country. However, the current immunization registry was in the format of an Excel workbook. The DHSS noticed several issues with the quality of the data maintained in the spreadsheets. As part of Janet’s practicum, she conducted an audit of the immunizations for the cohort of children born between 2012 and 2014, inclusive, within the registry.

Community health centres are required to submit immunizations they have administered via a monthly spreadsheet. The Disease Registry team then validates and cleans the information submitted and consolidates all the data into the immunization registry on one master Excel workbook. It is important to note that the original data submitted to the DHSS from the health centres is only added to the immunization registry after the Disease Registries Officer has confirmed that the data are clean.

To assess the validity and reliability of the data, the community health centres were contacted and asked to submit all paper immunization records for children in this cohort, which were then entered into another spreadsheet. The cohort spreadsheet and the immunization registry were compared to determine the number of errors across various variables.

To summarize, the audit was a comparison of the original community spreadsheet submitted to the DHSS with the paper immunization cards, which Janet entered into a separate spreadsheet to easily compare the two datasets.

Case Objectives

  1. Recognize the challenges that arise when dealing with data from health services in remote northern communities.
  2. Understand the importance of data quality when assessing a population’s vulnerability to disease and public health initiatives.
  3. Indicate the benefits of implementing a new information system to support the existing immunization registry in the NWT.
  4. Interpret immunization coverage data.

Case Study Questions

  1. Why did Janet compare the spreadsheet she created (i.e. populated with data from paper immunization records) with the original immunization data (i.e. spreadsheets submitted from the community), instead of directly comparing it with the existing immunization registry?
  2. What are some of the difficulties working with population level data in northern remote communities?
  3. What are the advantages and disadvantages of establishing an Immunization Registry in the NWT?
  4. Why would the DHSS be under-reporting immunization coverage if they did not perform an audit of paper immunization records?
  5. What limitations does the NWT’s mobile population present with respect to conducting a coverage analysis with the current immunization registry?


immunization coverage, immunization registry, information system, original immunization data, paper immunization records

Additional Author Information

Shannon LeBlanc, BSc, MPH

Heather Hannah, DrPH, Territorial Epidemiologist

Amanda Terry, PhD, Assistant Professor



Recommended Citation

LeBlanc, S., Hannah, H., Terry, A.L. (2016). Vaccination Under the Midnight Sun: Validation of an Immunization Registry in the Northwest Territories. in: Terry, A.L. & John-Baptiste, A. [eds] Western Public Health Casebook 2016. London, ON: Public Health Casebook Publishing.