At Santa Fe Public Schools, nurses can look up any student's shot record using the New Mexico Statewide Immunization Information System. Since parents aren't always good about keeping track of their child's shots, this electronic database helps prevent students from getting unnecessary, duplicate shots.

District nurses use the state's immunization registry to crosscheck the records of students.

"Parents often forget to take their vaccine record to the doctor office visits," said Cheri Dotson, lead nurse for Santa Fe Public Schools, "so the record presented at the time of (school) registration is quite often incomplete. (The registry) can help us with that problem."

At least, that's the way it should work.

The information system can be a powerful tool — if used properly. But at the moment, the database is in great need of improvement, according to Dotson.

"Hopefully, they can clean up some of the problems," she said.

Perhaps the biggest flaw is incomplete data. Some shots are recorded, and some are left out.

Many health care providers across the state aren't taking the time to enter a child's complete historical vaccine record, Dotson said. Instead, they have been entering only the shots administered at their office.

What's more, the system has not been compatible with other record-keeping systems. Initially, the plan was for school districts to share their vaccine records, but that source of data is not included in the database right now.

"School districts probably have the best set of records for children in our state," Dotson said, "but the download into (the registry) was never accomplished. They (the people managing NMSIIS) decided our files are too big."

The incompatibility problem puts an extra data-entry burden on nurses. If NMSIIS could connect with other electronic record-keeping systems, then the information from a doctor's office or a school could be downloaded at night.

Right now, some doctors' offices even send paper records to the Health Department, where state workers enter the shots records, Dotson said.

In 2007-08, the school district rolled out another software program to help nursing staff keep an "accurate, legal and confidential" record of all office visits, not just immunizations. Unfortunately, Health Office 2000 cannot share data with the New Mexico Statewide Immunization Information System, so nurses must enter the student's shot information in two different places.

"The two programs don't communicate," Dotson said. "The nurses don't like it."

On the positive side, the New Mexico Statewide Immunization Information System is fairly easy to use — just type three letters of a student's last name and two letters of the first name, and the student's shot record appears on screen. A school nurse can print a report of the vaccines a student has received over the last month or over a specified period of time.

"If there was a bad reaction to a shot, it alerts you there was a reaction and then we look to see what the reaction was," Dotson said.

Parents who don't want certain vaccines administered to their children can have that preference spelled out in NMSIIS. The program will flag the student as "Refusal of all childhood vaccines," or specify which vaccines should be omitted.

Also, nurses that learn that a child has had a case of the chicken pox can make a note in the student's record. In such a case, a shot against the chicken pox would not be necessary.

Though parents cannot access the database directly, they can request a printout of their child's vaccine history — even after the student graduates from Santa Fe Public Schools.

Dotson is a member of the Santa Fe Immunization Coalition, and she served on the Health Department committee that picked the original software for NMSIIS.

But, she has observed, getting NMSIIS to reach its full potential has entailed a lot more than its designers imagined. "Part of it is there has been a lot of turnover in staffing," she said.

At the beginning of each school year, about 66 percent of the District's students are fully immunized, Dotson said. If parents consent, students can get their missing shots at school. The district also sends home a list of clinics where students can get the missing shots.

By the end of last school year, the District raised the immunization rate to 94.6 percent.