In 2007, the New Mexico Department of Health purchased 63,480 doses of HPV vaccine. The newly developed vaccine is designed to ward off human papillomavirus, a sexually transmitted disease that often causes cervical cancer. But to date, no one knows how many New Mexico girls have completed the series of three injections, which are given over a period of six months.

In theory, the New Mexico Statewide Immunization Information System, a registry launched in 2006, should provide this information with a quick keystroke. But it cannot.

"We do not have an accurate assessment of how many doses have been given to girls in New Mexico," Dr. Maggi Gallaher, medical director for the Public Health Division, said. "We need a better reporting tool."

Following the lead of the U.S. Centers for Disease Control and Prevention, the state recommends that girls age 11 and 12, particularly those who are not yet sexually active, get the HPV vaccine. The state's vaccine supply also can be given to girls up to age 18, with a doctor's recommendation. Getting the vaccine is voluntary.

This year, the state registry will get a tuneup under a new contract with Electronic Data Systems, which also manages registries in nine other states, according to Health Department spokeswoman Deborah Busemeyer. Until now, the vaccine registry has been managed through the state's Department of Information Technology.

As a result, the database of shot records for children and adults should become more worthwhile to private doctor offices and the Health Department alike.

According to the Health Department Web site, the system was created to do all of these things:

• Store shot records

• Highlight medical reasons not to give shots to certain people

• Display shots due at each health care visit

• Create a schedule of shots for each patient

• Print up-to-date shot records

• Help health care providers monitor vaccine inventory

• Allow health care providers to print reminder letters to patients who are due for shots.

When the New Mexico Immunization Coalition hosts outreach clinics, workers use NMSIIS to look up a person's immunization record and often find shots that are not recorded on the person's handwritten record, and conversely, said Anna Pentler, executive director.

In 2007, the state's childhood immunization rate was 76 percent, compared with 77.4 percent for the U.S. national average. (Those figures cover a total of 15 shots.)

"New Mexico's rate has increased dramatically from 2002, but has fluctuated slightly for the past couple of years," Pentler said (The best year was 2004, not 2007.)

In 2001, a group of state workers and health care providers began discussing and researching the idea of an immunization registry. Around that time, New Mexico lagged considerably behind the national average. The group envisioned a high-powered computer system that would keep tabs on who is getting which vaccines, so that workers in schools, day-care centers and health care facilities could access immunization records online and print reminder cards for children who need shots.

The concept wasn't put in place until January 2006. First lady Barbara Richardson made it one of her pet projects.

"It really got moving when the first lady and the governor (Bill Richardson) gave it attention," Pentler said.

Yet getting the system to do all that it's supposed to do has been challenging.

The good news: Approximately 90 percent of the state's children — 626,495 at last count — have records in the system. The not-so-good news: For some of those, more than 10 years worth of data can be found in the system. For others, the record is much less complete.

Nonetheless, Pentler called it "an incredibly valuable tool."

She also said, "We're just excited for the new and improved version."

When the Health Department centralized vaccine records for New Mexico children from birth to age 18, it wanted better information about vaccination trends. But the project has had limited success so far.

Upgrading the system is "one of our top priorities within the Public Health Division," Gallaher said. She took charge of the state's immunization program about a year and a half ago.

When it comes to producing big-picture reports, such as the number of girls who have completed the HPV vaccine, NMSIIS is "cumbersome," Gallaher said.

As a result, many important questions are left unanswered. For instance, is the state buying the right amount of HPV vaccine, or could it buy less and still meet demand? All Gallaher knows for sure is "we have been able to keep up with the demand for HPV vaccine with our supplies."

Better information could lead to more effective purchasing and outreach to families.

Participation in the state's centralized vaccine registry is voluntary.

The system is supposed to allow health care providers to print shot reminder cards to send to parents, but that feature is inconsistently available.

"Some providers are able to use this functionality," Gallaher said. "We can't currently do this on a statewide basis, but expect to with the upgrades. Right now, providers can do it for their practice if they are doing their own data entry."

Some health care providers, especially in large practices with electronic medical records, don't bother participating because it would require entering a patient's information into two different computer systems — and so there is no notification.

In creating a statewide registry, New Mexico followed Wisconsin's lead. Now 12 states have similar systems. The grand vision is that one day a child could travel anywhere in the United States and a health care provider could access the child's vaccine record. But that's a "long way down the road," Gallaher said.

If a child's name does not come up, it could mean the parents decided not to participate in the registry. It also could mean that the health provider that administered the shots did not enter the information in the system. Or, it could mean the child is new to the state.

For more information about NMSIIS, go to www.health.state.nm.us.