Following the stages of Testing and Discovery and IIS Assessment, Validation is a summary step to acknowledge IIS that are progressing toward or achieving alignment with community-selected measures and tests. A Validation designation is automatically achieved when an IIS meets the designated measures and tests in a specific content area (e.g., Transport), as specified in the Aggregate Analysis Reporting Tool (AART).

Measures for each content area of Validation will be drawn from published IIS Assessment measures and tests, where results are already available to individual IIS via AART. No new measures or tests will be introduced in the Validation stage that are not already measured and visible in the IIS Assessment stage. All measures and tests throughout the Measurement and Improvement Initiative have been and will continue to be developed by the Measurement for Assessment and Certification Advisory Workgroup (MACAW), vetted for comment with the full IIS community via a Town Hall meeting format, and reviewed and approved by the AIRA Board prior to implementation.

As mentioned above, a “Validation” designation is automatically achieved when an IIS meets the designated measures and tests in a specific content area (e.g., Transport, Submission, Query, etc.), but interim steps/statuses toward Validation are also recognized. Statuses include:

  • Validated
  • Validated with Minor Differences
  • Major Differences
  • Not Measured
  • Opted Out


In keeping with Validation’s focus on transparency, the business rules for moving forward in the measurement process have also been simplified. MACAW assumes that IIS connecting with the Measurement and Improvement Initiative have a desire to participate and share results, unless an IIS states otherwise. Admin users can modify their participation and sharing settings at any time. Click here for more information on participation and sharing settings.

Certain content areas may be split into Basic or Complete measures. This graduated approach allows for more nuanced results and makes it easier to show both success and improvement. The Basic level includes essential measures an IIS would be expected to pass to minimally meet a specific functional area or content area, while the Complete level includes more comprehensive sets of measures for a given functional area or content area.

Validation by Content Area

Below are measures and tests developed to date. Baseline and quarterly re-measurement reports are also available for the completed IIS Validation content areas via the AIRA repository found here.


This content area examines the level of alignment with the formally defined transport specification, SOAP/Web Services and the CDC WSDL. When any two systems connect to exchange data, they must use an agreed upon transport layer to connect; otherwise, communication and the exchange of data will be impossible. An expert panel made up of Subject Matter Experts (SMEs) from across the IIS and stakeholder community selected the SOAP/Web Services and CDC WSDL as the IIS Standard in 2012.

Helpful resources for Transport Validation:

Message Submission (VXU) and Acknowledgment (ACK)

This content area focuses on Submission and Acknowledgment messages to an IIS. VXU, or vaccine update, is an HL7 message that contains demographic and vaccination data which is submitted to an IIS by an outside electronic health record system (EHR). ACK, or acknowledgment, is an HL7 message used to relay information back to the EHR regarding the status of the VXU.

Helpful resources for the Submission and Acknowledgment Validation:

  • Submission and Acknowledgment Validation Reports for the Basic level and the Complete level are available.
  • Finalized and approved measures and tests for Submission and Acknowledgment are available here.
  • Information on the community wide Town Hall meeting for Submission and Query Validation, along with a recording and presentation slides are available.

Message Query (QBP) and Response (RSP)

This content area focuses on Query by Parameter (QBP) HL7 message submissions that are sent to an IIS and Response (RSP) HL7 message submissions that are returned by an IIS in response to a querying system. The QBP is used to query data from the IIS and contains basic demographic data about a patient. The sending system wants to know if the IIS has any demographic and/or vaccination data on the said patient, so it therefore “asks” the IIS to respond to the QBP message. Once the IIS receives a QBP, the IIS attempts to match the demographic information contained in the QBP message with data in the IIS. It then sends back an appropriate response HL7 message (RSP) telling the sending system if the patient was found in the IIS and what information (if any) was found. 

Helpful resources for the Query and Response content area:

Additional Resources

Immunization Information System (IIS) Measurement and Improvement: Testing and Discovery, Assessment and Validation Overview

Information on Participation and Sharing Settings