Assessment Information


The National Immunization Program at CDC has identified several key strategies to improve immunization coverage. Among these is a provider-based process known by the acronym AFIX.  AFIX is a quality improvement strategy used to raise immunization coverage levels and improve standards of practice at the provider level.  The acronym stands for:

A –  Assessment of immunization coverage levels at the clinical or practice level
F –  Feedback of information to providers
I  –  Incentives, and
X – eXchange of information between/among providers.

Standardized collection, analysis, and feedback of information can assist providers in diagnosing service delivery problems, making improvements in policies and procedure, and evaluating the effectiveness of their interventions. Click here to view ACIP Immunization Assessment Recommendation :   MMWR, March 15, 1996, Vol. 45, No. 10, Pages 15-16.

For more information on AFIX click the LOGO above.


Comprehensive Clinical Assessment Software Application (CoCASA)
CoCASA is a tool for assessing immunization practices within a clinic, private practice, or any other environment where immunizations are provided.  This is a public domain software application developed by the CDC.   The latest version of the free software can be downloaded from the CoCASA Installation Page .   CoCASA has data entry and import capabilities.   After immunization data have been entered into CoCASA, data analysis capabilities can be utilized to pinpoint strengths and areas of improvement for individual immunization providers.

CoCASA will help providers:

  • Derive current vaccination coverage levels in their own facility;
  • Organize immunization data to suit their individual practice needs;
  • Produce reports from a menu which provides programmatic feedback such as:
  1. Immunization coverage levels for the practice;
  2. Antigen-specific immunization rates;
  3. Suggestions on practice changes to improve immunization rates;
  4. Up-to-date status of a defined age group;
  5. Up-to-date status of children at critical markers;
  6. Proportion of children who drop out of the vaccination schedule;
  7. Extent of missed opportunities for giving immunizations;
  8. List of immunization histories for all assessed children;
  9. List of missing immunizations for all assessed children;
  10. Reminder and recall letters and postcards.

*Missed opportunity is a healthcare encounter in which a person is eligible to receive vaccination, but is not vaccinated completely with age-appropriate vaccines.