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Immunization Detail Record Report (Washington)

This report is used to display a specific patient's immunization record. It displays the Dose Number, Vaccination Date, Patient Age, Manufacturer, Clinic, Lot Number, Dose Volume, VIS Date, Supply Source, Name of the person and their suffix that administered the vaccine, comments (if any), PPD reading (if entered), and all contraindications. Search for the patient before running this report.

Run the Report

To run this report, search for the patient and then click the Reports > State Reports > Patient Specific > Immunization Detail Record Report link. The Washington State Immunization Information System Immunization Detail Record displays for that patient in a new browser tab.  To print the report, use the browser's print function.

Example Report

The following image is of an example Immunization Detail Record report. Note that reports may differ in format and headings depending on settings.

Example Immunization Detail Record report for Washington

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