Run Childhood Immunization Status Chart Audit (Combination 10 by Age 2) — Free

Audit Scope and Patient Eligibility

Patient turns age 2 within the measurement period critical (required)

Verify the child is included in the audit population based on turning 2 years old during the applicable measurement period.

Yes No N/A

Note (optional)

Date of second birthday documented critical (required)

Record the child's second birthday used as the cutoff date for vaccine completion.

Note (optional)

Chart contains sufficient documentation for immunization review critical (required)

Confirm the chart includes enough evidence to determine immunization status, such as immunization history, registry data, or provider documentation.

Yes No N/A

Audit source identified

Identify the primary source used to validate immunization status.

Note (optional)

Combination 10 Vaccine Completion

DTaP series documented per measure requirements critical (required)

Verify DTaP doses are documented and meet the measure's completion criteria by age 2.

Yes No N/A

IPV series documented per measure requirements critical (required)

Verify IPV doses are documented and meet the measure's completion criteria by age 2.

Yes No N/A

MMR series documented per measure requirements critical (required)

Verify MMR doses are documented and meet the measure's completion criteria by age 2.

Yes No N/A

HiB series documented per measure requirements critical (required)

Verify Haemophilus influenzae type b immunization documentation meets the measure's completion criteria by age 2.

Yes No N/A

Hepatitis B series documented per measure requirements critical (required)

Verify hepatitis B doses are documented and meet the measure's completion criteria by age 2.

Yes No N/A

Varicella (VZV) series documented per measure requirements critical (required)

Verify varicella vaccination documentation meets the measure's completion criteria by age 2.

Yes No N/A

Pneumococcal series documented per measure requirements critical (required)

Verify pneumococcal vaccination documentation meets the measure's completion criteria by age 2.

Yes No N/A

Hepatitis A series documented per measure requirements critical (required)

Verify hepatitis A vaccination documentation meets the measure's completion criteria by age 2.

Yes No N/A

Timing and Documentation Validation

All qualifying vaccine doses were administered on or before the second birthday critical (required)

Verify the administration dates for all required vaccine components fall on or before the child's second birthday.

Yes No N/A

Immunization dates are clearly documented in the chart critical (required)

Confirm dates are legible and traceable to a source record, registry, or encounter note.

Yes No N/A

Evidence source supports each vaccine component critical (required)

Verify each required vaccine component can be traced to a documented source in the chart or immunization registry.

Yes No N/A

Any missing or delayed doses identified

Select any vaccine components that are missing, incomplete, or not documented by the second birthday.

Note (optional)

Findings and Corrective Action

Audit result critical (required)

Indicate whether the chart meets the childhood immunization status measure.

Deficiency summary

Summarize any non-conformance, missing documentation, or vaccine gaps identified during the chart audit.

Corrective action needed

Select any follow-up actions required to resolve documentation gaps or vaccine deficiencies.

Yes No N/A

Reviewer notes

Add any additional notes relevant to the audit, including exceptions, registry discrepancies, or chart limitations.

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Run: Childhood Immunization Status Chart Audit (Combination 10 by Age 2)

Audit Scope and Patient Eligibility

Combination 10 Vaccine Completion

Timing and Documentation Validation

Findings and Corrective Action

Get your results