Data Exchange (DX) FAQs



Vaccine Eligibility (VFC)

Troubleshooting DX



My clinic is interested in enrolling in data exchange (DX) with CAIR2. What are the steps?
Provider sites that are interested in submitting immunization data to CAIR2 from their EHR systems should first review the CAIR2 DX Support page. Any remaining questions should be directed to a CAIR DX Specialist:

I enrolled in CAIR2 for data exchange (DX) submission.  Do I need to enroll any of my staff as CAIR2 login users?
In most cases, the only user role a DX site will need is the ‘DX Quality Assurance’ (DX QA) user role (see CAIR2 User Roles).  This role does not require formal training and allows a member of your staff to monitor data exchange transactions using the ‘check status’ screen as well as to lookup patients and also to access other useful CAIR2 patient reports such as reminder/recall, the ad hoc patient reports, the manage patient status screen (allowing efficient inactivation of inactive patients), and the coming AFIX/IQIP reports that will allow practices to measure coverage rates among their active patients.   If your site plans to use CAIR2 to manage inventory, you will need to enroll at least one staff member as a ‘Power’ user so they can login to CAIR2 and enter vaccine inventory.  If your site wishes to correct doses manually or enter historical doses or Tb test results, the best role would be the ‘Regular ‘ user role.

If your site is transitioning to data exchange from manual login use of CAIR2 and you no longer need existing ‘Regular’ or ‘Power’ users, your clinic supervisor/CAIR2 contact can login to Account Update and request that these accounts either be inactivated or changed to either the ‘DX QA’ or ‘Read-Only’ user roles that do not require training.

Do I need to attend training if our org/site submits through data exchange (DX)?
It depends.  If you request either ‘Power’ or ‘Regular’ roles for your staff, they will need to attend training.  However, the only user role most DX sites need is the ‘DX Quality Assurance’ (DX QA) user role (see CAIR2 User Roles) which does not require formal training. This role is able to monitor DX transactions via the ‘Check Status’ screen and also run a variety of reports including reminder/recall and ad hoc patient reports, to use the ‘manage patient status’ screen to remove inactive patients (coming in June 2020), and eventually to run coverage reports (AFIX/IQIP module, coming in Oct 2020) on children and adolescents in their practice.

If your DX site has requested ‘Regular’ or ‘Power’ users in error, please contact the CAIR2 Help Desk at 800-578-7889 or

Can data exchange (DX) sites run reports in CAIR2?
Yes.  We encourage all sites to enroll a staff member in the ‘DX Quality Assurance’ (DX QA) user role (see CAIR2 User Roles) to be able to login to CAIR2 and run some useful reports including reminder/recall and custom ad hoc reports as needed.  The DX QA role will also be able to run coverage reports (AFIX/IQIP module, coming Oct 2020)

I’m a manual user of CAIR2. What changes does my site need to make to our clinic’s workflow to accommodate the transition from manual entry to data exchange (DX)?
Changing to DX will simplify the clinic’s workflow since double data entry into CAIR2 should no longer be necessary. One thing for the practice to consider is whether to continue using the CAIR2 interface for other reasons, such as inventory management or general reporting, particularly if such functionality does not exist in your EHR.

If I begin submitting data to CAIR2 via data exchange (DX), do I still need to disclose to my patients?
Yes.  Per California Immunization Registry law (Health and Safety Code, Section 120440), all patients/parents must receive proper disclosure before patient information can be entered into or submitted to CAIR. The standard CAIR Notice is available in many languages and downloadable from the CAIR Forms page.  If you have questions about disclosure, refer to the CAIR Disclosure/Sharing Policy page.

Should my clinic send historical immunizations to CAIR2 or just new immunizations?
Yes, historical doses should also be submitted if possible.  Data exchange submissions are transactional and normally include only administered and  historical doses newly added to a patient record, but not any pre-existing doses .   Historical immunizations can be retrieved from an EHR as a batch file and added to CAIR2, assuming all patients in the file have been disclosed.   Having complete patient records in CAIR2 is important when sites begin bidirectional data exchange (BiDX) since vaccine recommendations sent back to the EHR will be incorrect if CAIR2 does not have all the patient’s doses.

Once we transition to data submission by data exchange (DX), do we still need to use the CAIR2 interface?
Not really. However, we do encourage DX sites to enroll at least one staff member in the ‘DX Quality Assurance’ (DX QA) user role (see CAIR2 User Roles) in order to be able to monitor electronic data submissions using the ‘check status’ page.  This DX QA role also can run reminder/recall and ad hoc reports in CAIR2, and will be able to manage additional functions, including being able to inactivate patients using the ‘manage patient status’ functionality (coming June 2020), and eventually will be able to run coverage reports on children and adolescents (AFIX/IQIP module, coming in Oct 2020).

I know there is TB info in CAIR2.   Can I send TB information through data exchange (DX)?
No. CAIR2 cannot currently accept Tb information and asks that you suppress TB information,e.g. PPD, from being submitted to CAIR2. Please work with your EHR vendor support to see if this is an option.

Our site wants to start using bidirectional data exchange (BiDX). What are the requirements?
Please visit the CAIR2 BiDX page at for more information on how to get started. Once you have read and completed the steps outlined on the BiDX page, contact for more information.

If doses are being submitted to CAIR2 via data exchange (DX), will those doses be subtracted from inventory?
No.   Subtraction of inventory is initially set to “No” in CAIR2 for all DX providers.  This can be turned on but the DX Team will need to first confirm that your site is sending all required fields in your HL7 messages. The DX Team will also coordinate with your site on a date/time to turn on inventory subtraction so your site can reconcile their CAIR2 inventory before you go live.  Refer to the DX Inventory Management page for those vaccine elements that need to be sent in your electronic messages for your site to be eligible for inventory subtraction.

Our data exchange (DX) site is set up to subtract inventory but our inventory in CAIR2 doesn’t match what is in our refrigerator?
One possible explanation is that inventory subtraction feature is not turned on for your Sites. Another is that the inventory is not being managed in CAIR2 (e.g. critical data fields like funding source, trade name, or lot number  not being entered, new shipments not added, etc).  Another possibility is that the messages being sent do not contain the required data elements .  Refer to the DX Inventory Management page for requirements.

If my data exchange (DX) site has questions or is interested in managing our vaccine inventory in CAIR2, who should we contact?

Are VFC sites required to send vaccine eligibility information to CAIR2? 
VFC providers are required to record VFC eligibility. Submission of VFC eligibility to CAIR2 is strongly encouraged and is required for DX sites who manage their inventory in CAIR2. Talk to your EHR vendor or a CAIR DX Specialist if you have questions regarding submission of vaccine eligibility information in your DX messages.

Can VFC vaccine eligibility (VE) information be sent via data exchange (DX)?
Yes, CAIR accepts all the standard  vaccine eligibility categories through DX, including 1) the 4 VFC categories: VFC-Medi-Cal/CHDP, VFC-Uninsured, VFC-Underinsured, VFC-American Indian/Alaskan Native, 2) 317 Funded, 3) State General Fund, and 4) Private Pay. Please contact your EHR support to determine if these VE options are available in your EHR system and are being sent to CAIR2 appropriately in your immunization messages. Refer to the CAIR HL7 2.5.1 VXU Implementation Guide for specific VE fields and required codes .

Is there a way to monitor the data that I’m sending from my EHR to CAIR2?
Yes. We encourage you to use the ‘Check Status’ screen, an important feature in CAIR2 that allows you to monitor ongoing data exchange. The DX Quality Assurance (DX QA) and DX Power User account access levels in CAIR2 are able to utilize the ‘Check Status’ screen in CAIR2 to view immunizations submitted from your EHR. Refer to CAIR Data Exchange guides or videos for Check Status at

What should I do if the information sent in the data exchange (DX) message does not match what is in CAIR2?
Contact your EHR vendor and/or a DX Specialist. There may be a formatting issue with the messages being sent.  It’s also possible that the patient in question has a duplicate record in CAIR2 so that incoming doses are prevented form being uploaded.

If we identify an incorrectly merged record in CAIR2, what should be done?
First step is to contact the CAIR2 Help Desk ( If the incorrect merge is the result of a DX issue, a DX Specialist will be notified by the CAIR Help Desk and will work with your site to correct the record.

If our site submits data through data exchange (DX) but also continues to use CAIR2 to enter patient records and/or shots, would this create duplicate information in CAIR2?
CAIR2’s RunMatch system should automatically identify and prevent both duplicate patient records and duplicate shots within patient records. CAIR discourages DX sites from doing double data-entry because it creates more work for the site.  Refer to the CAIR2 Tip Sheet on Double Data-Entry for discussion of ways to avoid double data-entry.

What should I do if I have questions about our data exchange (DX) messages or our DX site account?
All DX questions should be directed to a DX Specialist at If you have a question about CAIR user accounts, please contact your LCR: or the CAIR Help Desk: