Specifications include, but are not limited to:The Rhode Island Department of Health’s (RIDOH) Rhode Island Child & Adult Immunization Registry (RICAIR) captures immunization administration data for those individuals’ receiving services from Rhode Island based immunizers. Recognizing that good health outcomes are often contingent on wellcoordinated systems of care, RIDOH has a long history of investing in system development and building data exchange capability to support planning, inform policy, and assure preventive health care through programs such as Immunization. RICAIR facilitates the collection and appropriate sharing of immunization data for the provision of timely and appropriate follow-up care. The Rhode Island immunization registry began as the immunization component of KIDSNET, an integrated child health information system which contains immunization data for individuals born on or after January 1, 1997 and serves as Rhode Island’s childhood immunization registry. The expansion of the immunization registry in RICAIR to include adults went live in late October of 2020. Due to the recency of the expansion to a lifelong registry, many adult immunization providers have not yet established electronic HL7 immunization interfaces with RICAIR for the exchange of immunization data, as required in the state supplied vaccine (SSV) agreement. Development of new or upgraded HL7 interfaces with RICAIR, making use of the most current HL7 version 2.5.1 messaging standards, as well as emerging specifications established by the CDC’s panel of national experts will enable improved interoperability and, for some EHRs, bidirectional data exchange.