Child Health Information Systems (CHISs) are computerised clinical record systems which support a range of health promotion and prevention activities for children, including immunisation and screening. There are a number of different providers of CHISs in England. These systems are managed by child health departments in each local area and not all are interoperable. The establishment of systems which record and maintain accurate information on the entire population is critical to assess vaccination coverage at both national and local levels. These systems should have the flexibility to adapt to a continuously evolving immunisation programme, a mechanism to rapidly feedback to local public health teams for outbreak prevention and control, and the ability to mount a timely response to vaccine safety scares. The ability to schedule (call and recall) immunisation appointments has contributed to improvements in vaccination coverage both in England and elsewhere. While this has been achieved in England through multiple CHISs the development of a single national register would reduce the complexities of maintaining accurate and complete immunisation records for the entire population.