Immunizations are critical for maintaining individual and population health. Yet ensuring that complete immunization histories are available at the point of care is challenging. Currently, immunization information systems (IIS) are used to aggregate data at a regional level, although their value is often limited by incomplete data. The Electronic Health Record (EHR) Incentive Program, which is an unprecedented federal initiative promoting EHR use, is linking financial payments in part to demonstrating ability to transmit EHR data directly to IIS and thus has potential to change immunization data management on a large scale. We believe that EHRs are critical for allowing more complete and timely immunization data capture and will offer many benefits. To achieve these benefits, however, it will be necessary to engage the EHR vendor community in developing EHRs that allow for comprehensive immunization data capture and policy makers to incentivize bidirectional, real-time exchange between IIS and EHRs.