Simple Tips to Expedite Vaccination in Your Practice

March 2014

Technically Speaking
Monthly Column by Deborah Wexler, MD
Deborah Wexler MD
Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children’s Hospital of Philadelphia Vaccine Education Center’s (VEC’s) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.
Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events.
Simple Tips to Expedite Vaccination in Your Practice
Published March 2014
Information presented in this article may have changed since the original publication date. For the most current immunization recommendations from the Advisory Committee on Immunization Practices, visit
Missed opportunities to vaccinate contribute to lower immunization rates in medical practices and healthcare systems across the nation. Here are some simple tips to help your practice facilitate vaccination during all patient visits.
Tip #1: Remember that vaccines can be given at any clinic visit — not just during well-child or adult physical exam visits.
All medical visits (including acute care and follow-up visits) offer the opportunity to assess your patients’ immunization status and provide them with needed vaccinations. In particular, patients with chronic illnesses, many of whom visit a provider only during an acute episode, may be the individuals who are most at risk for complications from vaccine-preventable illnesses. Don’t miss any opportunity to provide protection for your patients. Consider facilitating patient access to vaccines by establishing systems that allow them to walk in during regular office hours or to call ahead for a “nurse only” visit.
Tip #2: You don’t need to routinely check temperatures on all patients before vaccinating them.
Routinely measuring temperatures is not a prerequisite for vaccinating patients who appear to be healthy. As part of your routine pre-vaccination screening for contraindications and precautions, simply ask the parent or patient about the patient’s current state of health. Here are two handy checklists to help you screen.
Screening checklist for contraindications to vaccines for children and teens
Screening checklist for contraindications to vaccines for adults
Mild acute illness (e.g., diarrhea or mild upper-respiratory tract infection) with or without fever is not a reason to postpone vaccination. If an illness is reported that is moderate or severe, vaccination is considered to be a precaution, not a contraindication; but, in general, it probably should be postponed.
Tip #3: You don’t need to routinely test for pregnancy in girls and women of childbearing age before administering a live virus vaccine.
Routine pregnancy testing of girls and women of childbearing age before administering a live virus vaccine is not recommended, according to CDC’s General Recommendations on Immunization (see page 27). However, females of childbearing age should be asked about the possibility of their being pregnant or their intention to become pregnant during the next four weeks prior to being given any vaccine for which pregnancy is a contraindication or precaution. (See CDC’s Guidelines for Vaccinating Pregnant Women, page 8). The patient’s answer should be documented in the medical record. If the patient is uncertain if she is pregnant, a pregnancy test should be performed before administering live virus vaccines.
Summary of Recommendations for Child/Teen Immunization
Summary of Recommendations for Adult Immunization
Tip #4: Implementing standing orders for vaccination allows appropriate medical personnel to administer vaccines even if a physician is not on site.
Vaccines can be administered only with an order from a physician or a healthcare provider who is authorized by the state to prescribe them. However, a physician may not necessarily need to be present to administer vaccines if standing orders are used. Several studies have shown that the use of standing orders can improve vaccination rates, and the Task Force on Community Preventive Services strongly recommends the use of standing orders programs among children, adolescent and adult vaccination programs (see Table 15 on page 50). A comprehensive set of Sample Standing Orders for Child and Teen Vaccination and Adult Vaccination is available from IAC. These sample orders may be modified to suit your work setting.


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