Using Standing Orders to Vaccinate Increases Coverage Rates and Protects Patients

March 2016

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.
Using Standing Orders to Vaccinate Increases Coverage Rates and Protects Patients
Published March 2016
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
Using standing orders for vaccination in your medical practice allows appropriately trained healthcare professionals — who are permitted to do so under state law — to assess a patient’s need for vaccination, determine if there are contraindications and precautions, and then to administer vaccine without obtaining an individual physician’s written order.
Numerous studies have shown that standing orders, carried out by nurses or other qualified healthcare professionals, are one of the most consistently effective means for increasing vaccination rates and reducing missed opportunities for vaccination, thereby improving quality of care.
CDC’s Advisory Committee on Immunization Practices (ACIP) recommends the use of standing orders to increase adult vaccination rates. Standing orders may also be useful when vaccinating children and teens.
Exactly who is authorized to administer vaccines under standing orders varies by state law. To find out which medical personnel are legally permitted to administer vaccines under standing orders in your state, contact your state immunization program manager.
Are you interested in starting a standing orders program in your practice setting, but perhaps aren’t sure where to begin? The Immunization Action Coalition (IAC) has materials that help make standing orders easy to implement.
“Using Standing Orders for Administering Vaccines: What You Should Know”
Standing orders templates for routinely recommended vaccines
IAC has created standing orders templates for all vaccines that are routinely recommended for administration to children, teens and adults. These standing orders are based on ACIP’s vaccine recommendations and are reviewed for technical accuracy by CDC staff. IAC updates the content of its standing orders whenever ACIP makes changes in a vaccine’s recommendations.
You can find IAC’s standing orders templates for vaccines on IAC’s standing orders Web page. Some examples follow:
Standing Orders for Administering Influenza Vaccine to Adults
Standing Orders for Administering Influenza Vaccine to Children and Adolescents
Standing Orders for Administering Tdap/Td Vaccine to Adults
Standing Orders for Administering Tdap/Td to Children Age 7 Years and Older
Standing Orders for Administering Pneumococcal Vaccines (PCV13 and PPSV23) to Adults
Standing Orders for Administering Zoster Vaccine to Adults
Access all of IAC’s standing orders templates.
To be notified when new or revised standing orders templates become available, subscribe to IAC’s free weekly news service, IAC Express, which is sent to more than 50,000 healthcare professionals every Wednesday.


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