Technically Speaking: Standing Orders Protocols Can Improve Your Vaccination Rates

Standing orders for vaccine administration are written protocols approved by a physician or other authorized practitioner that allow qualified healthcare professionals (who are eligible to do so under state law, such as RNs or pharmacists) to assess the need for and administer vaccine to patients. The qualified healthcare professionals also must be eligible by state law to administer certain medications, such as epinephrine, under standing orders (should a medical emergency occur and a clinician not be available).

Having standing orders in place streamlines your practice workflow by eliminating the need to obtain an individual clinician’s order to vaccinate each patient. The use of standing orders is recommended by CDC’s Advisory Committee on Immunization Practices and by the Community Preventive Services Task Force.

Standing orders protocols will:

• Facilitate efficient assessment for and administration of vaccines in your practice
• Improve vaccination rates in your patients
• Protect more of your patients from vaccine-preventable diseases
• Empower nurses and/or other eligible staff to provide a valuable and potentially life-saving preventive service to patients
• Decrease opportunities for disease transmission, such as influenza, in your healthcare setting

The Immunization Action Coalition (IAC) has many free downloadable materials available on its website, including standing orders templates for vaccination and for how to medically manage vaccine reactions. These resources can help you implement standing orders in your office.

There are many IAC resources available on the immunize.org website:

• Standing Orders Templates for Administering Routinely Recommended Vaccines to Children, Teens, and Adults, including DTaP, HepA, HepB, Hib, HPV, IIV, IPV, MMR, MenACWY, MenB, PCV, PPSV, RV, Td, Tdap, Var, and Zos. All templates have been reviewed by CDC for technical accuracy. You can use any of the templates “as is,” or modify them to suit your practice’s needs.
• 10 Steps to Implementing Standing Orders for Immunization in Your Practice Setting
• Using Standing Orders for Administering Vaccines: What You Should Know
• Medical Management of Vaccine Reactions in Children and Teens
• Medical Management of Vaccine Reactions in Adults