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Standing Orders

Standing orders programs authorize nurses and pharmacists to administer immunizations according to an institution- or physician-approved protocol without a physician’s exam. In March of 2000, the Advisory Committee on Immunization Practices (ACIP) published recommendations based on evidence of the effectiveness of standing order programs, citing that they help decrease vaccine-preventable disease burdens and allow for the safe delegation of the immunization process. As it is with all immunization practices, DoD will follow ACIP recommendations for the use of standing orders. See our Standing Orders for Vaccine Delivery in the Department of Defense (DoD) information paper for more.

A physician must still be available to respond to a medical emergency whenever immunizations are given. The use of standing orders in the military allows healthcare personnel working within their scope of practice as determined by their license and each Service to administer vaccines without an individual order or physician’s exam. This saves both the individual vaccinee and the provider time, while allowing for a safe and efficient vaccine delivery process in the absence of adequate allergy and immunology specialists.

Examples

See below for examples of standing orders that meet existing quality assurance guidelines for safe delivery of immunizations. Additional examples of standing orders for routine immunizations can be found through the Immunization Action Coalition.

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