Download Standing Orders for Immunizations 2023-24,
a comprehensive booklet of the standing orders below and other immunization resources
Immunization standing orders are approved protocols that authorize appropriately trained health care personnel to assess patient immunization status and administer vaccinations without a written provider order or examination. Strong evidence demonstrates standing orders are an effective strategy for decreasing vaccine-preventable disease burdens while allowing for the safe delegation of the immunization process. Based upon such evidence, the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, the Community Preventive Services Task Force, the American Academy of Pediatrics and the National Vaccine Advisory Committee all recommend the use of standing orders to increase access to quality immunization health care and to reduce missed opportunities for immunizations in both children and adults. Similarly, the Defense Health Agency Immunization Healthcare Division strongly recommends the use of standing orders for vaccinations in children and adults within the Department of Defense.
The use of standing orders in the DOD is a requirement under Army Regulation 40–562; BUMEDINST 6230.15B; AFI 48–110_IP; CG COMDTINST M6230.4G (Immunizations and Chemoprophylaxis for the Prevention of Infectious Diseases). Standing orders allow eligible nurses and other health care professionals working within their scope of practice (as determined by their license and each service and/or the Defense Health Agency), to provide safe and efficient vaccine delivery in the absence of a privileged provider. All standing orders must be locally approved by a physician. A privileged provider must still be available to respond to a medical emergency when immunizations are given.
Please see below for examples of various standing orders; these are updated as needed. DHA Immunization Healthcare Division standing orders detail recommended practices for administering vaccines within the DOD; there will not be standing orders developed for every vaccine licensed for use in the United States.
*Standing orders will have to be downloaded and saved locally in order to add a digital signature.
Medical Management of Vaccine Reactions |
Date |
Medical Management of Vaccine Reactions in Children and Teens
|
May 8, 2023 |
Medical Management of Vaccine Reactions in Adults
|
October 2022 |
How to Use Standing Orders |
Information Paper: Standing Orders for Vaccine Delivery in the Department of Defense
|
March 21, 2022 |
2022 updates |
Recent Changes to Standing Orders (adult and pediatric)
|
June 2022 |
Anthrax |
Date |
Anthrax Vaccine Adsorbed (Adult)
|
June 2022 |
Chickenpox |
Date |
Varicella (Chickenpox) Vaccine (Pediatric)
|
May 15, 2023
|
Measles Mumps Rubella Varicella (MMRV) Vaccine (Pediatric)
|
May 15, 2023
|
COVID-19 |
Date |
Standing Orders for Administering COVID-19 Vaccine (Pediatric)
|
Oct. 20, 2023
|
Standing Orders for Administering COVID-19 Vaccine (Adult)
|
Oct. 20, 2023
|
Haemophilus Influenzae type b
|
Date |
Haemophilus influenzae type b Vaccine (Pediatric)
|
May 15, 2023
|
Haemophilus influenzae type b Vaccine (Adult)
|
May 15, 2023
|
Hepatitis A |
Date |
Hepatitis A Vaccine (Pediatric)
|
May 18, 2023
|
Hepatitis A Vaccine (Adult)
|
May 26, 2023
|
Hepatitis B |
Date |
Hepatitis B Vaccine (Pediatric)
|
April 6, 2023
|
Hepatitis B Vaccine (Adult)
|
May 17, 2023
|
Human Papillomavirus |
Date |
Human Papillomavirus Vaccine (Pediatric)
|
June 2022
|
Human Papillomavirus Vaccine (Adult)
|
June 2022
|
Influenza Seasonal |
Date |
Influenza Vaccine for Children and Adolescents
|
Sept. 7, 2023 |
Influenza Vaccine for Adults
|
Sept. 7, 2023
|
Japanese Encephalitis |
Date |
Japanese Encephalitis Vaccine (Pediatric)
|
June 2022 |
Japanese Encephalitis Vaccine (Adult)
|
June 2022
|
Meningococcal |
Date |
Meningococcal ABCWY Vaccine (Pediatric)
|
April 25, 2023
|
Meningococcal ABCWY Vaccine (Adult)
|
May 17, 2023
|
Measles-Mumps-Rubella |
Date |
Measles Mumps Rubella Vaccine (Pediatric)
|
May 15, 2023
|
Measles Mumps Rubella Varicella (MMRV) Vaccine (Pediatric)
|
May 15, 2023
|
Measles Mumps Rubella Vaccine (Adult)
|
May 17, 2023
|
Pneumococcal |
Date |
Pneumococcal Vaccines (Pediatric)
|
Oct. 12, 2023
|
Pneumococcal Vaccines (Adult)
|
Oct. 12, 2023
|
Polio |
Date |
Inactivated Polio Vaccine (Pediatric)
|
June 2022
|
Inactivated Polio Vaccine (Adult)
|
June 2022
|
Rabies |
Date |
Pre-Exposure Rabies Vaccine (Adult and Pediatric)
|
June 2022
|
Rotavirus |
Date |
Rotavirus Vaccine (Pediatric)
|
June 2022
|
Shingles |
Date |
Zoster (Shingles) Vaccine (Adult)
|
June 2022 |
Tetanus-Diphtheria-Pertussis |
Date |
Diphtheria, Tetanus and Acellular Pertussis (DTaP) Vaccine (Pediatric)
|
June 2022
|
Tetanus, Diphtheria and Pertussis (Tdap-Td) Vaccines (Pediatric)
|
June 2022
|
Tetanus, Diphtheria and Pertussis (Tdap-Td) Vaccines (Adult)
|
June 2022
|
Tick-Borne Encephalitis |
Date |
Tick-Borne Encephalitis Vaccine (ages 1 and older) |
June 2022
|
Typhoid |
Date |
Typhoid Vaccine (Pediatric)
|
June 2022
|
Typhoid Vaccine (Adult)
|
June 2022
|
Yellow Fever |
Date |
Yellow Fever Vaccine (Pediatric)
|
June 2022
|
Yellow Fever Vaccine (Adult)
|
June 2022
|
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Last Updated: October 27, 2023