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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, the Department of Defense (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.

Please see below standing order examples for each vaccine, which are updated on an as-needed basis. DHA-IHB standing orders detail recommended practices for administering vaccines in the Department of Defense (DoD). There will not be standing orders developed for every vaccine licensed for use in the United States.

Anthrax Date 
BioThrax Vaccine for Adults November 2018
Chickenpox Date 
Varivax Vaccine for Children and Adolescents April 2019
ProQuad (MMR and Varicella) Vaccine for Children and Adolescents November 2018
Varivax Vaccine for Adults
January 2019
Haemophilus Influenzae type b (Hib) Date 
PedvaxHIB Vaccine for Children November 2018
Hepatitis A Date 
Havrix Vaccine for Children and Adolescents November 2018
Havrix Vaccine for Adults November 2018
Twinrix (Hepatitis A-Hepatitis B) Vaccine for Adults November 2018
Hepatitis B Date 
Engerix-B Vaccine for Children and Adolescents November 2018
Pediarix (DTaP-IPV-Hepatitis B) Vaccine for Children
November 2018
Engerix-B Vaccine for Adults November 2018
Twinrix (Hepatitis A-Hepatitis B) Vaccine for Adults
November 2018
Human Papillomavirus (HPV) Date 
Gardasil 9 Vaccine for Children and Adolescents March 2019 
Gardasil 9 Vaccine for Adults January 2019
Influenza Seasonal Date 
Influenza Vaccine for Children and Adolescents August 2018
Influenza Vaccine for Adults August 2018
Japanese Encephalitis Date 
Ixiaro Vaccine for Children and Adolescents January 2019
Ixiaro Vaccine for Adults
January 2019
Meningococcal Date 
Bexsero (B) Vaccine for Children and Adolescents November 2018
Menactra Vaccine for Children and Adolescents November 2018
Menveo Vaccine for Children and Adolescents
November 2018
Bexsero (B) Vaccine for Adults
November 2018
Menactra Vaccine for Adults November 2018
Menveo Vaccine for Adults
November 2018
Measles-Mumps-Rubella Date 
MMR II Vaccine for Children and Adolescents November 2018
ProQuad (MMR and Varicella) Vaccine for Children and Adolescents
November 2018
MMR II Vaccine for Adults
November 2018
Pneumococcal Date 
Pneumococcal (PCV13) Vaccine for Children November 2018
Pneumococcal (PPSV23 and PCV13) Vaccines for Adults November 2018
Polio Date 
Kinrix (DTaP-IPV) Vaccine for Children
November 2018
Pediarix (DTaP-IPV-Hepatitis B) Vaccine for Children
November 2018
Inactivated Polio Vaccine (IPV) for Adults January 2019
Rabies Date 
Rabies Vaccine for Pre-Exposure Prophylaxis November 2018
Rotavirus Date 
Rotarix Vaccine for Infants November 2018
Shingles Date 
Shingrix Vaccine for Adults November 2018
Tetanus-Diphtheria-Pertussis Date 
Boostrix (Tdap) Vaccine for Children and Adolescents November 2018

Infanrix (DTaP) Vaccine for Children

November 2018
Kinrix (DTaP-IPV) Vaccine for Children November 2018
Tenivac (Td) Vaccine for Children and Adolescents November 2018
Pediarix (DTaP-IPV-Hepatitis B) Vaccine for Children November 2018
Boostrix (Tdap) Vaccine for Adults November 2018
Tenivac (Td) Vaccine for Adults November 2018
Typhoid Date 
Typhim Vi Typhoid Vaccine for Children and Adolescents November 2018
Typhim Vi Vaccine for Adults November 2018
Yellow Fever Date 
YF-VAX Vaccine for Adults December 2018
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