Increasing Appropriate Vaccination: Standing Orders
Task Force Finding
The Community Preventive Services Task Force recommends standing orders for vaccinations on the basis of strong evidence of effectiveness in increasing vaccination rates among adults and children; when used alone or with additional interventions; and across a range of settings and populations.
Read the full Task Force Finding and Rationale Statement for details including implementation issues, possible added benefits, potential harms, and evidence gaps.
Standing orders authorize nurses, pharmacists, and other healthcare personnel where allowed by state law, to assess a client's immunization status and administer vaccinations according to a protocol approved by an institution, physician, or other authorized provider. The protocol enables assessment and vaccination without the need for examination or direct order from the attending provider at the time of the interaction.
Standing orders can be established for the administration of one or more specific vaccines to clients in health care settings such as clinics, hospitals, pharmacies, and long-term care facilities. In settings that require attending provider signatures for all orders, standing order protocols permit assessment and vaccination in advance of the provider signature.
About the Systematic Review
The Task Force finding is based on evidence from a Community Guide systematic review completed in 2009 (29 studies, search period 1997-2009) combined with more recent evidence (6 studies, search period 2009-February 2012). The finding updates and replaces the 2009 finding for Standing Orders.
This review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to increasing appropriate vaccination. Subscribe to be notified as new materials on this topic become available.
- Evidence Gaps
- Included Studies - Effectiveness Review
- Included Studies - Economic Review
- Search Strategy - Economic Review
Jacob V, Chattopadhyay SK, Hopkins DP, Murphy Morgan J, Pitan AA, Clymer JM, the Community Preventive Services Task Force. Increasing coverage of appropriate vaccinations: a Community Guide systematic economic review. [PDF - 440 kB] Am J Prev Med 2016;50(6):797–808.
Read other Community Guide publications about Increasing Appropriate Vaccinations in our library.
The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.
The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Increasing appropriate vaccination: standing orders (abbreviated). www.thecommunityguide.org/vaccines/standingorders.html. Last updated: MM/DD/YYYY.
Review completed: March 2015
- Page last reviewed: May 26, 2016
- Page last updated: May 26, 2016
- Content source: The Guide to Community Preventive Services