Note: The booklet Standing Orders for Immunizations 2023-24 is currently being updated. It will be posted again once that update is complete. Meanwhile, individual standing orders can be found below.

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.