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Model Standing Orders for Immunizations

The model standing orders listed below and standing orders for any newly recommended vaccines will be updated within one month from the date that ACIP makes its recommendation or at the discretion of the Oregon Health Authority.

An interim order is published when clinical guidance is needed but the Advisory Committee on Immunization Practices recommendations haven’t yet been published in the MMWR. The interim order will be replaced with a final order once the recommendations are published.

Note to clinicians: The vaccines and biologics listed here are routinely recommended in the state of Oregon. Any clinician ordering travel vaccines in addition to these is advised to review package information regarding simultaneous administration.

Model Standing Orders

These issues are PDF files that require Adobe Reader software to be read and printed.

Disclaimer of liability, reliability and endorsement.

Vaccine/biologic Date Issued
Guidelines For Managing Adverse Events 07/17
Adverse Event E-kit Checklist 07/17

Easy Access Medication Sheets
Example: Anaphylaxis
Example: Urticaria
Example: Syncope
Diphtheria and Tetanus Toxoid 07/17  
DTaP and Combination Vaccines 07/17
Hepatitis A and Twinrix 09/17 New!!  
Hepatitis B and Twinrix 07/17  
Hib and combination vaccines 07/17  
HPV (9vHPV ) 07/17
Immune globulin, Hepatitis A and Measles
   HepA IG Dose Change
09/17 New!! 
Immune globulin, Hepatitis B 07/17
Immune globulin, Tetanus 07/17
Immune globulin, Varicella 09/17 New!!
Influenza (IIV) 2017-18 Interim 09/17 New!! 
Meningococcal (A, C, Y, W, and B) 07/17
Meningococcal B - Outbreak Control Only 08/17
MMR and MMRV 07/17  
Pneumococcal Vaccines 07/17
Polio (inactivated) and combo vaccines 07/17  
Rotavirus 07/17  
TST and Live Virus Vaccines 07/17  
Varicella-containing vaccines 07/17  
Sites For Administration of Vaccine 07/17  
Vaccine Misadministration Guidelines 07/17
Table of Contents 09/17

Vaccines for Travelers Date Issued
Cholera 07/17  
Japanese Encephalitis 07/17  
Polio for Travelers 07/17
Rabies 07/17
Typhoid 07/17
Yellow Fever 07/17

To request this material in an alternative format (e.g. Braille) or to clarify any part of the model standing order, contact the Oregon Health Authority Acute and Communicable Disease Prevention program at 971-673-1111.

Emergency Preparedness/Post-exposure Prophylaxis

The standing order for anthrax includes an additional algorithm. Other post-exposure prophylaxis model standing orders will be added as developed and updated.

Emergency Preparedness/Post-exposure Prophylaxis Date
Anthrax 12/16
Meningococcus 10/16
Pertussis 04/17
Pneumonic Plague 08/15
Smallpox 06/16
Tularemia 08/15

VAERS

Vaccine Adverse Event Reporting

Oregon Public providers are to complete the Vaccine Adverse Events Reporting System (VAERS) report online by going to https://vaers.hhs.gov/reportevent.html. Save the report number for your records and send copies of the report and VAERS ID number to the Oregon Immunization Program Vaccine Safety Coordinator via confidential email or fax (971-673-0278).

Private providers are to report adverse events directly to VAERS and can read about options on how to do so at https://vaers.hhs.gov.

Regarding Zostavax and Adults age 50 and older

Update based upon the August 22, 2014 MMWR

On August 22, 2014 ACIP made the following determinations:

  1. Not to recommend Zostavax for persons <60 years of age.
  2. The burden of herpes zoster increases with age, especially after age 60.
  3. Adults receiving herpes zoster vaccine before age 60 years might not be protected when the risks for herpes zoster and its complications are the highest.
  4. Vaccination at age 60 years would prevent the most shingles cases (26,147 per 1 million persons).
  5. The protection of herpes zoster vaccine wanes within the first 5 years after vaccination.
  6. Booster doses have not been studied.
  7. The CDC is actively monitoring data on duration of vaccine protection in adults vaccinated at age =60 years. As additional data become available, ACIP will reevaluate the optimal age for vaccination and the need for revaccination.
  8. Zostavax is covered by some Medicare Part D policies for patients =65 years of age. Oregon Medicaid covers zoster vaccine for those age 60 and older. Other insurance companies may not cover the cost of Zostavax, especially for indications (e.g., <60 years of age) that lie outside of ACIP recommendations.

Disclaimer of Liability

This site is provided as a public service by the Immunization Program of the Oregon Health Authority Public Health Division. The model standing orders provided here are intended for use by the public and private sectors to promote quality standard of practice in immunization. This information is designed to help practitioners provide precise and timely immunization services to the client. These orders are not in effect unless they have been reviewed and authorized by a medical doctor. Although the information and forms displayed here are carefully reviewed before publication, in providing immunizations, the practitioner should consult the package insert and recommendations made by both the American Academy of Pediatrics and the Advisory Committee on Immunization Practices. The state of Oregon does not make either express or implied warranties regarding the use of these forms and information. Each practitioner must depend on his or her own knowledge and expertise in using or modifying these forms and information.

Disclaimer of Reliability
In preparation of these sites, every effort has been made to offer the most current information possible. The information and data included on this have been compiled by state staff from a variety of sources, and are subject to change without notice. The state of Oregon makes no warranties or representation whatsoever regarding the quality, content, completeness, or adequacy of such information and data. The state of Oregon disclaims any responsibility for typographical errors and accuracy of the information that may be contained on state of Oregon web pages. In any situation where the official printed publications of the state of Oregon differ from the text contained in this system, official printed documents take precedence.

The state of Oregon makes no representations or warranties regarding the condition or functionality of this web site, its suitability for use, or that this web service will be uninterrupted or error-free. If misleading, inaccurate or otherwise inappropriate information is brought to our attention, a reasonable effort will be made to fix or remove it. Such concerns should be addressed to the Immunization Program at 971-673-0300.

Disclaimer of Endorsement
Reference herein to any specific commercial products, process, or service by trade name, trademark, manufacturer, or otherwise, does not constitute or imply its endorsement, nor its recommendation by the state of Oregon. The views and opinions of authors expressed herein do not state or reflect those of the state of Oregon, and may not be used for advertising or product endorsement purposes.

 

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