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Pharmacy Protocols

Oregon Pharmacy Protocols for Immunization

Note to pharmacists:
The following Pharmacy Protocols for Immunization are reviewed yearly. Generally, updates are made as new recommendations are published by the Advisory Committee on Immunization Practices (ACIP).

2018 Expiration Extension

With the approval of the Immunization Program Medical Director, we are extending the expiration date of all standing orders / pharmacy protocols until August 31, 2018. This will allow for a thorough review of all updated information. We will be posting the updated orders / protocols as they are approved, but will wait to post the updated table of contents until all of the new orders /protocols are posted.

We are hoping to post the first batch of updated orders / protocols in the next week. We will indicate the updated orders by adding a “new” tag and by the updated expiration date of July 31, 2019.

An interim protocol 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 protocol will be replaced with a final protocol once the recommendations are published.


Please read through all the protocols carefully. If you decide to change any part of them, your changes must be submitted in writing to Jeanine Whitney and approved by the OHA Immunization Program.

If you have any questions about these revised protocols, please call Jeanine Whitney at (971) 227-0023.

Please read the Disclaimer.

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

Vaccine/biologic  Date of Last Revision
Guidelines for managing adverse events July 2017
Adverse Events E-kit Checklist and Report Form July 2017
Cholera July 2017
Diphtheria and Tetanus Toxoids August 2017
Haemophilus influenzae type b (Hib) July 2017
Hepatitis A &Twinrix July 2017
Hepatitis A Outbreak Only January 2018
Hepatitis B &Twinrix July 2017
Human papillomavirus vaccine (HPV 9) July 2017
Influenza (IIV 2017-18) January 2018
Japanese Encephalitis  July 2017
Meningococcal A, C, W, Y July 2017
Meningococcal B Outbreak Only July 2018
MMR/MMRV July 2017
Mumps - Outbreak Only March 2018
Pneumococcal Vaccines July 2017
Polio July 2017
Polio for Travelers August 2017
Rabies (inactivated) July 2017
Shingrix February 2018
Typhoid July 2017
Varicella-containing vaccines July 2017
Yellow fever  July 2017
Sites for Administration of Vaccine July 2017
Vaccine Misadministration Guidelines July 2017
Table of Contents March 2018
Multiple Signature Page July 2017


Regarding Yellow Fever

Certified immunizing pharmacists in the state of Oregon are now eligible to apply for the Uniform Stamp and Yellow Fever Center Agreement. Get more information: Administering Yellow Fever and other travel vaccines.

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 an

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