The Effects of Vaccine Standing Orders on Pediatric Vaccination Rates: A Pilot Study

Vaccinations are one of the greatest public health achievements of the 20th century, leading to a reduction in morbidity and mortality associated with the infectious diseases they prevent. Unfortunately, vaccination rates within the U.S. have been declining, and many of these vaccine-preventable diseases are again on the rise. Due to this, methods to increase vaccination rates are being explored. Vaccine standing orders are one method being employed. This pilot study explored the effects vaccine standing orders placed in the electronic medical record (EMR) had on the number of pediatric vaccinations administered in one South Dakota clinic.

Nursing staff reviewed the EMR and state records to determine what immunizations the pediatric patients, defined as those 18 years of age and under, were due for according to the Center for Disease Control's (CDC) recommended vaccination schedule. They then placed vaccine standing orders in the EMR for each delinquent vaccination based on these findings. The number of vaccines administered during a five-month period before (Jan. 1 - May 31, 2019) and a five-month period after (June 1 - Oct.31, 2019) implementation of standing orders were compared. Results were analyzed using an independent samples t-test.

The absolute number of vaccinations administered after standing orders were instituted was greater than those administered prior to standing orders. The average number of vaccines given per month more than doubled, resulting in a statistically significant increase in vaccination rates by 117 percent.

This pilot study demonstrated a significant increase in the number of immunizations administered with the use of standing orders.