Recommendations from the Advisory Committee on Immunization Practices

The Advisory Committee on Immunization Practices (ACIP) has established recommendations on Use of Standing Orders Programs to Increase Adult Vaccination Rates. ACIP has also established recommendations on Adult Immunization Programs in Nontraditional Settings: Quality Standards and Guidance for Program Evaluation.

You may also download these Recommendations in Adobe Acrobat format. The Adobe Acrobat reader software is needed to view these documents after downloading. To obtain this free software, go to the Adobe Acrobat web site.

Nursing Facility Immunization Policy and Procedure

IMMUNIZATION POLICY:  All residents will be immunized against vaccine-preventable diseases that may be encountered in this facility and as recommended by the Advisory Committee for Immunization Practices. These vaccines will be provided to all persons upon admission, unless medically contraindicated or unless the resident or his or her responsible party refuses.

All new residents will be assessed by the nursing staff, upon admission, for the following vaccination status: influenza, pneumococcal vaccine, and Td (tetanus and diphtheria toxoids).

1. Residents will be counseled on the benefits and adverse effects of each vaccine, and a consent/refusal form will be offered to the resident (or their responsible party) prior to administration of the vaccines.
   
2. The Immunization Program Coordinator, or facility designee, will obtain the appropriate signature with the dates of signing on the appropriate Consent Form for each immunizing agent (influenza and pneumococcal vaccines and Td) during the admission process.
   
3. If the resident or responsible party consents to the immunizing agent included in these orders:

• obtain signature from resident and/or responsible party and date the appropriate consent forms;

• obtain/verify physician’s order;

• administer immunizing agents per manufacturer guidelines within 72 hours of admission;

• document the date, time, and injection site in the resident’s Immunization Record;

• monitor for any adverse reactions for 72 hours after giving the vaccine;
  
• document any adverse reactions in the medical record and in the Resident Immunization Record and notify the attending physician;

4. If resident or responsible party refuses an immunizing agent included in these orders:

• resident and/or responsible party should sign and date the appropriate refusal slip;

• document the reason(s) the immunizing agent was refused, such as history and nature of adverse reaction, on the permission/refusal slip;

• for residents refusing influenza and/or pneumococcal vaccine indicate the nonvaccination status in a clearly visible location, such as a designated place in the medical record.