Five Vaccines Added to DoD’s “Standing Orders” Program

Five Vaccines Added to DoD’s “Standing Orders” Program

Story Highlights

  • Standing orders authorize non-physician health professionals (NPHP) to provide patient care following protocols often based on national clinical guidelines, including administering federally recommended vaccines without a physician’s pre-screening examination prior to vaccination.
  • Civilians and military personnel are subject to vaccination standing orders in settings such as hospitals and in-patient/outpatient medical facilities, pharmacies, workplaces, etc.
  • Standing orders raise safety issues and may restrict the right to exercise informed consent.

In the year 2000, the Advisory Committee on Immunization Practices (ACIP) of the U.S. Centers for Disease Control and Prevention (CDC) published recommendations based on the effectiveness of vaccination “standing order” programs, which are put in place in settings providing health care, including medical facilities, pharmacies and even the workplace, increase vaccination rates among adults and children.1

What is a “Standing Order”?

Standing orders allow non-physician health professionals to treat patients following protocols that are often based on national clinical guidelines.2

According to the CDC’s 2000 report, vaccination standing order protocols authorize nurses and pharmacists to administer vaccinations according to an institution- or physician-approved protocol without a physician’s exam.” The report states that vaccination standing order programs can be implemented in multiple settings that include inpatient and outpatient facilities, long-term-care facilities, managed-care organizations, assisted living facilities, correctional facilities, pharmacies, adult workplaces, home health-care agencies, client, resident and employee settings.1

The Immunization Action Coalition (IAC) is a national non-profit organization funded by the CDC and vaccine manufacturers Astra Zeneca, GlaxoSmithKline, Merck, Pfizer, Sanofi Pasteur and Seqiris.3 4 IAC “works to increase immunization rates” and lobbies for vaccine mandates and the elimination of vaccine exemptions.5 In recent years, IAC has added, “other appropriately trained healthcare personnel where allowed by state law” to the list of those who can administer vaccines under standing orders.6

As with all vaccination protocols, the U.S. Department of Defense (DoD) follows the recommendations published by the CDC’s ACIP as the basis for issuing vaccination standing orders that apply to active duty military personnel and family dependents, as well.7 Currently, the ACIP has 44 vaccines listed as part of the DoD standing orders program, out of which five vaccines were added to the list beginning January 2019. The vaccines that have been recently added include HPV (Gardasil 9); Inactivated Polio Vaccine for adults; varicella zoster (Varivax) chickenpox vaccine for adults; Japanese encephalitis (Ixiaro) vaccine for adults and Japanese encephalitis (Ixiaro) children and adolescents.6

The DoD Military Health System’s website states that a physician must still be available to respond to a medical emergency when vaccines are administered should the patient suffer an immediate adverse effect that could be life threatening; however, the DoD website also states, “The use of standing orders in the military allows healthcare personnel working within their scope of practice as determined by their license and each Service to administer vaccines without an individual order or physician’s exam. This saves both the individual vaccinee and the provider time, while allowing for a safe and efficient vaccine delivery process in the absence of adequate allergy and immunology specialists.”6

The list of vaccines that can be giving under standing orders to all children and adults in the U.S. is listed here on the IAC website.

Safety Implications of Standing Orders

One of the major safety concerns relating to vaccination standing orders is that it eliminates the need for a physician’s pre-screening examination.  Although non-physician health professionals (NPHP) are required to assess and screen patients for potential vaccine contraindications and precautions before administering a vaccine,1 this is unlikely to occur given that there are almost no medical contraindications to vaccination today8 and health care professionals are taught that vaccines are generally safe for everyone, even though it is clear that there are known and unknown biological risk factors that make some individuals more susceptible to being harmed by vaccinations.9

This creates a potentially dangerous situation for children and adults getting their vaccines under standing orders protocols and leads to another question: Are non-physician NPHPs monitoring and reporting serious vaccine reactions, hospitalizations, injuries and deaths that follow the vaccinations they administer to people to the federal Vaccine Adverse Events Reporting System (VAERS)? Since NPHPs are now administering a substantial portion of vaccines given to children and adults in the U.S., are they obeying the legal responsibility of reporting vaccine adverse events to VAERS mandated under the National Childhood Vaccine Injury Act of 1986 or are they simply ignoring vaccine reactions and failing to report?10

The human right to exercise informed consent to medical risk taking is also violated under standing orders that allow health professionals to coerce individuals to receive vaccines without their informed and voluntary consent. Regardless of what a health professional’s beliefs are about the benefits and risks of vaccination, informed consent is required for all medical interventions that carry a risk of harm, such as surgery or the use of pharmaceutical products that carry the risk of injury or death.11

The informed consent principle stems from the human right to autonomy.12 Patients have the legal right to be fully informed about the benefits, risks and failures of a physician-recommended medical procedure prior to making an informed and voluntary decision about whether or not to accept the risks.13

The right to autonomy, which includes the right to exercise freedom of thought, conscience and religion, is an internationally recognized human right.14 Standing orders that enable a physician or NPHP to coerce people against their conscience into agreeing to a medical intervention, such as vaccination, is a violation of a basic human right.


1 Centers for Disease Control and Prevention. Use of Standing Orders Programs to Increase Adult Vaccination Rates. Morbidity and Mortality Weekly Report 2000; 49(RR01): 15-26.
2 Center for Excellence in Primary Care. University of California-San Francisco 2013.
3 Immunization Action Coalition. IAC Funding 2018. Nov. 15, 2018.
4 Immunization Action Coalition. Advisory Board. Mar. 7, 2018
5 NVIC Advocacy Portal Team. State Vaccine Legislation in American 2015-2017: Follow the Money. National Vaccine Information Center Oct. 25, 2017.
6 Immunization Action Coalition. Using Standing Orders for Administering Vaccines: What You Should Know. Immunization Action Coalition December 2018.
7 The Military Health System. Standing Orders. January 2019.
CDC. Vaccine Recommendations and Guidelines of the ACIP: Jan. 10, 2019.
Health Resources & Services Administration. Vaccine Injury Compensation Program Data and Statistics. Mar. 1, 2017.
Parpia R. The Safety Implications of Pharmacists Giving Vaccines. The Vaccine Reaction Apr. 22, 2017.        
Parpia R. Biologics R Vaccines: Beware of “Informed Consent”. The Vaccine Reaction Jan. 31, 2018.
Dryden J. Autonomy. Internet Encyclopedia of Philosophy
Fisher BL. Why Is Informed Consent a Human Right? NVIC Newsletter June 28, 2017.
Universal Declaration of Human Rights. United Nations Dec. 10, 1948.

18 Responses to "Five Vaccines Added to DoD’s “Standing Orders” Program"

  1. Sandra Lee Smith   January 25, 2019 at 10:22 pm

    To say that vaccines are safe for all and there are almost no contraindications is absurd; that’s just Big Pharma wanting their money, not a medially sound statement. Introducing a foreign protein to anyone’s body always carries a risk; more for some than others. And those are introducing foreign proteins!

  2. Dede   January 25, 2019 at 10:44 pm

    How would we know these things if it were not for NVIC, The Vaccine Reaction.
    God Bless you for enabling us to be knowledgeable about what has been and is going on behind the scenes in this sector. Frightening does not even begin to describe it. This is how the “Health” Dept. gets away with the drive by shootings of Flu Vaccines. They advertise, you drive by, get the flu shot, and off you go. No waiting for a reaction time.
    The Flu vaccine injuries are paid out by the Governments Grand Vaccine Master. Big Pharma all the way.

  3. Elizabeth Keelor   January 26, 2019 at 1:34 am

    There are several either typographical and/or grammatical errors throughout this article. These take away from the substance and importance of the information within.

  4. David   January 26, 2019 at 7:10 am

    How are people so blind to what is going on?.
    They have implicit faith in doctors and their recommendations.
    Don’t doctor’s make mistakes? How often do they get it wrong?
    At what cost?
    Of course it depends what you mean by a doctor, “Junior doctors
    have a much higher error rate than older doctors.
    If your lucky 50% of the older one’s get it wrong.
    And then there is the treatment.
    When Pharma manipulate studies and omit negative side effects
    there is no way a doctor can know what he is prescribing.
    And what is coming to the fore more frequently, they offer medications
    without reference to the patients biochemical status. This is madness.
    Drugs rob the body of nutrients and give rise to side effects,
    Take statins (if you are driven by fear) to offset the side effects
    one needs to take CO Enzyme Q10.
    Other drugs and the nutrients they deplete the body of can be
    discovered with a little research.
    There are complimentary ways of looking at illness which
    require a change of diet….no need for drugs. Why not explore these
    options ?. Otherwise you are on the treadmill which 93% of the
    population will be on and by the time they are 55-60 will be on
    5 drugs a day plus for which there is no science as drugs are
    approved singly. Healthcare is a business which operates according
    to business “ethics”, how much money can we make from this
    product or service. Once you realise that you are free of unrealistic
    expectations that doctors should care for you and yours. Please,
    this sort of thinking is for children..
    Does that mean all doctors are out for their pound of flesh? No, there
    are actually some good ones who put clinical judgement over
    pecuniary interest. They are worth their weight in gold.

  5. George   January 26, 2019 at 10:31 am

    America is fast becoming a mirror of Nazi Germany or Stalinist Russia. Human rights are eroding faster than at any time in our history, and the Constitution is being torn to shreds. This type of medical tyranny MUST NOT STAND!

  6. Shirley Jacobson   January 26, 2019 at 1:39 pm

    When the title says “Five Vaccine’s Added….” I wish it would be easy to scan through the article and clearly see what those five are. I couldn’t find them listed.

    • Bee   January 26, 2019 at 6:25 pm

      There is a word “here” in blue right above the second bold title ‘Safety Implications of Standing Order’ that will link you to the list.

  7. Mary   January 26, 2019 at 2:03 pm


  8. Jenny   January 26, 2019 at 3:21 pm

    Every time you or your child gets a vaccine, you are taking part in an experiment!

    There has not been a single safety trial for vaccines. Therefore, every time you get one, you are the subject in an experiment.

  9. Anon   January 26, 2019 at 5:32 pm

    I agree. However, it is not a mirror, it IS the nazi’s … we took their scientists into our country and gave them freedom to run their ‘program’ here. See “Project Paperclip”.

  10. jo   January 26, 2019 at 6:25 pm

    I never understood how military top brass could allow the injury of their people, by the Anthrax Vaccine.
    How could Gov & Military do that, to its people?
    _ BiG money went to pushing the later-even-worse vaccines on the population. BIG PIG PHARMA bought “our” gov. Greed! The Rich Filthy Thus, since 1986, you cannot sue the vaccine/drug/chemical makers/sellers. Corporations control the gov: fascism.
    _ Thus, now I understand, HOW “OUR” “REPRESENTATIVES” COULD DO THAT, TO THEIR NEIGHBOR CITIZEN CONSTITUENTS!!! They’re “souled-out.” Garbage!
    _ Vet Paul Rieckhoff pointed out, in response to a President saying America was at war, “America is not at war. The military & their families are at war. Everyone else is shopping.”
    _ It’s so true it just makes me sick. Maybe, We The Poor People hallucinate we can’t fight city hall, just because they’re sick tyrants.
    _ Visit “your” “Reps.” Ask them to help STOP the Ultra-Rich VACCINE COMPANIES. Post their responses. It won’t be long before they block you from visiting. THIS IS FOR WHAT YOUR PHONE WAS MADE.

  11. J   January 26, 2019 at 11:41 pm

    Only 4 are mentioned, our facts need to be accurate and impeccable. ..

  12. Jason   January 26, 2019 at 11:43 pm

    Only 4 are listed

    • Marco Caceres   February 4, 2019 at 2:22 am

      << The vaccines that have been recently added include HPV (Gardasil 9); Inactivated Polio Vaccine for adults; varicella zoster (Varivax) chickenpox vaccine for adults; Japanese encephalitis (Ixiaro) vaccine for adults and Japanese encephalitis (Ixiaro) children and adolescents. >>

  13. Jason   January 26, 2019 at 11:46 pm

    Only 4 are mentioned

    • Marco Caceres   February 4, 2019 at 2:22 am

      << The vaccines that have been recently added include HPV (Gardasil 9); Inactivated Polio Vaccine for adults; varicella zoster (Varivax) chickenpox vaccine for adults; Japanese encephalitis (Ixiaro) vaccine for adults and Japanese encephalitis (Ixiaro) children and adolescents. >>

  14. Joel Chudnow   January 27, 2019 at 5:08 am

    US Supreme Court: “Vaccines are unavoidably unsafe.”

    Our bodies have no deficiency of a single drug or vaccine!

  15. Patrick LaChance   January 27, 2019 at 6:37 pm

    In addition to active duty, the DOD “Standing Orders” ALSO apply to all Guard & Reserve members so that IF they are not current with their medical status (immunizations), they are considered to be in a NON-deployable status and will eventually be dropped from earning points and pay. Basically, this would end your part-time career as Guard or Reserve.
    Regarding the dependent family members, my experience is that the dependent children are required to be current with all required vaccinations to be able to attend Dept of Defense Schools, base child care facilities, and youth center programs. There are medical and religious exemption/waivers ONLY – no personal belief exemption/waivers will be recognized.
    Being overseas in the DOD limits your rights because you are not geographically located within a US state. Also, your school and child care options are more limited overseas due to language, cultural, and legal barriers. In addition, the DOD mandates that ALL immunizations are administered to all dependent family members in order to PCS (Permanent Change of Station) to an overseas location.


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