Vaccine Protocols

Information and templates for writing a vaccine administration order, also called a protocol.

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On this page:

Guidance Documents	HPV
Supporting Documents	Influenza
Vaccine Protocol Templates	Meningococcal
DT	MMR and MMRV
DTaP	Pneumococcal
DTap-IPV	Polio
DTaP-IPV-HepB	Rotarix
DTap-IPV-Hib	Rotateq
Hep A	Td
Hep A and Hep B (Twinrix)	Tdap
Hep B	Varicella and MMRV
Hib	Zoster

Guidance Documents

Guidance for Adopting Vaccine Protocols (PDF: 72KB/4 pages)
Information on why vaccine protocols are necessary, why there are so many protocols, annual signing of protocols, and how to get started.

Vaccine Protocol Tracking Sheet (Excel: 41KB/2 pages) (Word: 124KB/3 pages)
Tracking sheet to help you keep track of the vaccine protocols in Excel or Word versions.

Influenza Vaccine Products by Excipient
List of less-known ingredients found in flu vaccine products to help determine potential allergens.

Supporting Documents

Vaccine Product Summary
Summary chart showing each vaccine's generic and brand names, manufacturer, age group licensed to receive, dosing information, and administration route.

Guide to Contraindications and Precautions to Commonly Used Vaccines
Guide designed to help immunization providers determine what common symptoms and conditions should contraindicate vaccination and which ones should not.

Suggested Intervals between Administration of Antibody-Containing Products and Measles-Containing and Varicella-Containing Vaccines (adopted from the ACIP General Recommendations, 2006, Table 4) (PDF: 43KB/2 pages)

Vaccine Protocol Templates

Vaccine protocol templates to be filled in and used.

DT

Diphtheria and Tetanus (DT) Vaccine Protocol for Children Under Age 7 Years (Word: 73KB/2 pages)

Diphtheria and Tetanus (DT) Vaccine Protocol for Catch-Up in Children Less than Age 7 Years (Word: 87KB/2 pages)

DTaP

Diphtheria, Tetanus, and Pertussis (DTaP) Vaccine Protocol (Word: 79KB/3 pages)

Diphtheria, Tetanus, and Pertussis (DTaP) Vaccine Protocol for Catch-Up Vaccination (Word: 90KB/3 pages)

DTap-IPV

Combination Diphtheria, Tetanus, and Pertussis - Polio (DTap-IPV) as Kinrix Vaccine Protocol (Word: 86KB/3 pages)

DTaP-IPV-Hep B

Combination Diphtheria, Tetanus, and Pertussis - Polio - Hepatitis B (DTaP-IPV-HepB) Vaccine Protocol for Pediarix (Word: 86KB/3 pages)

Combination Diphtheria, Tetanus, and Pertussis - Polio - Hepatitis B (DTaP-IPV-HepB) Vaccine Catch-Up Protocol for Pediarix (Word: 100KB/3 pages)

DTap-IPV-Hib

Combination Diphtheria, Tetanus, and Pertussis - Polio - Haemophilus influenza, type B (DTap-IPV-Hib) as Pentacel Vaccine Protocol (Word: 86KB/3 pages)

Combination Diphtheria, Tetanus, and Pertussis - Polio - Haemophilus influenza, type B (DTap-IPV-Hib) Vaccine Catch-Up Protocol for Pentacel (Word: 102KB/3 pages)

Hepatitis A

Hepatitis A (Hep A) Vaccine Protocol for Routine Childhood Vaccination (Word: 72KB/2 pages)

Hepatitis A (Hep A) Vaccine Protocol for Catch-Up Vaccination of Children Age 2 through 18 Years (Word: 82KB/2 pages)

Hepatitis A (Hep A) Vaccine Protocol for Adults Age 19 and Older (Word: 72KB/2 pages)

Hepatitis A and Hepatitis B (Twinrix)

Hepatitis A and Hepatitis B as Twinrix Vaccine Protocol for Persons Age 18 and Older (Word: 77/2 pages)

Hepatitis B

Hepatitis B (Hep B) Vaccine Protocol for Routine Infant Vaccination (Word: 72KB/2 pages)

Hepatitis B (Hep B) Vaccine Protocol for Catch-Up Vaccination of Children through Age 19 Years (Word: 80KB/2 pages)

Hepatitis B (Hep B) Vaccine Protocol for Recombivax HB Two-dose Adolescent Vaccination (Word: 81KB/2 pages)

Hepatitis B (Hep B) Vaccine Protocol for Adults Age 20 and Older (Word: 72KB/2 pages)

Hepatitis B (Hep B) Vaccine Protocol for Catch-Up Vaccination in Adults Age 20 Years and Older (Word: 74KB/2 pages)

Haemophilus Influenza, Type b (Hib) - Hepatitis B as Comvax Vaccine Protocol (Word: 73KB/2 pages)

Hib

Haemophilus Influenza, Type b (Hib) as ActHIB Vaccine Protocol (Word: 74KB/2 pages)

Haemophilus Influenza, Type b (Hib) Vaccine Protocol for ActHIB Catch-Up (Word: 77KB/2 pages)

Haemophilus Influenza, Type b (Hib) as Hiberix Booster Vaccine Protocol (Word: 75KB/2 pages)

Haemophilus Influenza, Type b (Hib) - Hepatitis B as Comvax Vaccine Protocol (Word: 73KB/2 pages)

HPV

Bivalent Human Papillomavirus (HPV2) Vaccine as Cervarix Vaccination Protocol (Word: 90KB/2 pages)

Bivalent Human Papillomavirus (HPV2) Vaccine as Cervarix Catch-Up Vaccination Protocol (Word: 90KB/2 pages)

Quadrivalent Human Papillomavirus (HPV4) Vaccine as Gardasil Vaccination Protocol (Word: 79KB/2 pages)

Quadrivalent Human Papillomavirus (HPV4) Vaccine as Gardasil Catch-up Vaccination Protocol (Word: 56KB/2 pages)

Influenza

Trivalent Live Attenuated Influenza Vaccine (LAIV) Vaccine Protocol Persons Age 2 through 49 Years (Word: 94KB/3 pages)

Seasonal Trivalent Inactivated Influenza Vaccine (TIV) Protocol Children Age 6 Months Through 8 Years (Word: 109KB/4 pages)

Seasonal Trivalent Inactivated Influenza Vaccine (TIV) Protocol Persons Age 9 Years and Older (Word: 104KB/3 pages)

Meningococcal

Meningococcal Conjugate Vaccine, 4-Valent (MCV4) Protocol for At-risk Persons Age 9 months through 55 Years (Word: 70KB/2 pages)

Meningococcal Conjugate Vaccine, 4-Valent (MCV4) Protocol for Routine or Catch-up Vaccination (Word: 79KB/2 pages)

Meningococcal Polysaccharide Vaccine, 4-Valent (MPSV4) Protocol for At-risk Persons Age 56 or Older (Word: 82KB/2 pages)

MMR

MMR Routine Vaccination Protocol (Word: 75KB/2 pages)

MMR Non-Routine Vaccination Protocol for Infants Age 6 through 11 Months Old and Persons Age 7 Years and Older (Word: 79KB/2 pages)

Combination Measles, Mumps, Rubella, and Varicella (MMRV) Vaccine as ProQuad Vaccination Protocol (Word: 84KB/3 pages)

Pneumococcal

Pneumococcal Polysaccharide Vaccine, 23-valent (PPV23), Protocol for At-risk Persons Age 2 through 18 Years (Word: 90KB/3 pages)

Pneumococcal Polysaccharide Vaccine, 23-valent (PPV23), Protocol for At-risk Persons Age 19 through 64 Years (Word: 90KB/2 pages)

Pneumococcal Polysaccharid Vaccine, 23-valent (PPV23), Protocol for Persons Age 65 Years or Older (Word: 83KB/2 pages)

Pneumococcal Conjugate, 13-valent (PCV13) as Prevnar Vaccine Protocol for Routine Infant Immunization (Word: 78KB/2 pages)

Pneumococcal Conjugate, 13-valent (PCV13) as Prevnar Protocol for Catch-Up & Supplemental Vaccination (Word: 83KB/3 pages)

Polio

Inactivated Poliovirus Vaccine (IPV) Protocol (Word: 72KB/2 pages)

Inactivated Polio Vaccine (IPV) Catch-up Protocol (Word: 80KB/2 pages)

Rotarix

Rotavirus as Rotarix (RV1) Vaccine Protocol (Word: 84KB/2 pages)

Rotavirus (RV1) as Rotarix VaccineProtocol for Catch-Up Vaccination (Word: 60KB/2 pages)

Rotateq

Rotavirus as Rotateq (RV5) Vaccine Protocol (Word: 83KB/2 pages)

Rotavirus (RV5) as Rotateq Vaccine Protocol for Catch-Up Vaccination (Word: 59KB/2 pages)

Td

Diphtheria & Tetanus Toxoids (Td) Vaccine Protocol for use in Primary Series and as Booster Doses (Word: 81KB/3 pages)

Tdap

Tetanus & Diphtheria Toxoids and Acellular Pertussis (Tdap) Vaccine Protocol for a Primary Series in Persons Age 7 Years or Older (Word: 86KB/3 pages)

Tetanus & Diphtheria Toxoids and Acellular Pertussis (Tdap) as One-time Booster Vaccine Protocol (Word: 81KB/3 pages)

Varicella

Varicella Vaccine Protocol for Routine Vaccination (Word: 90KB/3 pages)

Varicella Vaccine Protocol for Catch-Up in Children Age 15 Months through 3 Years or 7 through 12 Years or for Post Exposure Prophylaxis in Persons Under Age 13 Years (Word: 93KB/3 pages)

Varicella Vaccine Protocol for Persons Age 13 Years and Older and for Post Exposure Prophylaxis (Word: 87KB/3 pages)

Combination Measles, Mumps, Rubella, and Varicella (MMRV) Vaccine as ProQuad Vaccination Protocol (Word: 84KB/3 pages)

Zoster

Zoster Vaccination Protocol (Word: 89KB/2 pages)

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Updated Monday, 10-Dec-2012 15:26:47 CST