How many doctors use standing orders for vaccines?


Standing orders have a positive impact on vaccination rates. However, a new study indicates that some doctors aren’t using them for a variety of reasons.

The use of standing orders has been shown as a good way to increase overall vaccination rates, a positive thing in an era of antivax sentiment. How many pediatricians actually use them? A new study in Pediatrics takes a look.1

Researchers sent an internet and mail survey from June 2017 to September 2017 to 471 pediatricians, a nationally representative sample. A total of 372 responded to the survey. Among the respondents, 59% said that they used standing orders.

Among nonusers, the most common concerns were that the incorrect vaccine would be administered (68%); the belief that parents and patients would like to talk about the vaccine before administration (62%); and the belief that it’s important to be the one recommending the vaccine’s administration (57%). The investigators found that pediatricians with higher physician responsibility scores were less likely to use standing orders.

The use of standing orders also was linked to lower concerns about office processes, suburban or rural location, and system-level decision-making about vaccines in bivariate analysis, but not in multivariable analysis

Researchers concluded that the use of standing orders for vaccinations was not universal. In order to increase the use of standing orders, they said efforts should take into account organizational factors and address the attitude of pediatricians.


1. Cataldi J, O’Leary ST, Lindley MC, et al. Use of standing orders for vaccination among pediatricians. Pediatrics. 2020;145(5):e20191855. doi: 10.1542/peds.2019-1855

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