Policy Under these standing orders eligible nurses and other healthcare professionals eg pharmacists where allowed by state law may vaccinate adults who meet the criteria below Procedure 1 Identify adults in need of vaccination against tetanus dipht ID: 54151
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PurposePolicyProcedure Assess Adults for Need of Vaccination www.immunize.org/catg.d/p3078.pdf • Item #P078 (3/20)continued on the next page Prepare to Administer Vaccine gender and weight of patientneedle gaugeneedle lengthFemale or male less than 130 lbsFemale or male 130–152 lbsFemale 153–200 lbsMale 153–260 lbsFemale 200+ lbsMale 260+ lbsA ⅝" needle may be used in patients weighing less than 130 lbs (<60 kg) for IM injection in the deltoid muscle only if Administer Td or Tdap Vaccine,0, 1, and 6–12 month intervals, including one dose of Tdap, preferably as the �rst dose, followed by a history of previous DTP, DTaPvaccinationdose and schedule for administration of dap** Give Tdap as dose #1. Give dose #2 (Td or Tdap) at least 4 weeks later, and dose #3 (Td or Tdap) 6–12 months after dose #2.1 previous dose (not Tdap)Give Tdap as dose #2 at least 4 weeks after dose #1. Give dose #3 (Td or Tdap) 6–12 months after dose #2.1 previous dose (as Tdap)Give Td or Tdap as dose #2 at least 4 weeks after dose #1. Give dose #3 (Td or Tdap) 6–12 months after dose #2. 2 previous doses (none Tdap)Give Tdap as dose #3 at least 6 months after dose #2. 2 previous doses (including 1 Tdap)Give dose #3 (Td or Tdap) at least 6 months after dose #2.3 or more previous doses (none Tdap)Give Tdap as soon as possible. (You do not need to wait 10 years 1 dose of Tdap)Give Td or Tdap booster every 10 years unless patient needs prophylaxis for wound management sooner.**Either Td or Tdap may be given for catch-up and booster doses.Tdap vaccination for pregnant womenPregnant women should receive Tdap during through 36 weeks’ gestation, regardless of number of years since prior Td or Tdap vaccination. Standing Orders for Administering Td/Tdap Vaccine to Adults Record the date the vaccine was administered, the manufacturer and lot number, the vaccination site cal records/charts should be documented and retained in accordance with applicable state laws and regulations. If vaccine was not administered, record the reason(s) for non-receipt of the vaccine (e.g., medical contraindication, patient refusal). Discuss the need for vaccination with the patient at the next visit. Vaccine Reactions in Adults in a Community Setting,” go to www.immunize.org/catg.d/p3082.pdf. To prevent syncope, vaccinate patients while they are seated or lying down and consider observing them for 15 minutes after (800) 822-7967.Standing Orders Authorization Standing Orders for Administering Td/Tdap Vaccine to Adults This policy and procedure shall remain in effect for all patients of the name of practice or clinic until rescinded or until date .Medical Director’s signature Signature date Effective date Immunization Action Coalition • Saint Paul, Minnesota • 651-647-9009 • www.immunize.org • www.vaccineinformation.orgwww.immunize.org/catg.d/p3078.pdf • Item #P078 (3/20)