How to Start an Office-based Immunization Program

Women are much more likely to receive immunizations following a recommendation and offer from their doctor. Setting up an office-based immunization program allows you to offer your patients, their families, and your community protection from diseases. For more information, read "Immunizations and Routine Obstetric-Gynecologic Care: A Guide for Providers and Patients." 

The Vaccinating Adults: A Step-by-Step Guide, developed by staff at the Immunization Action Coalition and reviewed by the Centers for Disease Control and Prevention and the National Vaccine Program Office provides practical information in an easy-to-use format to help you implement or enhance adult immunization services in your health care setting. The Guide also includes an abundance of web addresses and references to assist you in staying up to date with the most current information.  

Vaccination Coordinator

The most important aspect of an immunization program in the office is the designation of an office vaccination coordinator. The coordinator should also have a back-up person trained in all of the duties below. The coordinator will have the following responsibilities:

  • Ordering and maintaining vaccines, syringes, and other supplies.
  • Development or procurement of medical protocols for vaccination and assuring competence of the staff.
  • Following vaccine storage protocols including temperature monitoring and recording.
  • Verification of vaccine record system.
  • Clear understanding of current immunization recommendations.

One of the first duties of the coordinator will be to gain support and to ensure that all staff has access to the same information while an immunization program is incorporated into the practice. All staff, especially medical and clerical, will be impacted by changes in office procedure and it is imperative they understand and accept the importance of new or expanded vaccine services.

As part of initial planning, the clinic should decide where vaccinations will be given. Basic considerations are:  

  • Adequate lighting
  • Ventilation
  • Hand washing sink
  • Telephone access
  • Location of refrigerator that stores vaccines
  • The vaccination area must have adequate space for sharps containers, dry storage, forms for record-keeping, and informational materials.
  • Adequate space for patients to sit or recline should be available.

Storage and Handling

Appropriate vaccine storage and handling practices are an integral part of the safe and effective delivery of immunizations to patients. The Centers for Disease Control and Prevention (CDC) has multiple resources on proper vaccine storage and handling. Click the links below to access these resources.


Depending on the size of the practice and services provided, many of the supplies necessary for the immunization program may already be on hand. Syringes, needles (22–25 gauge in various lengths), alcohol wipes, spot and rectangular Band-Aids, gauze or cotton balls, and medical tape are among the needed basic supplies. Although anaphylactic reactions to vaccines are rare, emergency provisions must be available to treat these reactions. An emergency kit should include, at a minimum:

  • Standing orders for medical emergencies
  • Aqueous epinephrine
  • Diphenhydramine
  • Ammonia Inhalant Capsules (for fainting)
  • Syringes for medication administration
  • Adult airways (small, medium, large)
  • Sphygmomanometer
  • Stethoscope
  • Adult size pocket mask with one way valve
  • Alcohol wipes
  • Tourniquet
  • Tongue depressors
  • Flashlight with extra batteries
  • Timing device


Electronic or paper documentation is an important part of establishing an immunization program. A vaccine questionnaire should be used to assess the immunization status of patients and determine what vaccines may be needed based on age and circumstances (i.e. planning a pregnancy or international travel). ACOG's Vaccine Questionnaire can be found in Appendix C of Immunizations and Routine Gynecologic Care: A Guide for Providers and Patients. 

Standing Orders

Standing orders authorize nurses and other trained health care professionals, where allowed by state law, to assess the need for vaccination and to administer vaccinations according to a protocol approved by a physician, institution or authorized practitioner. Standing orders work by enabling assessment and vaccination of the patient without the need for clinician examination or direct order from the attending provider at the time of the interaction. Standing orders have been shown to increase vaccination coverage rates. Vaccine standing orders are updated as needed and reviewed for technical accuracy by immunization experts at CDC. The most current versions can be accessed by going to

Take A Stand™: Use Standing Orders to Improve Adult Immunization Rates, developed by the Immunization Action Coalition (IAC), facilitates the implementation of standing orders programs for adult immunizations in physician practices of multiple sizes that are currently providing at least one adult vaccine, and provides basic support to these practices for one year.  

Vaccine Information Statements (VIS)

Vaccine Information Statements (VISs), immunization record cards for patients, screening questionnaires, refrigerator temperature logs, Vaccine Adverse Event Reporting System (VAERS) forms (if needed), and billing forms are necessary documents for an immunization program.

Vaccine Information Statements can be downloaded in more than 40 languages. See ACOG's Liability webpage for more information. 

ACOG's Immunization resource, "Immunizations and Routine Gynecologic Care: A Guide for Providers and Patients," is available for sale in the ACOG bookstore 

Immunization Business & Clinical Strategies for Ob-Gyn Practices

The webinar, “Immunization Business & Clinical Strategies for Ob-Gyn Practices” was presented by ACOG’s Immunization Program in collaboration with the American Academy of Pediatrics (AAP). Building on the successful implementation of immunizations in pediatric care, the webinar focuses on the application of strategies used successfully for years by pediatricians as a model for immunization programs in ob-gyn practices. The webinar was led by a panel of ACOG and AAP experts in infectious diseases and practice management. The goal of the program is to provide concrete business strategies for creating sustainable immunization programs in ob-gyn practices.

 Updated 12/8/17


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