If the patient meets criteria for influenza vaccination and/or pneumococcal vaccination, the PPS will inform him/her that influenza/pneumococcal vaccine is/are recommended for them and that the vaccination will be offered to eligible patients in the ED at no additional charge beyond that which is reimbursed by their insurance. Patients will be referred to a physician for additional assessment if they have a questionable or possible contraindication. The PPS will provide all eligible patients with the appropriate Vaccine Information Statement(s) and answer any questions. If the patient agrees to be vaccinated, the PPS will place a preprinted order form in the patient’s chart, ask the physician to sign the order, and alert the patient’s nurse. The patient will be offered vaccination by an ED nurse while they are undergoing evaluation and treatment in the emergency room. The nurse giving the vaccination will document the lot number, expiration date, time and location of the injection(s) on a label that will be placed in the patient’s chart.