# Presentation: 432226

## Vaccine Storage and Handling

**Epidemiology and Prevention of Vaccine-Preventable Diseases**
**National Immunization Program**
**Centers for Disease Control and Prevention**

**Revised January 2007**

## Effect  of Temperature on Vaccines

**Live vaccines**
**tolerate freezing**
**deteriorate rapidly after removal from freezer**
**Inactivated vaccines **
**damaged by exposure to freezing temperatures**
**tolerate short time out of refrigeration**

## Cold Chain

**Vaccines must be stored properly from the time they are manufactured until they are administered to your patients**
**Manufacturer to distributor**
**Distributor to office**
**Office to patient**

## Vaccine Storage and Handling Guidelines

**Develop and maintain detailed written protocol**
**Assign responsibilities to one person**
**Designate a back-up person**
**Provide training on vaccine storage and handling**

## Vaccine Storage Requirements

**Maintain required temperature range throughout the year**
**Separate doors for refrigerator and freezer**
**Large enough to hold year’s largest vaccine inventory**
**Dedicated to biologics (no food or beverages!)**
**Dorm-style refrigerators should NOT be used to store varicella, zoster, MMRV or LAIV vaccine**

## Vaccine Storage Requirements

## Recommended Temperatures

_**Refrigerator**_
**35****o**** - 46****o****F**
**or**
**2****o**** - 8****o****C**
**Average 40****o****F (5****o****C)**

_**Freezer**_** **
_**<**_**+5****o****F**
**or**
_**<**_**-15****o****C**
**	****(****varicella/zoster, MMRV, LAIV)**

## Temperature Monitoring

**Check and record the temperatures twice a day**
**Use temperature log for both refrigerator and freezer compartments**
**Keep temperature logs for at least 3 years**
**Take **_**immediate action**_** when the temperature is outside the recommended range**
**Do NOT administer mishandled vaccine**

## Temperature Monitoring

**Separate thermometer for refrigerator and freezer compartments**
**Use good quality certified calibrated thermometer (biosafe liquid, continuous graphic, or minimum/maximum)**
**Manually check temperatures twice a day even if using continuous graphic thermometer**

## Certified Calibrated Thermometers

## Preventive Measures

**Use a plug guard or safety-lock plug**
**Post a warning sign above the plug and on the refrigerator**
**Label fuses and circuit breakers**
**Install a temperature alarm**

## Preventive Measures

## Preventive Measures

**Remove vegetable bins and replace with bottles of water to stabilize refrigerator temperature**
**Keep extra cold packs or blue ice in the freezer**
_**Never**_** store vaccines in the door of the refrigerator or freezer**

## Preventive Measures

## Prefilling Syringes

**Increases the risk for administration errors**
**Increases vaccine wastage**
**May result in bacterial growth in vaccines that do not contain a preservative**

## Consider using manufacturer-supplied prefilled syringes for large immunization events

Syringes other than those filled by the manufacturer should be discarded at the end of the clinic day

**Syringes other than those filled by the manufacturer should be discarded at the end of the clinic day**

**Prefilling Syringes**

## Vaccine Inventory Control

**Conduct a monthly vaccine inventory**
**Avoid stocking excessive vaccine supplies**
**Monitor expiration dates**
**Rotate stock**
_**Never**_** use expired vaccine or diluent**

## Emergency Planning

**Develop an emergency vaccine retrieval and storage plan**
**Identify a back-up site with a generator in the event of equipment failure or power outage**

## Vaccine Storage and Handling Toolkit

**Available on the National Immunization Program website**
**CD version available in spring 2007**

## National Immunization ProgramContact Information

**Telephone****	****	****800.CDC.INFO**** **
**Email****	****	****	****nipinfo@cdc.gov**** **
**Website****	****	****www.cdc.gov/nip**