text
 

Table of Contents
 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

General Information 

Vaccine Storage and Handling Best Practices 5 

Selected Biologicals 

Diphtheria Toxoid-, Tetanus Toxoid- and acellular Pertussis-Containing 

Vaccines 

DTaP: DAPTACEL, Infanrix, Tripedia 11 

DTaP-IPV: KINRIX 11 

DTaP-HepB-IPV: Pediarix 11 

DTaP-IPV/Hib: Pentacel 11 

Haemophilus influenzae type b-Containing Vaccines 

Hib: ActHIB, Hiberix, PedvaxHIB 15 

Hib-HepB: Comvax 15 

DTaP-IPV/Hib: Pentacel 11 

Hepatitis-Containing Vaccines 

HepA: Havrix, VAQTA 19 

HepB: Engerix-B, Recombivax HB 19 

HepA-HepB: Twinrix 19 

DTaP-HepB-IPV: Pediarix 11 

Hib-HepB: Comvax 15 

Human Papillomavirus Vaccines
 

HPV2: Cervarix 23 

HPV4: Gardasil 23 

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Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Influenza Vaccines 

LAIV: FluMist 27 

TIV: Afluria, Fluarix, FluLaval, Fluvirin, 

Fluzone, Fluzone High-Dose, Fluzone Intradermal
	 29 

Measles-, Mumps- and Rubella-Containing Vaccine 

MMR: M-M-RII 33 

MMRV: ProQuad 69 

Meningococcal Vaccines 

MCV4: Menactra, Menveo 37 

MPSV4: Menomune 41 

Pneumococcal Vaccines 

PCV13: Prevnar 13 45 

PPSV23: Pneumovax 23 45 

Poliovirus-Containing Vaccine 

IPV: IPOL 49 

DTaP-HepB-IPV: Pediarix 11 

DTaP-IPV: KINRIX 11 

DTaP-IPV/Hib: Pentacel 11 

Rotavirus Vaccines 

RV1: ROTARIX 53 

RV5: RotaTeq 53 

Tetanus Toxoid Vaccine 

TT: Tetanus Toxoid 57 

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Table of Contents
 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Tetanus Toxoid- and diphtheria toxoid-Containing Vaccines 

Td: DECAVAC 

DT: Diphtheria and Tetanus Toxoid 

61 

61 

Tetanus Toxoid-, diphtheria toxoid-, and acellular pertussis- Containing 

Vaccines 

Tdap: Adacel, Boostrix 65 

Varicella-Containing Vaccines 

VAR: Varivax (chickenpox) 

ZOS: Zostavax (herpes zoster/shingles) 

MMRV: ProQuad 

69 

69 

69 

Resources 

CDC Resources 

Other Resources 

State Immunization Program Information 

Manufacturer/Distributor Contact Information 

74 

75 

76 

77 

Information contained in this document is based on the recommendations of the 

Advisory Committee on Immunization Practices (ACIP) and the manufacturer’s 

product information. 

A combination vaccine is defined as a product containing components that can be 

divided equally into independently available routine vaccines. A dash ( - ) between 

vaccine products indicates that products are supplied in their final form by the 

manufacturer and do not require mixing or reconstitution by the user. A slash ( / ) 

indicates that the products must be mixed or reconstituted by the user. 
General Information
 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Vaccine Storage and Handling Best Practices 

Vaccines must be stored properly from the time they are manufactured until they 

are administered. Immunization providers are responsible for proper storage and 

handling from the time vaccine arrives at the facility until the vaccine is given. 

Below is an outline of vaccine storage and handling best practices. CDC’s Storage 

and Handling Toolkit contains detailed information on vaccine management. 

Immunization providers and staff are strongly encouraged to review the Storage and 

Handling Toolkit annually. Educate all staff, including temporary staff, as part of new 

staff orientation. In addition, Vaccines for Children (VFC) providers should follow 

VFC policy and work with their immunization program. 

●		 Vaccine Management includes, but is not limited to, these three 

components. 

1. The equipment used for vaccine storage and temperature monitoring is 

reliable and appropriate. 

2.	 Staff is knowledgeable regarding proper vaccine storage and handling. 

At least 2 staff members should be responsible for vaccine management. 

3. Written storage and handling plans are updated at least annually for: 

–	 routine storage and handling of vaccines; and 

–	 emergency vaccine retrieval and storage. 

Routine Vaccine Storage and Handling Plan should include 

the following four elements. 

1.	 Ordering and Accepting Vaccine Deliveries 

●		 Store vaccines at the recommended temperatures IMMEDIATELY upon 

arrival. 

–	 Store refrigerated vaccines between 35°F and 46°F (2°C and 8°C). 

–	 Store frozen vaccines between -58°F and +5°F (-50°C and -15°C). 

●		 Ensure vaccines are delivered when the facility is open. Vaccine 

shipments should be delivered when staff is available to unpack and 

store the vaccine properly. Inform manufacturer/distributor when vaccine 

shipments can be delivered. VFC providers should also notify the 

immunization program. Consider holidays, vacations, changes in hours of 

operation, and staff schedules when ordering vaccines. 

●		 Educate all facility staff about vaccine storage. Vaccine shipments 

are often accepted by nonmedical staff. They should be aware that 

vaccine needs to be stored according to the manufacturer’s guidelines 

immediately upon delivery. 

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General Information
 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

●		 Order vaccines to maintain an adequate amount to meet the needs of 

the facility’s patients. The amount of vaccine needed can vary throughout 

the year. Anticipate peak periods such as back-to-school appointments or 

influenza season and order accordingly. 

●		 Order the vaccines and presentations that are appropriate for the ages 

and types of patients the facility serves. Influenza vaccine, for example, is 

available from many manufacturers with differing indications. 

●		 Maintain a vaccine inventory log including: 

1. vaccine name and number of doses received; 

2. date vaccine received; 

3. condition of vaccine on arrival; 

4. vaccine manufacturer and lot number; and 

5. vaccine expiration date. 

2.	 Storing and Handling Vaccines 

● Store vaccines in refrigerator and freezer units which can maintain 

the appropriate temperature range and are large enough to maintain 

the year’s largest inventory without crowding. Stand alone units are 

preferred but household combination units with separate exterior doors 

and thermostats can be used. Dormitory-style refrigerators should not 

be used. A dormitory-style refrigerator is defined as a small combination 

freezer/refrigerator unit that is outfitted with one exterior door with an 

evaporator plate (cooling coil), which is usually located inside an icemaker 

compartment (freezer) within the refrigerator. 

● Store vaccine in storage units designated specifically for biologics. If 

biologic specimens must be stored in the same unit, these should be 

stored on a lower shelf to prevent contamination. Food and drinks should 

never be stored in the same unit with vaccines. 

●		 Keep a calibrated thermometer with a Certificate of Traceability and 

Calibration* in the refrigerator and freezer. These thermometers should be 

recalibrated as recommended by the manufacturer. 

●		 Post “Do Not Unplug” signs next electrical outlets and “Do Not Stop 

Power” signs near circuit breakers to maintain a consistent power source. 

●		 Read and document refrigerator and freezer temperatures at least twice 

each workday- in the morning and before the end of the workday. Keep 

temperature logs for at least 3 years. 

*Certificate of Traceability and Calibration thermometer with calibration measurements traceable to a testing 

laboratory accredited by the International organization of Standardization, to the standards of the National 

Institute of Standards and Technology, or to another internationally recognized standards agency 

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General Information

● Store vaccine according to the manufacturer’s instructions. Aim to 

maintain storage unit temperatures within the middle of the acceptable 

temperature range. This allows for the small temperature fluctuations 

that can occur in refrigerators and freezers without exposing vaccines to 

unacceptable temperatures.

● Ensure good air circulation around the vaccine in the storage unit. Proper 

air circulation is essential to maintaining the correct storage temperatures. 

Bins, baskets, or some other type of uncovered containers that allow 

for air circulation should be used to store the vaccines. There should be 

space between the containers to promote air flow.

● Store vaccines on the shelves away from the walls, and vents in the 

part of the unit best able to maintain the required temperature. Vaccines 

should never be stored in the door of the freezer or refrigerator. The 

temperature here is not stable. 

● Place frozen packs in the door of the freezer and water bottles in the 

door of the refrigerator to help the storage unit maintain a constant 

temperature. Frozen packs or water bottle should be placed securely 

so they do not dislodge and prevent the door from closing. In addition, 

caution must be taken to avoid weighing down the door so much that the 

seal is compromised when the door is closed.

● Store unopened and opened vaccines in their original box with the lid 

in place until administration. Several vaccines must be protected from 

light. This practice also helps to ensure different vaccines are not stored 

together in the same bins or containers which can lead to vaccine 

administration errors. And in the event of a power failure, studies have 

shown storing vaccines in the box helps to maintain the vaccine at the 

appropriate temperature. 

● Prepare vaccines at the time the vaccine is administered. This includes 

reconstituting or “mixing” vaccine, if indicated. Use only the diluent 

supplied by the vaccine manufacturer. Store diluent according to the 

manufacturer’s instructions. 

3. Managing Inventory

● Rotate stock so vaccine and diluent with the shortest expiration date 

is used first. Place vaccine with the longest expiration date behind the 

vaccine that will expire the soonest. Remove expired vaccine and diluent 

from usable stock. 

● Keep vaccine stock well organized. VFC providers should separate and 

identify VFC and other vaccines purchased with public funds within the 

storage unit. In addition, clearly label the space where the vaccine is 

placed to help staff choose the appropriate vaccine.
General Information
 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

●		 Inspect the storage unit daily. A physical inspection helps to ensure 

vaccines and thermometers are placed appropriately within the unit. 

During a busy work day, vaccines and thermometers can be easily moved 

or displaced to an area inappropriate for vaccine storage. 

●		 Dispose of all vaccine materials using medical waste disposal procedures. 

Contact the immunization program for details and state specific guidance. 

4.	 Managing Potentially Compromised Vaccines 

●		 Identify and isolate all potentially compromised vaccines and diluents. 

Label these “DO NOT USE”. Store separately from uncompromised 

vaccines and diluents in the recommended temperature range. A clearly 

labeled paper bag can be used for this purpose. Do not automatically 

discard the vaccine or diluent. 

●		 Contact vaccine manufacturers and/or state immunization program for 

appropriate actions that should be followed for all potentially compromised 

vaccines and diluents. 

●		 Educate staff administering vaccines on correct handling and preparation 

procedures to decrease the likelihood of vaccine or diluent inadvertently 

being compromised. For example, each vaccine should be prepared just 

prior to administration. 

Emergency Vaccine Retrieval and Storage Plan should 

include the following components. 

1. Designate an alternate site where vaccines and diluents can be safely 

stored. Considerations when choosing a site include types of storage unit(s) 

available, temperature monitoring capabilities, and back-up generator. 

Potential back-up locations include local hospitals, another provider’s facility, 

retail or clinic pharmacies, long-term care facilities, or the Red Cross. Identify 

procedures that allow 24-hour access to alternate facilities. 

2. Obtain and store an adequate number/amount of appropriate packing 

containers and materials (e.g., frozen and refrigerated gel packs, bubble 

wrap) in the facility that will be needed to pack vaccines for safe transport. 

Acceptable packing containers are described in the Storage and Handling 

Toolkit. Consider the year’s largest inventory when stocking supplies. Store 

these supplies with a copy of the emergency vaccine retrieval and storage 

plan. Communicate to staff where everything is kept. 

3. Include written directions for packing vaccines and diluents for transport. A 

calibrated thermometer should be placed in each packing container near the 

vaccine or refrigerated diluent. 

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General Information
 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

4.	 Develop a plan in which vaccine coordinators will be notified of power 

outages at the facility. Include instructions for gaining 24-hour access to 

where the vaccines are stored. 

5. Incorporate written procedures for managing potentially compromised 

vaccines. 

6. Include contact information for vaccine manufacturers and/or the 

immunization program. 

For more detailed information on proper vaccine storage and handling please refer 

to CDC’s Vaccine Storage and Handling Toolkit. 

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Selected Biologicals

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Diphtheria Toxoid-, Tetanus Toxoid- and acellular 

Pertussis-Containing Vaccines 

DTaP: DAPTACEL, Infanrix, Tripedia 

DTaP-HepB-IPV: Pediarix 

DTaP-IPV: KINRIX 

DTaP-IPV/Hib: Pentacel 

Condition upon Arrival 

Diphtheria toxoid-, tetanus toxoid- and acellular pertussis-containing vaccines 

(DTaP, DTaP-HepB-IPV, DTaP-IPV, DTaP-IPV/Hib) should arrive packed in an 

insulated container. Examine the shipping container and contents for damage 

during transport. Some vaccines are shipped with a temperature monitor. If a 

temperature monitor is present, check and follow the instructions. The vaccine 

should not have been frozen or exposed to freezing temperatures. If the interval 

between shipment from the distributor/manufacturer and arrival of the vaccine at the 

facility has been more than 48 hours or you have questions about the condition of 

the vaccine at the time of delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

● DTaP-IPV/Hib (Pentacel) has 2 components. The lyophilized Hib vaccine 

(ActHIB) and DTaP-IPV diluent vials should arrive packaged together in the 

same shipping container. 

Storage Requirements 

Refrigerate vaccine and diluent, if applicable, immediately upon arrival. Do not 

freeze or expose to freezing temperatures. 

●		 DTaP, DTaP-HepB-IPV (Pediarix), DTaP-IPV (KINRIX): Refrigerate 

between 35°F* and 46°F (2°C and 8°C). 

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Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

●		 DTaP-IPV/Hib (Pentacel): Refrigerate the lyophilized Hib vaccine 

(ActHIB) and the vaccine diluent (DTaP-IPV) together between 35°F* and 

46°F (2°C and 8°C). Do not store them separately. 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

Shelf Life 

Check expiration date on the container, vial or manufacturer-filled syringe of the 

vaccine AND diluent, if applicable. Do not use after the expiration date shown on the 

label. 

Preparation 

Inspect the vaccine visually for extraneous particulate matter and/or discoloration. 

If these conditions exist, the vaccine should not be used. DTaP, DTaP-HepB-IPV 

(Pediarix), DTaP-IPV (KINRIX), DTaP-IPV/Hib (Pentacel) vaccines should not be 

combined or mixed with any other vaccines. Refer to the Resources section at the 

end of this document for information on vaccine administration. 

●		 DTaP, DTaP-HepB-IPV (Pediarix), DTaP-IPV (KINRIX): Just before use, 

shake vial or manufacturer-filled syringe well. After shaking, the vaccine 

should be a cloudy, white colored liquid. Do not use vaccine if it cannot be 

resuspended with thorough agitation. 

●		 DTaP-IPV/Hib (Pentacel): This vaccine is supplied in 2 vials that must 

be mixed together before administration. Consider posting reminders or 

labeling the vaccine to remind staff to reconstitute DTaP-IPV/Hib (Pentacel) 

prior to administering it. Only use the diluent supplied by the vaccine 

manufacturer to reconstitute the vaccine. Refer to the Resources section 

at the end of this document for an example of a label and the educational 

handout “Vaccines with Diluents: How to Use Them”. 

1. Just before use, shake the vial of DTaP/IPV diluent. 

2. Withdraw the entire contents of the diluent vial (blue capped vial) and 

inject it into the vial containing the lyophilized vaccine component (green 

capped vial). 

3.	 Shake the vial containing the lyophilized vaccine and diluent well to 

mix thoroughly. Do not use the vaccine if it cannot be resuspended with 

thorough agitation. 

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Selected Biologicals 

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National Center for Immunization and Respiratory Disease

4. The reconstituted vaccine is a cloudy, uniform, white to off-white (yellow 

tinged) liquid. 

Beyond Use Date*: Shelf Life after Opening 

Single-Dose Vials: All of the vaccine should be drawn into a sterile syringe using a 

sterile needle at the time the vaccine is administered. 

Manufacturer-Filled Syringes: Manufacturer-filled syringes should be activated 

(i.e., syringe tip removed and/or needle attached) at the time the vaccine is 

administered. 

DTaP-IPV/Hib (Pentacel): All of the reconstituted vaccine should be drawn into 

a sterile syringe using a sterile needle at the time the vaccine is administered. 

Administer immediately. Unused, reconstituted DTaP-IPV/Hib may be stored in 

the refrigerator between 35°F and 46°F (2°C and 8°C) for up to 30 minutes. Do not 

freeze or expose reconstituted vaccine to freezing temperatures. Agitate stored, 

reconstituted vaccine prior to administration. 

●		 Do not administer reconstituted DTaP-IPV/Hib (Pentacel) vaccine if it 

is not used within 30 minutes. Follow the immunization program guidance 

before discarding VFC or other vaccines purchased with public funds. 

*The date or time after which the vaccine should not be used; determined from the date or time the manufacturerfilled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

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Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Special Instructions 

Diphtheria toxoid-, tetanus toxoid- and acellular pertussis-containing vaccines are 

easily confused increasing the risk for error. Consider organizing vaccines in the 

storage unit by age group and/or color coding labels to distinguish vaccines from 

each other. Do not store sound-alike or look-alike vaccines next to each other. 

Labeling the space where the vaccine is stored with name, age indications or other 

information unique to the vaccine can help prevent vaccine administration errors. 

Refer to the Resources section at the end of this document for examples of labels. 

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Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Haemophilus influenzae type b-Containing 

Vaccines 

Hib: ActHIB, Hiberix, PedvaxHIB 

Hib-HepB: Comvax 

Note: Information pertaining to DTaP/IPV-Hib (Pentacel) can be found on page 11 

Condition upon Arrival 

Haemophilus influenzae type b-containing vaccines (Hib, Hib-HepB) should arrive 

packed in an insulated container. Examine the shipping container and contents for 

damage during transport. Some vaccines are shipped with a temperature monitor. 

If a temperature monitor is present, check and follow the instructions. The vaccine 

should not have been frozen or exposed to freezing temperatures. If the interval 

between shipment from the distributor/manufacturer and arrival of the vaccine at the 

facility has been more than 48 hours or you have questions about the condition of 

the vaccine at the time of delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

● ActHIB and Hiberix vaccines each have 2 components. The lyophilized 

Hib vaccine and diluent vials should arrive packaged together in the same 

shipping container. 

Storage Requirements 

Store the vaccine and diluent, if applicable, according to the manufacturer’s 

guidelines immediately upon arrival. Do not freeze or expose to freezing 

temperatures. 

●		 PedvaxHIB and Comvax vaccines: Refrigerate vaccine between 35°F* 

and 46°F (2°C and 8°C). 

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Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

●		 ActHIB vaccine: Refrigerate lyophilized vaccine and diluent between 

35°F and 46°F (2°C and 8°C). Do not store them separately. 

●		 Hiberix vaccine: If space allows, store the lyophilized vaccine and diluent 

together in the refrigerator. 

Vaccine: Refrigerate the lyophilized vaccine between 35°F* and 46°F 

(2°C and 8°C). Protect vaccine from light at all times by storing in the original 

box. 

Diluent: Store in the refrigerator between 35°F* and 46°F (2°C and 8°C) 

or at room temperature between 68°F and 77°F (20°C and 25°C). 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

Shelf Life 

Check expiration date on the container, vial or manufacturer-filled syringe of the 

vaccine AND diluent, if applicable. Do not use vaccine or diluent after the expiration 

date shown on the label. 

Preparation 

Inspect the vaccine visually for extraneous particulate matter and/or discoloration. If 

these conditions exist, the vaccine should not be used. These vaccines should not 

be combined or mixed with any other vaccines. Refer to the Resources section at 

end of this document for information on vaccine administration. 

●		 PedvaxHIB and Comvax vaccines: Just before use, shake the vial. The 

vaccine should be a slightly opaque, white liquid. Do not use vaccine if it 

cannot be resuspended with thorough agitation. 

●		 ActHIB and Hiberix vaccines: These vaccines must be reconstituted before 

administration. Consider posting reminders or labeling the vaccine to remind 

staff to reconstitute these vaccines. ActHIB and Hiberix diluents are not the 

same and they are NOT interchangeable. ActHIB is reconstituted with 0.4% 

sodium chloride diluent. Hiberix is reconstituted with 0.9% sodium chloride 

diluent. Only use the diluent supplied by the vaccine manufacturer to 

reconstitute the vaccine. Refer to the Resources section at the end of this 

document for examples of labels and the educational handout “Vaccines with 

Diluents: How to Use Them”. 

1. Just before use, withdraw the entire contents of the diluent vial and inject 

it into the vial containing the lyophilized Hib vaccine. 

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2.	 Shake the vial containing the lyophilized vaccine and diluent well to 

mix thoroughly. Do not use the vaccine if it cannot be resuspended with 

thorough agitation. 

3. The reconstituted vaccine should be a clear and colorless liquid. 

Beyond Use Date*: Shelf Life after Opening 

PedvaxHIB and Comvax vaccines: All of the vaccine should be drawn into a sterile 

syringe using a sterile needle at the time the vaccine is administered. 

ActHIB and Hiberix vaccines: All of the reconstituted vaccine should be drawn 

into a sterile syringe using a sterile needle at the time the vaccine is administered. 

Administer immediately. Unused, reconstituted ActHIB or Hiberix may be stored 

in the refrigerator between 35°F and 46°F (2°C and 8°C) for up to 24 hours. Do 

not freeze or expose reconstituted vaccines to freezing temperatures. Protect 

reconstituted Hiberix from light. Agitate stored, reconstituted vaccine prior to 

administration. 

●		 Do not administer reconstituted ActHIB or Hiberix vaccine if it is not 

used within 24 hours. Follow the immunization program guidance before 

discarding VFC or other vaccines purchased with public funds. 

*The date or time after which the vaccine should not be used; determined from the date or time the manufacturerfilled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

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Selected Biologicals 

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Special Instructions 

Providers can have different products or presentations containing the same vaccine 

in the storage unit. For example, single antigen and combination vaccines. Vaccine 

products and presentations often have different approved indications (e.g., ages). 

Storing multiple products and presentations can be confusing to staff and increases 

the risk for vaccine administration errors. Consider organizing vaccines in the 

storage unit by age group and/or color coding labels to distinguish vaccines from 

each other. Do not store sound-alike or look-alike vaccines next to each other. 

Labeling the space where the vaccine is stored with name and age indications can 

help prevent vaccine administration errors. Refer to the Resources section at the 

end of this document for examples of labels. 

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Hepatitis-Containing Vaccines 

HepA: Havrix, VAQTA 

HepB: Engerix-B, Recombivax HB 

HepA-HepB: Twinrix 

Note: Information pertaining to DTaP-IPV-HepB (Pediarix) can be found on page 11 

Information pertaining to Hib-HepB (Comvax) can be found on page 15 

Condition upon Arrival 

Hepatitis-containing vaccines (HepA, HepB, HepA-HepB) should arrive packed in an 

insulated container. Examine the shipping container and contents for damage during 

transport. Some vaccines are shipped with a temperature monitor. If a temperature 

monitor is present, check and follow the instructions. The vaccine should not have 

been frozen or exposed to freezing temperatures. If the interval between shipment 

from the distributor/manufacturer and arrival of the vaccine at the facility has been 

more than 48 hours or you have questions about the condition of the vaccine at the 

time of delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate immediately upon arrival. Store between 35°F* and 46°F (2°C and 

8°C). Do not freeze or expose to freezing temperatures. 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

Shelf Life 

Check expiration date on the container, vial or manufacturer-filled syringe. Do not 

use after the expiration date shown on the label. 

Vaccine Storage and Handling Guide —————————————————————————————— Page 19 
Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Preparation 

Inspect the vaccine visually for extraneous particulate matter and/or discoloration. If 

these conditions exist, the vaccine should not be used. Just before use, shake vial 

or manufacturer-filled syringe well. Do not use vaccine if it cannot be resuspended 

with thorough agitation. After shaking, the vaccine should be white, slightly cloudy 

in color. These vaccines should not be combined or mixed with any other vaccines. 

Refer to the Resources section at the end of this document for information on 

vaccine administration. 

Beyond Use Date*: Shelf Life after Opening 

Single-Dose Vials: All of the vaccine should be drawn into a sterile syringe using a 

sterile needle at the time the vaccine is administered. 

Manufacturer-Filled Syringes: Manufacturer-filled syringes should be activated 

(i.e., syringe tip removed and/or needle attached) at the time the vaccine is 

administered. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

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Special Instructions 

Providers can have different products or presentations containing the same 

vaccine in the storage unit. Vaccine products and presentations often have different 

approved indications and uses (e.g., ages). For example, single antigen HepA 

and HepB vaccines have different formulations based on age. Storing multiple 

products and presentations can be confusing to staff and increases the risk for 

vaccine administration errors. Consider organizing vaccines in the storage unit by 

age group and/or color coding labels to distinguish vaccines from each other. Do 

not store sound-alike or look-alike vaccines next to each other. Labeling the space 

where the vaccine is stored with name and age indications can help prevent vaccine 

administration errors. Refer to the Resources section at the end of this document 

for examples of labels. 

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Human Papillomavirus Vaccines 

HPV2: Cervarix 

HPV4: Gardasil 

Condition upon Arrival 

Human papillomavirus vaccine (HPV) should arrive packed in an insulated 

container. Examine the shipping container and contents for damage during 

transport. Some vaccines are shipped with a temperature monitor. If a temperature 

monitor is present, check and follow the instructions. The vaccine should not have 

been frozen or exposed to freezing temperatures. If the interval between shipment 

from the distributor/manufacturer and arrival of the vaccine at the facility has been 

more than 48 hours or you have questions about the condition of the vaccine at the 

time of delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate immediately upon arrival. Store between 35°F* and 46°F (2°C and 

8°C). Do not freeze or expose to freezing temperatures. 

●		 HPV4 (Gardasil): Protect vaccine from light at all times by storing in the 

original box. 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

Shelf Life 

Check expiration date on the container, vial or manufacturer-filled syringe. Do not 

use after the expiration date shown on the label. 

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Preparation 

Inspect visually for extraneous particulate matter and/or discoloration. If these 

conditions exist, the vaccine should not be used. Just before use, shake vial or 

manufacturer-filled syringe well. After shaking, HPV vaccine is a white, cloudy 

liquid. Through agitation immediately before administration is needed to maintain 

suspension. Do not use vaccine if it cannot be resuspended with thorough agitation. 

These vaccines should not be combined or mixed with any other vaccines. Refer 

to the Resources section at the end of this document for information on vaccine 

administration. 

●		 HPV2 (Cervarix): May separate to a fine, white deposit on the bottom of the 

vial with a clear, colorless liquid above during storage. This does not indicate 

deterioration. 

Beyond Use Date*: Shelf Life after Opening 

Single-Dose Vials: All of the vaccine should be drawn into a sterile syringe using a 

sterile needle at the time the vaccine is administered. 

Manufacturer-Filled Syringes: Manufacturer-filled syringes should be activated 

(i.e., syringe tip removed and/or needle attached) at the time the vaccine is 

administered. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

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4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

Storing multiple products and presentations can be confusing to staff and increase 

the risk for vaccine administration errors. There are two HPV products available 

from different manufacturers with different indications. HPV4 can be administered to 

males and females. HPV2 is approved for use in females only. Consider indications 

and the facility’s patient population when ordering HPV vaccine. 

Vaccines that sound alike are often confused. For example, HPV, HepB and Hib 

vaccines are often confused, increasing the risk for an error. Consider organizing 

vaccines in the storage unit by age group and/or color coding labels to distinguish 

vaccines from each other. Do not store sound-alike or look-alike vaccines next 

to each other. Label the space where HPV is stored with name, gender and age 

indications to help decrease the likelihood of a vaccine administration error. Refer to 

the Resources section at the end of this document for examples of labels. 

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Influenza Vaccines 

LAIV: FluMist 

Condition upon Arrival 

Live, attenuated influenza vaccine (LAIV) should arrive packed in an insulated 

container. Examine the shipping container and contents for damage during 

transport. Some vaccines are shipped with a temperature monitor. If a temperature 

monitor is present, check and follow the instructions. The vaccine should not have 

been frozen or exposed to freezing temperatures. If the interval between shipment 

from the distributor/manufacturer and arrival of the vaccine at the facility has been 

more than 48 hours or you have questions about the condition of the vaccine at the 

time of delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate immediately upon arrival. Store between 35°F and 46°F (2°C and 8°C). 

Do not freeze or expose to freezing temperatures. 

Shelf Life 

Influenza vaccine is formulated for use during the current influenza season. Check 

expiration date on the nasal sprayer. Do not use after the expiration date shown on 

the label. 

Preparation 

This vaccine should not be combined or mixed with any other vaccines. Each nasal 

sprayer contains a single dose of LAIV. Refer to the Resources section at the end of 

this document for information on vaccine administration. 

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Beyond Use Date*: Shelf Life after Opening 

Single-Dose Sprayer: The nasal sprayer should be removed from the refrigerator 

at the time the vaccine is administered. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

Often providers have different influenza presentations in the same storage unit. 

Influenza products and presentations have different approved indications (e.g., 

ages). Storing multiple products and presentations can be confusing to staff and 

increase the risk for vaccine administration errors. Consider organizing vaccines 

in the storage unit by age group and/or color coding labels to distinguish vaccines 

from each other. Do not store sound-alike vaccines next to each other. Labeling 

the space where the vaccine is stored with name, age indications, and route 

of administration can help prevent vaccine administration errors. Refer to the 

Resources section at the end of this document for an example of a label. 

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Influenza Vaccines 

TIV: Afluria, Fluarix, FluLaval, Fluvirin, Fluzone, Fluzone HighDose, Fluzone Intradermal 

Condition upon Arrival 

Trivalent influenza vaccine (TIV) should arrive packed in an insulated container. 

Examine the shipping container and contents for damage during transport. Some 

vaccines are shipped with a temperature monitor. If a temperature monitor is 

present, check and follow the instructions. The vaccine should not have been frozen 

or exposed to freezing temperatures. If the interval between shipment from the 

distributor/manufacturer and arrival of the vaccine at the facility has been more than 

48 hours or you have questions about the condition of the vaccine at the time of 

delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate immediately upon arrival. Store between 35°F* and 46°F (2°C and 

8°C). Do not freeze or expose to freezing temperatures. 

●		 Afluria, Fluarix, FluLaval, and Fluvirin: Protect vaccine from light at all 

times by storing in the original box. 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

Shelf Life 

Influenza vaccine is formulated for use during the current influenza season. Check 

expiration date on the container, vial or manufacturer-filled syringe. Do not use after 

the expiration date shown on the label. 

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Preparation 

Inspect the vaccine visually for extraneous particulate matter and/or discoloration. If 

these conditions exist, the vaccine should not be used. Shake vial or manufacturerfilled syringe well before use. Shake multidose vials each time before withdrawing 

a dose. Do not use vaccine if it cannot be resuspended with thorough agitation. 

These vaccines should not be combined or mixed with any other vaccines. Refer 

to the Resources section at the end of this document for information on vaccine 

administration. . 

Beyond Use Date*: Shelf Life after Opening 

Single-Dose Vials: All of the vaccine should be drawn into a sterile syringe using a 

sterile needle at the time the vaccine is administered. 

Manufacturer-Filled Syringes: Manufacturer-filled syringes should be activated 

(i.e., syringe tip removed or needle attached) at the time the vaccine is administered. 

Intradermal Microinjection Syringe: Manufacturer-filled microinjection syringe 

should be activated (i.e., needle cap removed) at the time the vaccine is 

administered. 

Multidose Vials: Shake vial well prior to withdrawing each dose. Withdraw a single 

age-appropriate dose of vaccine into sterile syringe using a sterile needle at the 

time the vaccine is administered. A separate, sterile syringe and needle should 

be used for each immunization. Unused portions of multidose vials should be 

refrigerated between 35°F and 46°F (2°C and 8°C). A multidose vial that is normal 

in appearance, stored and handled properly can be used through the expiration date 

printed on the vial unless otherwise stated in the manufacturer’s product information. 

● Once entered, a multidose vial of Afluria or FluLaval should be 

discarded after 28 days. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

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1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

Vaccines, including TIV, should be drawn from the vial into the syringe at the time 

of administration. CDC strongly discourages providers from prefilling syringes in 

advance. If more than one dose of vaccine must be predrawn, only draw up a few 

syringes (no more than 10 doses or the contents of one multidose vial). 

Provider prefilled syringes should be administered by the person who filled them. 

Any syringes prefilled by the provider must be stored within the recommended 

temperature range and used or discarded by the end of the workday. 

CDC recommends manufacturer-filled syringes for large immunization events, such 

as community influenza vaccination clinics. Once a manufacturer-filled syringe is 

activated (e.g., syringe cap removed or needle attached) it must be stored within the 

recommended temperature range and used or discarded by the end of the workday. 

Often providers have different TIV presentations in the same storage unit. Influenza 

products and presentations have different approved indications (e.g., ages, route). 

Storing multiple products and presentations can be confusing to staff and increase 

the risk for vaccine administration errors. Consider organizing vaccines in the 

storage unit by age group and/or color coding labels to distinguish vaccines from 

each other. Do not store sound-alike or look-alike vaccines next to each other. 

Labeling the space where the vaccine is stored with name, age indications, dosage 

and route of administration can help prevent vaccine administration errors. Refer to 

the Resources section of this document for examples of labels. 

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Measles-, Mumps- and Rubella-Containing 

Vaccine 

MMR: M-M-RII 

Note: Information pertaining to MMRV (ProQuad) can be found on page 69 

Condition upon Arrival 

Measles, Mumps, Rubella vaccine (MMR) has 2 components: lyophilized vaccine 

and diluent. Both components should arrive together in the same shipping container. 

The vaccine and diluent should be in separate compartments. Examine the shipping 

container and contents for damage during transport. Some vaccines are shipped 

with a temperature monitor. If a temperature monitor is present, check and follow 

the instructions. If the interval between shipment from the distributor/manufacturer 

and arrival of the vaccine at the facility has been more than 48 hours or you have 

questions about the condition of the vaccine at the time of delivery, you should take 

three steps. 

1. Immediately place the vaccine in the recommended storage between -58°F 

and +46°F (-50°C and +8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Store lyophilized vaccine and diluent according to the manufacturer’s guidelines 

immediately upon arrival. 

Lyophilized vaccine: Store MMR lyophilized vaccine in the refrigerator or 

freezer between -58°F and +46°F (-50° and +8°C). Protect vaccine from light at all 

times by storing in the original box. 

Diluent: Store diluent in the refrigerator between 35°F* and 46°F (2°C and 8°C) 

or at room temperature between 68°F and 77°F (20°C and 25°C). Do not freeze 

or expose to freezing temperatures. 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

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Shelf Life 

Check expiration date on the container or vial of the vaccine AND diluent. Do not 

use after the expiration date shown on the label. 

Preparation 

MMR is supplied in 2 vials that must be mixed together before administration. 

Consider posting reminders or labeling the vaccine to remind staff to reconstitute 

it. Only use the diluent supplied by the vaccine manufacturer to reconstitute 

the vaccine. Refer to the Resources section at the end of this document for an 

example of a label and the educational handout “Vaccines with Diluents: How to Use 

Them”. This vaccine should not be combined or mixed with any other vaccines. The 

Resources section at the end of this document also includes vaccine administration 

information. 

1. Just before use, withdraw the entire contents of the diluent vial and inject it 

into the vial containing the lyophilized vaccine component. 

2.	 Shake the vial now containing the lyophilized vaccine and diluent to mix 

thoroughly. Do not use the vaccine if it cannot be resuspended with thorough 

agitation. 

3. The reconstituted vaccine should be a yellow, clear liquid. Inspect visually for 

extraneous particulate matter and/or discoloration. If these conditions exist, 

the vaccine should not be used. 

Beyond Use Date*: Shelf Life after Opening 

All of the reconstituted vaccine should be drawn into a sterile syringe using a sterile 

needle at the time the vaccine is administered. Administer immediately. Unused, 

reconstituted MMR may be stored in the refrigerator between 35°F and 46°F (2°C 

and 8°C) for up to 8 hours. Do not freeze or expose reconstituted vaccine to 

freezing temperatures. Protect reconstituted vaccine from light at all times. Agitate 

stored, reconstituted vaccine prior to administration. 

●		 Do not administer reconstituted MMR vaccine if it is not used within 8 

hours. Follow the immunization program guidance before discarding VFC or 

other vaccines purchased with public funds. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

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Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1.	 Place the vaccine in the recommended storage between -58°F and +46°F 

(-50°C and +8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

MMR vaccine can be stored in the refrigerator or freezer. Consider storing MMR in 

the freezer between -58°F and +5°F (-50°C and -15°C). 

●		 Storing MMR in the freezer can free up storage space in the refrigerator. 

More vaccines must be stored in the refrigerator than in the freezer. Storing 

MMR in the freezer increases the space available for vaccines that should be 

stored in the refrigerator. 

●		 In addition, storing MMR in the freezer can decrease confusion when 

stocking both MMR and MMRV (ProQuad). MMRV must be stored in the 

freezer. MMRV has been inadvertently moved to the refrigerator storage 

because staff confused it with MMR. Storing MMR and MMRV in the freezer 

decreases the likelihood of this happening. 

MMR may be stored and/or transported in an insulated container between 

35°F and 46°F (2°C and 8°C). Place a calibrated thermometer in the container 

with the vaccine. Monitor and record the temperature. Use of dry ice is not 

recommended, even for temporary storage. Dry ice may subject MMR vaccine to 

temperatures colder than -58°F (-50°C). 

Providers can have different products or presentations containing the same vaccine 

in the storage unit, for example, MMR and MMRV (ProQuad) vaccines. Vaccine 

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products and presentations often have different approved indications and uses (e.g., 

ages). Storing multiple products and presentations can be confusing to staff and 

increase the risk for vaccine administration errors. Consider organizing vaccines 

in the storage unit by age group and/or color coding labels to distinguish vaccines 

from each other. Do not store sound-alike or look-alike vaccines next to each other. 

Labeling the space where the vaccine is stored with name and age indications can 

help prevent vaccine administration errors. Refer to the Resources section at the 

end of this document for an example of a label. 

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Meningococcal Vaccines 

MCV4: Menactra, Menveo 

Condition upon Arrival 

Meningococcal conjugate vaccine (MCV4) should arrive packed in an insulated 

container. Examine the shipping container and contents for damage during 

transport. Some vaccines are shipped with a temperature monitor. If a temperature 

monitor is present, check and follow the instructions. The vaccine should not have 

been frozen or exposed to freezing temperatures. If the interval between shipment 

from the distributor/manufacturer and arrival of the vaccine at the facility has been 

more than 48 hours or you have questions about the condition of the vaccine at the 

time of delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from other uncompromised 

vaccines. A clearly labeled paper bag can be used for this purpose.
 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

● Menveo has 2 components. The lyophilized Men A vaccine and the diluent 

(Men C, Y, W-135) vials should arrive packaged together in the same 

shipping container. 

Storage Requirements 

Refrigerate vaccine and diluent, if applicable, immediately upon arrival. Do not 

freeze or expose to freezing temperatures. 

●		 Menactra: Refrigerate between 35°F and 46°F (2°C and 8°C). 

●		 Menveo: Refrigerate the lyophilized Men A vaccine and vaccine diluent 

(Men C, Y, W-135) together between 35°F* and 46°F (2°C and 8°C). Do not 

store them separately. Protect Menveo from light at all times by storing in the 

original box. 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

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Shelf Life 

Check expiration date on the container, vial or manufacturer-filled syringe of the 

vaccine AND diluent, if applicable. Do not use vaccine or diluent after the expiration 

date shown on the label. 

Preparation 

Inspect visually for extraneous particulate matter and/or discoloration. If these 

conditions exist, the vaccine should not be used. These vaccines should not be 

combined or mixed with any other vaccines. Refer to the Resources section at the 

end of this document for information on vaccine administration. 

●		 Menactra: This vaccine is a clear to slightly cloudy liquid. 

●		 Menveo: This vaccine is supplied in 2 vials that must be mixed together 

before administration. Consider posting reminders or labeling the vaccine to 

remind staff to reconstitute it. Only use the diluent supplied by the vaccine 

manufacturer to reconstitute the vaccine. Refer to the Resources section 

at the end of this document for an example of a label and the educational 

handout “Vaccines with Diluents: How to Use Them”. 

1. Just before use, withdraw the entire contents of the diluent vial and inject 

it into the vial containing the lyophilized vaccine component. 

2.	 Shake the vial containing the lyophilized vaccine and diluent well to mix 

thoroughly. Do not use the vaccine if it cannot be resuspended with 

thorough agitation 

3. The reconstituted vaccine should be a clear, colorless liquid. 

Beyond Use Date*: Shelf Life after Opening 

Menactra: All of the vaccine should be drawn into a sterile syringe using a sterile 

needle at the time the vaccine is administered. 

Menveo: All of the reconstituted vaccine should be drawn into a sterile syringe using 

a sterile needle at the time the vaccine is administered. Administer immediately. 

Unused, reconstituted Menveo may be stored at or below 77°F (25°C) for up to 

8 hours. Do not freeze or expose reconstituted vaccine to freezing temperatures. 

Protect from light. Agitate any stored, reconstituted vaccine prior to administration. 

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●		 Do not administer reconstituted Menveo vaccine if it is not used within 

8 hours. Follow the immunization program guidance before discarding VFC 

or other vaccines purchased with public funds. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

Providers can have different products or presentations containing the same 

vaccine in the storage unit. Vaccine products and presentations often have different 

approved indications and uses (e.g., ages). For example, meningococcal vaccines 

(MCV4 and MPSV4) can be confused when stored in the same storage unit. Storing 

multiple products and presentations can be confusing to staff and increase the 

risk for vaccine administration errors. Consider organizing vaccines in the storage 

unit by age group and/or color coding labels to distinguish vaccines from each 

other. Do not store sound-alike or look-alike vaccines next to each other. Labeling 

the space where the vaccine is stored with name, age indications, and/or route 

of administration can help prevent vaccine administration errors. Refer to the 

Resources sections at the end of this document for examples of labels. 

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Meningococcal Vaccines 

MPSV4: Menomune 

Condition upon Arrival 

Meningococcal polysaccharide vaccine (MPSV4) has 2 components: lyophilized 

vaccine and diluent. MPSV4 should arrive packed in an insulated container. Both 

components should arrive packaged together in the same shipping container. 

Examine the shipping container and contents for damage during transport. Some 

vaccines are shipped with a temperature monitor. If a temperature monitor is 

present, check and follow the instructions. The vaccine should not have been frozen 

or exposed to freezing temperatures. If the interval between shipment from the 

distributor/manufacturer and arrival of the vaccine at the facility has been more than 

48 hours or you have questions about the condition of the vaccine at the time of 

delivery, you should take three steps. 

1. Immediately place the vaccine and diluent in the refrigerator between 35°F 

and 46°F (2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from other uncompromised 

vaccines. A clearly labeled paper bag can be used for this purpose.
 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate the lyophilized vaccine and diluent immediately upon arrival. Store the 

lyophilized vaccine and diluent between 35°F and 46°F (2°C and 8°C). Do not 

freeze or expose to freezing temperatures. 

Shelf Life 

Check expiration date on the container or vial of the vaccine AND diluent. Do not 

use vaccine or diluent after the expiration date shown on the label. 

Preparation 

MPSV4 is supplied in 2 vials that must be mixed together before administration. 

Consider posting reminders or labeling the vaccine to remind staff to reconstitute 

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it. Only use the diluent supplied by the vaccine manufacturer to reconstitute 

the vaccine. Refer to the Resources section at the end of this document for an 

example of a label and the educational handout “Vaccines with Diluents: How to Use 

Them”. This vaccine should not be combined or mixed with any other vaccines. The 

Resources section at the end of this document also includes vaccine administration 

information. 

1. Just before use, withdraw the entire contents of the diluent vial and inject it 

into the vial containing the lyophilized vaccine component. 

2.	 Swirl the vial containing the lyophilized vaccine and diluent well to mix 

thoroughly. Do not use the vaccine if it cannot be resuspended with thorough 

agitation. 

3. The reconstituted vaccine should be a clear, colorless liquid. Inspect visually 

for extraneous particulate matter and/or discoloration. If these conditions 

exist, the vaccine should not be used. 

Beyond Use Date*: Shelf Life after Opening 

Single-Dose Vials: All of the reconstituted vaccine should be drawn into a sterile 

syringe using a sterile needle at the time the vaccine is administered. Administer 

immediately. Unused, reconstituted MPSV4 vaccine may be stored in the 

refrigerator between 35°F and 46°F (2°C and 8°C) for up to 30 minutes. Agitate any 

stored, reconstituted vaccine prior to administration. 

●		 Do not administer reconstituted MPSV4 vaccine if it is not used within 

30 minutes. Follow the immunization program guidance before discarding 

VFC or other vaccines purchased with public funds. 

Multidose Vials: Shake well prior to withdrawing each dose. Withdraw a single 

dose (0.5 mL) of vaccine into sterile syringe using a sterile needle at the time the 

vaccine is administered. A separate, sterile syringe and needle should be used for 

each immunization. Unused portions of multidose vials should be refrigerated 

between 35°F and 46°F (2°C and 8°C). 

●		 Once entered, the multidose vial of MPSV4 should be discarded after 35 

days. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

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Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

Providers can have different products or presentations containing the same 

vaccine in the storage unit. Vaccine products and presentations often have different 

approved indications and uses (e.g., ages, route). For example, meningococcal 

vaccines (MCV4 and MPSV4) can be confused when stored in the same storage 

unit. Storing multiple products and presentations can be confusing to staff and 

increase the risk for vaccine administration errors. Consider organizing vaccines 

in the storage unit by age group and/or color coding labels to distinguish vaccines 

from each other. Do not store sound-alike or look-alike vaccines next to each other. 

Labeling the space where the vaccine is stored with name, age indications and 

route of administration can help prevent vaccine administration errors. Refer to the 

Resources section at the end of this document for an example of a label. 

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Pneumococcal Vaccines 

PCV13: Prevnar 13 

PPSV23: Pneumovax 23 

Condition upon Arrival 

Pneumococcal vaccines (PCV13, PPSV23) should arrive packed in an insulated 

container. Examine the shipping container and contents for damage during 

transport. Some vaccines are shipped with a temperature monitor. If a temperature 

monitor is present, check and follow the instructions. The vaccine should not have 

been frozen or exposed to freezing temperatures. If the interval between shipment 

from the distributor/manufacturer and arrival of the vaccine at the facility has been 

more than 48 hours or you have questions about the condition of the vaccine at the 

time of delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate immediately upon arrival. Store between 35°F* and 46°F (2°C and 

8°C). Do not freeze or expose to freezing temperatures. 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

Shelf Life 

Check expiration date on the container, vial or manufacturer-filled syringe. Do not 

use after the expiration date shown on the label. 

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Preparation

Inspect the vaccine visually for extraneous particulate matter and/or discoloration. If 

these conditions exist, the vaccine should not be used. These vaccines should not 

be combined or mixed with any other vaccines. Refer to the Resources section at 

the end of this document for information on vaccine administration. 

●		 PCV13: During storage, the aluminum phosphate particles may settle, and 

this can result in a clear liquid solution above the aluminum phosphate 

particles. Just before use, shake VIGOROUSLY. After shaking, PCV13 is a 

white liquid. Do not use the vaccine if it cannot be resuspended with thorough 

agitation. 

●		 PPSV23: Just before use, shake vial well. After shaking, PPSV23 should be a 

clear, colorless liquid. Do not use the vaccine if it cannot be resuspended with 

thorough agitation. 

Beyond Use Date*: Shelf Life after Opening 

Single-Dose Vials: All of the vaccine should be drawn into a sterile syringe using a 

sterile needle at the time of administration. 

Manufacturer-Filled Syringes: Manufacturer-filled syringes should be activated 

(i.e., syringe tip removed and/or needle attached) at the time the vaccine is 

administered. 

PPSV23 Multidose Vials: Shake vial well prior to withdrawing each dose. Withdraw 

a single dose (0.5 mL) vaccine into sterile syringe using a sterile needle at the 

time the vaccine is administered. A separate, sterile syringe and needle should 

be used for each immunization. Unused portions of multidose vials should be 

refrigerated between 35°F and 46°F (2°C and 8°C). A multidose vial that is normal 

in appearance, stored and handled properly can be used through the expiration date 

printed on the vial unless otherwise stated in the manufacturer’s product information. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

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1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

Providers can have different products or presentations containing the same 

vaccine in the storage unit. Vaccine products and presentations often have different 

approved indications and uses (e.g., ages). For example, pneumococcal vaccines 

(PCV13 and PPSV23) can be confused when stored in the same storage unit. 

Storing multiple products and presentations can be confusing to staff and increase 

the risk for vaccine administration errors. Consider organizing vaccines in the 

storage unit by age group and/or color coding labels to distinguish vaccines from 

each other. Do not store sound-alike or look-alike vaccines next to each other. 

Labeling the space where the vaccine is stored with name and age indications can 

help prevent vaccine administration errors. Refer to the Resources section of this 

document for examples of labels. 

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Poliovirus-Containing Vaccine 

IPV: IPOL 

Note: Information pertaining to DTaP-IPV (KINRIX) can be found on page 11 

Information pertaining to DTaP-IPV/HepB (Pediarix) can be found on page 11 

Information pertaining to DTaP-IPV-Hib (Pentacel) can be found on page 11 

Condition upon Arrival 

Inactivated polio vaccine (IPV) should arrive packed in an insulated container. 

Examine the shipping container and contents for damage during transport. Some 

vaccines are shipped with a temperature monitor. If a temperature monitor is 

present, check and follow the instructions. The vaccine should not have been frozen 

or exposed to freezing temperatures. If the interval between shipment from the 

distributor/manufacturer and arrival of the vaccine at the facility has been more than 

48 hours or you have questions about the condition of the vaccine at the time of 

delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate immediately upon arrival. Store between 35°F and 46°F (2°C and 8°C). 

Do not freeze or expose to freezing temperatures. 

Shelf Life 

Check expiration date on the container, vial or manufacturer-filled syringe. Do not 

use after the expiration date shown on the label. 

Preparation 

Inspect visually for extraneous particulate matter and/or discoloration. If these 

conditions exist, the vaccine should not be used. This vaccine should not be 

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National Center for Immunization and Respiratory Disease

combined or mixed with any other vaccines. Refer to the Resources section at the 

end of this document for information on vaccine administration. 

Beyond Use Date*: Shelf Life after Opening 

Manufacturer-Filled Syringes: Manufacturer-filled syringes should be activated 

(i.e., syringe tip removed or needle attached) at the time the vaccine is administered. 

Multidose Vials: Withdraw a single dose (0.5 mL) of vaccine into sterile syringe 

using a sterile needle at the time the vaccine is administered. A separate, sterile 

syringe and needle should be used for each immunization. Unused portions of 

multidose vials should be refrigerated between 35°F and 46°F (2°C and 8°C). 

A multidose vial that is normal in appearance, stored and handled properly can be 

used through the expiration date printed on the vial unless otherwise stated in the 

manufacturer’s product information. 

*The date or time after which the vaccine should not be used; determined from the date (time) the manufacturerfilled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

Providers can have different products or presentations containing the same vaccine 

in the storage unit. For example, single antigen and combination vaccines. Vaccine 

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products and presentations often have different approved indications and uses (e.g. 

ages). Storing multiple products and presentations can be confusing to staff and 

increase the risk for vaccine administration errors. Consider organizing vaccines 

in the storage unit by age group and/or color coding labels to distinguish vaccines 

from each other. Do not store sound-alike or look-alike vaccines next to each other. 

Labeling the space where the vaccine is stored with name, age indications can help 

prevent vaccine administration errors. Refer to the Resources section at the end of 

this document for an example of a label. 

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Rotavirus Vaccines 

RV1: ROTARIX 

RV5: RotaTeq 

Condition upon Arrival 

Rotavirus vaccines (RV1, RV5) should arrive packed in an insulated container. 

Examine the shipping container and contents for damage during transport. Some 

vaccines are shipped with a temperature monitor. If a temperature monitor is 

present, check and follow the instructions. The vaccine should not have been frozen 

or exposed to freezing temperatures. If the interval between shipment from the 

distributor/manufacturer and arrival of the vaccine at the facility has been more than 

48 hours or you have questions about the condition of the vaccine at the time of 

delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

● RV1 (ROTARIX) has 2 components. The lyophilized vaccine and diluent 

should arrive packaged together in the same shipping container. 

Storage Requirements 

Store the vaccine and diluent, if applicable, according to the manufacturer’s 

guidelines immediately upon arrival. Do not freeze or expose to freezing 

temperatures. Protect vaccine from light at all times by storing in the original box. 

●		 RV1 (ROTARIX): Refrigerate lyophilized vaccine between 35°F and 46°F 

(2°C and 8°C). Store diluent separately at room temperature between 

68°F and 77° F (20°C and 25°C). 

●		 RV5 (RotaTeq): Refrigerate between 35°F* and 46°F (2°C and 8°C). 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

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Shelf Life 

Check expiration date on the container or vial of vaccine AND diluent. Do not use 

vaccine or diluent, if applicable, after the expiration date shown on the label. 

Preparation 

RV1 and RV5 should not be combined or mixed with any other vaccines. Refer 

to the Resources section at the end of this document for information on vaccine 

administration. 

●		 RV1 (ROTARIX): This vaccine is supplied in 2 vials that must be mixed 

together before administration. Consider posting reminders or labeling the 

vaccine to remind staff to reconstitute it. Only use the diluent supplied 

by the vaccine manufacturer to reconstitute the vaccine. Reconstituted 

vaccine is a cloudy, white liquid. Refer to the Resources section at the end 

of this document for an educational handout “Vaccines with Diluents: How to 

Use Them”. 

●		 RV5 (RotaTeq): This vaccine is supplied in a single dose squeezable plastic, latexfree dosing tube with a twist off cap. The dosing tube is contained in a pouch 

Beyond Use Date*: Shelf Life after Opening 

RV1 (ROTARIX): After reconstitution, administer immediately. Store unused, 

reconstituted RV1 in the oral applicator between 35°F and 46°F (2°C and 8°C) 

or at room temperature up to 77°F (25°C) for up to 24 hours. Agitate any stored, 

reconstituted vaccine prior to administration. Do not freeze reconstituted vaccine. 

●		 Do not administer reconstituted RV1 vaccine if it is not used within 24 

hours. Follow the immunization program guidance before discarding VFC or 

other publicly purchased vaccines. Follow the immunization program guidance 

before discarding VFC or other vaccines purchased with public funds. 

RV5 (RotaTeq): This vaccine should be removed from the refrigerator and the screw 

cap removed at the time the vaccine is administered. Once the screw cap has been 

removed, the dosing tube should not be returned to the refrigerator. Administer 

immediately. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

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Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

Providers may have different products or presentations containing the same 

vaccine in the storage unit. Vaccine products and presentations often have 

different approved indications and uses (e.g., ages). Storing multiple products 

and presentations can be confusing to staff and increase the risk for vaccine 

administration errors. Consider organizing vaccines in the storage unit by age group 

and/or color coding labels to distinguish vaccines from each other. Do not store 

sound-alike or look-alike vaccines next to each other. Labeling the space where the 

vaccine is stored with name, age indications and route of administration can help 

prevent vaccine administration errors. Refer to the Resources section at the end of 

this document for examples of labels. 

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Tetanus Toxoid Vaccine 

TT: Tetanus Toxoid 

Condition upon Arrival 

Tetanus toxoid vaccine (TT) should arrive packed in an insulated container. Examine 

the shipping container and contents for damage during transport. Some vaccines 

are shipped with a temperature monitor. If a temperature monitor is present, check 

and follow the instructions. The vaccine should not have been frozen or exposed 

to freezing temperatures. If the interval between shipment from the distributor/ 

manufacturer and arrival of the vaccine at the facility has been more than 48 hours 

or you have questions about the condition of the vaccine at the time of delivery, you 

should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate immediately upon arrival. Store between 35°F and 46°F (2°C and 8°C). 

Do not freeze or expose to freezing temperatures. 

Shelf Life 

Check expiration date on the container or vial. Do not use after the expiration date 

shown on the label. 

Preparation 

Inspect visually for extraneous particulate matter and/or discoloration. If these 

conditions exist, the vaccine should not be used. Just before use, shake vial well. Do 

not use vaccine if it cannot be resuspended with thorough agitation. This vaccine 

should not be combined or mixed with any other vaccines. Refer to the Resources 

section at the end of this document for information on vaccine administration. 

Vaccine Storage and Handling Guide —————————————————————————————— Page 57 
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National Center for Immunization and Respiratory Disease

Beyond Use Date*: Shelf Life after Opening 

Multidose Vials: Shake vial well prior to withdrawing each dose. Withdraw a 

single dose (0.5 mL) of vaccine into a sterile syringe using a sterile needle at the 

time the vaccine is administered. A separate, sterile syringe and needle should 

be used for each immunization. Unused portions of multidose vials should be 

refrigerated between 35°F and 46°F (2°C and 8°C). A multidose vial that is normal 

in appearance, stored and handled properly can be used through the expiration date 

printed on the vial unless otherwise stated in the manufacturer’s product information. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

TT vaccine should only be used for tetanus immunization if the person has a 

severe, life-threatening allergy to the diphtheria component in other tetanuscontaining vaccines. For persons 11 years of age and older who need a tetanus 

toxoid-containing vaccine, the Advisory Committee on Immunization Practices 

recommends the following: 

●		 Tdap vaccine, if available, is preferred to TT or Td for those not previously 

vaccinated with Tdap. 

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●		 Td vaccine, if available, is preferred to TT for those previously vaccinated 

with Tdap. 

●		 Tdap or Td vaccines, if neither available, TT should be administered. 

Tetanus toxoid-containing vaccines are easily confused increasing the risk for a 

vaccine administration error. Consider organizing vaccines in the storage unit 

by age group and/or color coding labels to distinguish vaccines from each other. 

Do not store sound-alike or look-alike vaccines next to each other. Labeling the 

space where the vaccine is stored with name, age indications or other information 

unique to the vaccine can help prevent vaccine administration errors. Refer to the 

Resources section at the end of this document for an example of a label. 

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Tetanus Toxoid- and diphtheria toxoid-Containing 

Vaccines 

Td: DECAVAC 

DT: Diphtheria and Tetanus Toxoid 

Condition upon Arrival 

Tetanus toxoid- and diphtheria toxoid-containing vaccines (Td; DT) should arrive 

packed in an insulated container. Examine the shipping container and contents for 

damage during transport. Some vaccines are shipped with a temperature monitor. 

If a temperature monitor is present, check and follow the instructions. The vaccine 

should not have been frozen or exposed to freezing temperatures. If the interval 

between shipment from the distributor/manufacturer and arrival of the vaccine at the 

facility has been more than 48 hours or you have questions about the condition of 

the vaccine at the time of delivery, you should take three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate immediately upon arrival. Store between 35°F and 46°F (2°C and 8°C). 

Do not freeze or expose to freezing temperatures. 

Shelf Life 

Check expiration date on the container, vial or manufacturer-filled syringe. Do not 

use after the expiration date shown on the label. 

Preparation 

Inspect visually for extraneous particulate matter and/or discoloration. If these 

conditions exist, the vaccine should not be used. Just before use, shake vial or 

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Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

manufacturer-filled syringe well. Do not use vaccine if it cannot be resuspended 

after thorough agitation. These vaccines should not be combined or mixed with 

any other vaccines. Refer to the Resources section at the end of this document for 

information on vaccine administration. 

●		 After shaking, Td vaccine is a cloudy, whitish-gray colored liquid. 

Beyond Use Date*: Shelf Life after Opening 

Single-Dose Vials: All of the vaccine should be drawn into a sterile syringe using a 

sterile needle at the time the vaccine is administered. 

Manufacturer-Filled Syringes: Manufacturer-filled syringes should be activated 

(i.e., syringe tip removed and/or needle attached) at the time the vaccine is 

administered. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

Diphtheria toxoid- and tetanus toxoid-containing vaccines are easily confused 

increasing the risk for a vaccine administration error. Consider organizing vaccines 

Vaccine Storage and Handling Guide —————————————————————————————— Page 62 
Selected Biologicals 

in the storage unit by age group and/or color coding labels to distinguish vaccines 

from each other. Do not store sound-alike or look-alike vaccines next to each other. 

Labeling the space where the vaccine is stored with name, age indications or other 

information unique to the vaccine can help prevent vaccine administration errors. 

Refer to the Resources section at the end of this document for examples of labels.

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease 

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Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Tetanus Toxoid-, diphtheria toxoid-, and acellular 

pertussis- Containing Vaccines 

Tdap: Adacel, Boostrix 

Condition upon Arrival 

Tetanus toxoid-, diphtheria toxoid- and acellular pertussis-containing vaccine 

(Tdap) should arrive packed in an insulated container. Examine the shipping 

container and contents for damage during transport. Some vaccines are shipped 

with a temperature monitor. If a temperature monitor is present, check and follow 

the instructions. The vaccine should not have been frozen or exposed to freezing 

temperatures. If the interval between shipment from the distributor/manufacturer 

and arrival of the vaccine at the facility has been more than 48 hours or you have 

questions about the condition of the vaccine at the time of delivery, you should take 

three steps. 

1. Immediately place the vaccine in the refrigerator between 35°F and 46°F 

(2°C and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the distributor and immunization program regarding shipments of Vaccines for Children (VFC) or 

other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Refrigerate immediately upon arrival. Store between 35°F* and 46°F (2°C and 

8°C). Do not freeze or expose to freezing temperatures. 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

Shelf Life 

Check expiration date on the container, vial or manufacturer-filled syringe. Do not 

use after the expiration date shown on the label. 

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Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Preparation 

Inspect visually for extraneous particulate matter and/or discoloration. If these 

conditions exist, the vaccine should not be used. Just before use, shake vial or 

manufacturer-filled syringe well. Do not use vaccine if it cannot be resuspended 

after thorough agitation. After shaking, Tdap should be a cloudy, white colored liquid. 

These vaccines should not be combined or mixed with any other vaccines. Refer 

to the Resources section at the end of this document for information on vaccine 

administration. 

Beyond Use Date*: Shelf Life after Opening 

Single-Dose Vials: All of the vaccine should be drawn into a sterile syringe using a 

sterile needle at the time the vaccine is administered. 

Manufacturer-Filled Syringes: Manufacturer-filled syringes should be activated 

(i.e., syringe tip removed and/or needle attached) at the time the vaccine is 

administered. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions) 

Vaccine exposed to temperatures outside the recommended range- either too warm 

or too cold- requires immediate corrective action! Vaccine providers should have 

a current emergency vaccine retrieval and storage plan that includes, but is not 

limited to, these four actions. 

1. Place the vaccine in the recommended storage between 35°F and 46°F (2°C 

and 8°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the manufacturer and/ 

or the immunization program for further guidance. 

4.	 Do not discard vaccine unless directed to by the immunization program and/ 

or the manufacturer. 

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

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Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Special Instructions 

Diphtheria toxoid- and tetanus toxoid-containing vaccines are easily confused 

increasing the risk for a vaccine administration error. Consider organizing vaccines 

in the storage unit by age group and/or color coding labels to distinguish vaccines 

from each other. Do not store sound-alike or look-alike vaccines next to each other. 

Labeling the space where the vaccine is stored with name, age indications or other 

information unique to the vaccine can help prevent vaccine administration errors. 

Refer to the Resources section at the end of this document for an example of a 

label. 

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Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Varicella-Containing Vaccines
 VAR: Varivax (chickenpox)
 

ZOS: Zostavax (herpes zoster/shingles)
	

MMRV: ProQuad 

Condition upon Arrival 

Varicella-containing vaccines (VAR, MMRV and ZOS) have 2 components: 

lyophilized vaccine and diluent. Both components should arrive together in the same 

shipping container. The vaccine and diluent should be in separate compartments. 

Examine the shipping container and contents for damage during transport. If the 

interval between shipment from the manufacturer and arrival of the vaccine at the 

facility has been more than 3 days or you have questions about the condition of the 

vaccine at the time of delivery, you should take three steps. 

1.	 Immediately place the vaccine in the freezer between -58°F and +5°F (-50°C 

and -15°C). 

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3.	 Follow your immunization program policy and contact the distributor, 

manufacturer and/or the immunization program for guidance.
	

NOTE: Contact the manufacturer and immunization program regarding shipments of Vaccines for Children (VFC) 

or other vaccines purchased with public funds that may not have been transported properly. 

Storage Requirements 

Store the lyophilized vaccine and diluent according to the manufacturer’s guidelines 

immediately upon arrival. Do not store lyophilized vaccine and diluent together. 

Lyophilized vaccine: Store lyophilized vaccine in the freezer between -58°F 

and +5°F (-50°C and -15°C). Protect vaccine from light at all times by storing in the 

original box. Vaccine should only be stored in freezers or refrigerator/freezer units 

with separate compartments and exterior doors. 

Diluent: Store separately from lyophilized vaccine in the refrigerator between 

35°F* and 46°F (2°C and 8°C) or at room temperature between 68°F and 77°F 

(20°C and 25°C). Do not freeze or expose to freezing temperatures. 

*Storage temperatures between 36°F and 46°F (2°C and 8°C) are specified in the label and the license for these 

products. However, 2 ̊C is exactly converted to 35.6 ̊F so the manufacturer’s guidance for Fahrenheit is rounded 

by the manufacturer. 

Vaccine Storage and Handling Guide —————————————————————————————— Page 69 
 

Selected Biologicals 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Shelf Life 

Check expiration date on the container or vial of the vaccine AND diluent. Do not 

use after the expiration date shown on the labels. 

Preparation 

These vaccines must be reconstituted before administration. Consider posting 

reminders or labeling the vaccine to remind staff to reconstitute it. Only use the 

diluent supplied by the vaccine manufacturer to reconstitute the vaccine. 

Refer to the Resources section at the end of this document for examples of labels 

and the educational handout “Vaccines with Diluents: How to Use Them”. These 

vaccines should not be combined or mixed with any other vaccines. The Resources 

section at the end of this document also includes vaccine administration information. 

1. Just before use, withdraw the entire contents of the diluent vial and inject it 

slowly into the vial containing the lyophilized vaccine vial. 

2.	 Gently shake or agitate the vial now containing the lyophilized vaccine and 

diluent to mix thoroughly. Do not use the vaccine if it cannot be resuspended 

with thorough agitation. 

3. Inspect visually for extraneous particulate matter and/or discoloration. If 

these conditions exist, the vaccine should not be used. Reconstituted vaccine 

should have the following appearance: 

●		 VAR: Clear, colorless to pale yellow liquid. 

●		 ZOS: Semi-hazy to translucent, off white to pale, yellow liquid. 

●		 MMRV: Pale yellow to light pink, clear liquid. 

Beyond Use Date*: Shelf Life after Opening 

All of the reconstituted vaccine should be drawn into a sterile syringe using a sterile 

needle at the time the vaccine is administered. Administer immediately. Unused, 

reconstituted varicella and MMRV vaccines may be stored at room temperature 

between 68°F and 77°F (20°C and 25°C) for up to 30 minutes. Protect from light. Do 

not freeze or exposed reconstituted vaccine to freezing temperatures. Agitate any 

stored, reconstituted vaccine prior to administration. 

●		 Do not administer reconstituted varicella-containing vaccine (VAR, 

ZOS, MMRV) if it is not used within 30 minutes. Follow the immunization 

program guidance before discarding VFC or other vaccines purchased with 

public funds. 

*The date or time after which the vaccine should not be used; determined from the date or time the 

manufacturer-filled syringe is activated, vial is entered or vaccine is reconstituted; may be different from the 

expiration date. 

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Vaccine Storage and Handling Guide 

Vaccine Storage and Handling Guide —————————————————————————————— Page 71 National Center for Immunization and Respiratory Disease

Selected Biologicals 

Vaccines Exposed to Inappropriate Temperatures 

(Temperature Excursions)

Varicella-containing vaccines exposed to temperatures outside the recommended 

range require immediate corrective action! Vaccine providers should have a 

current emergency vaccine retrieval and storage plan that includes, but is not limited 

to, these four actions.

1. Place the vaccine in the freezer between -58°F and +5°F (-50°C and -15°C). 

Any freezer that has a separate sealed freezer door and reliably maintains 

a temperature between -58°F and +5°F (-50°C and -15°C) is acceptable for 

storage of varicella-containing vaccines.

2. Mark vaccine “Do Not Use” and separate from uncompromised vaccines. A 

clearly labeled paper bag can be used for this purpose. 

3. Follow your immunization program policy and contact the manufacturer and/

or the immunization program for further guidance. 

4. Do not discard vaccine unless directed to by the immunization program and/

or the manufacturer.

NOTE: Contact the immunization program whenever VFC or other vaccines purchased with public funds are 

exposed to temperatures outside the recommended range. 

Special Instructions 

In order to maintain temperatures between -58°F and +5°F (-50°C and -15°C), 

it will be necessary in most combination refrigerator/freezer models to turn the 

temperature dial down to the coldest setting. This may result in the refrigerator 

compartment temperature being lowered as well. Careful monitoring of the 

refrigerator temperature will be necessary to avoid freezing vaccines stored in the 

refrigerator. 

“Dormitory-style” refrigerator/freezer is not appropriate for the storage of varicellacontaining vaccines. A dormitory-style refrigerator is defined as a small combination 

freezer/refrigerator unit that is outfitted with one exterior door and an evaporator 

plate (cooling coil), which is usually located inside an icemaker compartment 

(freezer) within the refrigerator.

CDC and the vaccine manufacturer do not recommend transporting varicellacontaining vaccines. If varicella-containing vaccines must be transported, CDC 

recommends transport with a portable freezer unit that maintains the temperature 

between -58°F and +5°F (-50°C and -15°C). Portable freezers may be available 
Vaccine Storage and Handling Guide 

Vaccine Storage and Handling Guide —————————————————————————————— Page 72 National Center for Immunization and Respiratory Disease

Selected Biologicals 

for rent in some places. If varicella-containing vaccines must be transported and a 

portable freezer unit is not available complete the following actions: 

Varicella-containing vaccines may be transported at refrigerator temperature 

between 36°F and 46°F, (2°C and 8°C) for up to 72 continuous hours prior to 

reconstitution.

 

1. Place a calibrated thermometer in the container used for transport as close 

as possible to the vaccine. 

2. Record:

a. the time the vaccine was removed from the storage unit and placed in 

the container 

b. temperature during transport 

c. document the time and temperature at the beginning and end of 

transport 

3. According to the vaccine manufacturer, immediately upon arrival at the 

alternate storage facility: 

a. place the vaccine in the freezer between -58°F and +5°F (-50°C and 

-15°C). Any freezer that has a separate sealed freezer door and reliably 

maintains a temperature between -58°F and +5°F (-50°C and -15°C) is 

acceptable for storage of varicella-containing vaccines.

b. document the time the vaccine was removed from the container and 

placed in the alternate storage unit. 

c. note that this is considered a temperature excursion, so contact the 

manufacturer at 1-800-637-2590 for further guidance. 

4. Do not discard vaccine without contacting the manufacturer and/or the 

immunization program for guidance.

Use of dry ice is not recommended, even for temporary storage or emergency 

transport. Dry ice may subject varicella-containing vaccine to temperatures colder 

than -58°F (-50°C). 

Providers can have different products or presentations containing the varicellacontaining vaccines in the storage unit. For example, single antigen and combination 

vaccines. Vaccine products and presentations often have different approved 

indications and uses (e.g., ages, route). Storing multiple products and presentations 

can be confusing to staff and increase the risk for vaccine administration errors. 

Consider organizing vaccines in the storage unit by age group and/or color coding 

labels to distinguish vaccines from each other. Do not store sound-alike or look-alike 

vaccines next to each other. Labeling the space where the vaccine is stored with 

name and age indications can help prevent vaccine administration errors.
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Vaccine Storage and Handling Guide —————————————————————————————— Page 73
 
 

Resources
 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

CDC Resources 

Advisory Committee on Immunization Practices U.S. VACCINE 

ABBREVIATIONS 

http://www.cdc.gov/vaccines/recs/acip/downloads/vac-abbrev.pdf 

Epidemiology and Prevention of Vaccine-Preventable Diseases 12th Edition 

Storage and Handling Chapter 5 

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-storage.pdf 

Storage and Handling Resources Appendix C 

http://www.cdc.gov/vaccines/pubs/pinkbook/pink-appendx.htm#appc 

Vaccine Administration Appendix D 

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/appdxfull-d.pdf 

Epidemiology and Prevention of Vaccine-Preventable Disease Course 

Session 2 includes vaccine storage and handling information 

http://www.cdc.gov/vaccines/ed/epivac/default.htm 

General Recommendations on Immunization: Recommendations of the 

Advisory Committee on Immunization Practices (ACIP) 

http://www.cdc.gov/mmwr/pdf/rr/rr6002.pdf 

Storage and Handling web page 

http://www.cdc.gov/vaccines/recs/storage/default.htm 

Storage and Handling ToolKit 

http://www2a.cdc.gov/vaccines/ed/shtoolkit/ 

Vaccine Label Examples 

http://www.cdc.gov/vaccines/recs/storage/guide/vaccine-storage-labels.pdf

Vaccine Administration web page 

http://www.cdc.gov/vaccines/recs/vac-admin/default.htm 

Vaccine Storage and Handling Guide —————————————————————————————— Page 74
Resources
 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Other Resources 

Alliance for Immunization in Michigan (AIM) Provider ToolKit 

www.aimtoolkit.org 

Storage and Handling Materials 

http://www.aimtoolkit.org/vaccine.php 

Vaccine Administration Materials 

Children 

http://www.aimtoolkit.org/children.php 

Adolescents 

http://www.aimtoolkit.org/adolescents.php 

Adults 

http://www.aimtoolkit.org/adults.php 

EZIZ- California Vaccines for Children (VFC) Program 

www.eziz.org 

Storage and Handling Educational Video 

http://eziz.org/eziz-training/ 

Storage and Handling Job Aides 

http://eziz.org/resources/materials_storageandhand.html 

Vaccine Administration Educational Video 

http://eziz.org/eziz-training/ 

Vaccine Administration Job Aides 

http://eziz.org/resources/vaccine-admin-job-aids/ 

Immunization Action Coalition (IAC) 

www.immunize.org 

Handling and Storage Resources 

http://www.immunize.org/handouts/vaccine-storage-handling.asp 

Handling and Storage FAQ’s 

http://www.immunize.org/askexperts/experts_general.asp 

Checklist for Safe Vaccine Storage and Handling 

http://www.immunize.org/catg.d/p3035.pdf 

Don’t be Guilty of These Errors in Vaccine Storage and Handling 

http://www.immunize.org/catg.d/p3036.pdf 

Emergency Response Worksheet 

http://www.immunize.org/catg.d/p3051.pdf 

Vaccine Storage and Handling Guide —————————————————————————————— Page 75
Resources
 

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Skills Checklist for Immunization 

http://www.immunize.org/catg.d/p7010.pdf 

Temperature Logs for Refrigerator and Freezer: 

Celsius http://www.immunize.org/catg.d/p3039a.pdf 

Fahrenheit http://www.immunize.org/catg.d/p3039.pdf 

Vaccines with Diluents: How to Use Them 

http://www.immunize.org/catg.d/p3040.pdf 

Vaccine Handling Tips 

http://www.immunize.org/catg.d/p3048.pdf 

Vaccine Administration Resources 

http://www.immunize.org/clinic/administering-vaccines.asp 

Vaccine Administration FAQ’s 

http://www.immunize.org/askexperts/experts_general.asp#admin 

Administering Vaccines: Dose, Route, Site, and Needle Size 

http://www.immunize.org/catg.d/p3085.pdf 

How to Administer IM and SC Injections 

http://www.immunize.org/catg.d/p2020.pdf 

Manufacturer’s Product Information 

http://www.immunize.org/packageinserts/ 

Thermal Analysis of Refrigeration Systems Used for Vaccine Storage 

http://www.nist.gov/customcf/get_pdf.cfm?pub_id=904574 

State Immunization Program Information 

State Immunization Program Websites 

http://www.cdc.gov/vaccines/spec-grps/prog-mgrs/grantee-imz-websites.htm 

Vaccine Storage and Handling Guide —————————————————————————————— Page 76
Resources: Manufacturer Quality Control Office Telephone Numbers
	

Vaccine Storage and Handling Guide 

National Center for Immunization and Respiratory Disease

Manufacturer / Distributor 

Websites 

Telephone 

Number/E-mail Products 

Centers for Disease Control 

and Prevention 

www.cdc.gov/ncidod/srp/drugs/ 

drug-service.html 

http://www.cdc.gov/laboratory/ 

drugservice/index.html 

404-639-3670/ 

drugservice@cdc.gov 

Distributor for 

diphtheria antitoxin, VIG, 

smallpox vaccine 

GlaxoSmithKline (GSK) 

http://www.gskvaccines.com/ 

866-475-8222 

DTaP, DTaP-HepB-IPV, 

DTaP-IPV, HepA, HepB, 

HepA-HepB, HPV2, 

RV1, Tdap, TIV 

Massachusetts Biological 

Labs 

http://www.umassmed.edu/ 

massbiolabs/index.aspx 

617-474-3000 IGIM, Td, TT 

MedImmune 

http://www.medimmune.com/ 

877-633-4411 

medinfo@medimmune.com LAIV 

Merck & Co., Inc 

https://www.merckvaccines.com/ 800-637-2590 

HepA, HepB, Hib, HibHepB, HPV4, MMR, 

MMRV, PPSV23, Td, 

TIV, VAR, ZOS 

Biotest Pharmaceuticals 

http://www.biotestpharma.com/ 

products/nabiHB.html 

800 458-4244 

ma@biotestpharma.com HBIG 

Novartis 

http://www.novartisvaccines.com/ 

us/index.shtml 

877 683-4732 

Vaccineinfo.us@novartis.com TIV 

Pfizer/Wyeth 

http://pfizerpro.com/ 800-438-1985 PCV13 

Sanofi Pasteur 

https://www.vaccineshoppe.com/ 800-822-2463 

DT, DTaP, DTaP-IPV/ 

Hib, Hib, IPV, MCV4, 

MPSV4, Rabies, RIG, 

Td, Tdap, TIV, TT 

Talecris Biotherapeutics 

http://www.talecris.com/talecrisbiotherapeutics-us-home.htm 

800-520-2807 

talecris@medcomsol.com HBIG, IGIM, RIG, TIG 

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