Safe Storage of Vaccines: A Simple Guide

The Problem

Within recent years there have been changes to the CDC’s Vaccine Storage and Handling Guidelines due to the concerns with clinics improperly storing vaccines. Safe storage of vaccines is crucial to preserving efficacy. Mishandling vaccines can result in their loss of potency and effectiveness giving patients a false sense that they are inoculated against a particular virus. Administering ineffective vaccines could be potentially harmful and fatal, especially to those most at risk (children and the elderly). As many medical professionals know, vaccines are very expensive and extremely fragile. For instance, they require strict temperature parameters. Improper temperature storage can adversely affect the potency which could potentially cause harm to the patient’s health and also cost thousands of dollars to your facility.

The Solution

The CDC has prepared guidelines for healthcare professionals that, if followed properly, will ensure that you are properly storing your vaccines. These guidelines outline the best practices as well as the equipment needed to achieve the best storage environment.

To start, prepare your facility by having cold-storage equipment and temperature monitoring devices that are with-in the parameters given for proper storage. The refrigeration unit(s) your facility will use can make a significant difference in whether or not your vaccines are sufficiently protected.

Refrigerator & Freezers for Safe Storage of Vaccines

Recommended:
–Varicella-Containing Vaccines (Frozen): Should be stored in a stand-alone, pharmaceutical grade freezers with a built-in digital temperature display, alarms, and locking door.
–Inactivated Vaccines (Refrigerated): Should be stored in stand-alone, pharmaceutical grade refrigerators with a built-in digital temperature display, alarms, and locking door.
Not Recommended:
-Household & Commercial and/or combination refrigeration units are not recommended due to their lack of temperature uniformity and random cold spots within the units.
-Dormitory or Bar-style refrigerators/freezers are not allowed for storage of any vaccines under any circumstances.

Temperature Monitoring & Data Logging

Recommended:
- NIST Traceable Thermometers with high/low temperature alarms and minimum/maximum temperature memory.
- Remote Temperature Monitors allow you to monitor temperatures even when away from the office or lab, and provide alarms and data storage as needed.

Combining the proper unit and monitoring system ensures you have the proper tools for safe storage. Below is the CDC’s recommended protocol for safe handling, receiving and storage of vaccines.

When receiving new vaccines at your medical office or lab, unpack and place in refrigeration unit immediately.
- Place vaccines in trays or uncovered containers and leave 2-3 inches between all vaccines and the refrigeration unit walls. This will allow for proper air flow throughout the unit.
- Practice FIFO (first in, first out) method: Place vaccines that are set to expire first in the front.
- Keep vaccines in their original boxes with lids closed in order to prevent light exposure.
- Separate & label by vaccine type and VFC/Public or Private.
Store Vaccines at ideal temperature
- Refrigerated Vaccines: 40°F (min. 36°F, max. 46°F)
- Frozen Vaccines: -4°F (min. -58°F, max. +5°F)
Checking and Recording temperatures: I think that data loggers are standard now and are necessary no matter what. Therefore, the below info. might be a little outdated.
- If you do not have a data logger, carry out the following steps first thing in the morning, then again before leaving at night:
  i. Check and record the current temperature.
  ii. Check and record the coldest and warmest the refrigeration unit has been since the last time the thermometer was reset.
  iii. Push the reset button on the thermometer so new minimum and maximum temperatures can be recorded.
- If you have a Data Logger, follow these steps:
  i. Set your data logger or remote monitoring system to record the temperature at least every 8 hours or more. ii. Download the data once a week to your computer.
Take action if temperatures are out of range
- Contact the state or local health department immediately. If they are private vaccines, call the manufacturer directly.
- Give them details especially the total amount of time the refrigerator was out of range.

Vaccine Storage and Handling Do’s & Don’ts

Do:
- Always make sure the refrigerator/freezer door is shut.
- Use water bottles (refrigerator) or ice packs (freezer) to fill unused space which will help maintain consistent temperatures throughout. If water bottles are used, label them “Do Not Drink”.
- Leave 2-3 inches between all vaccines and the refrigeration unit walls.
- Post “DO NOT UNPLUG” signs on unit and by electrical outlet.
Don’t:
- When storing refrigerated vaccines, DO NOT store on top shelf, in doors or on the floor of the unit (colder and sometimes freezing temperatures can be reached in these locations).