Storage and Handling
UPDATED! For information on storage and handling of vaccines, see CDC’s Storage and Handling Toolkit.
Vaccines only work when they are viable, intact, and undamaged. For this reason, the appropriate handling and storage of vaccines are vital parts of an immunization program. Ideally, vaccine deliveries should only be made when the vaccine coordinator or back-up person is present. Packages should be opened immediately and inspected for any damage. The coordinator should check the quantities, lot numbers, and expiration dates against the packing slip in addition to the condition of vaccines. Packages will often have temperature indicators that should be checked to insure the vaccine has not been exposed to improper temperatures. If there are no temperature indicators, verify that the container includes appropriate insulation and refrigerant (e.g. dry ice, gel packs, or ice packs). When the shipment arrives, verify that the inactivated vaccines are cold but not frozen; inactivated vaccines are damaged by freezing. Live virus varicella-containing vaccine must arrive frozen. MMR may be frozen, but this is not required. If the product seems to have been exposed to extremes of temperature (by appearance or by package indicator), separate the vaccine in a marked container (label DO NOT USE), store in the refrigerator at the proper temperature, and immediately contact the source of shipment for further instructions.
All vaccines except varicella containing vaccine can safely be kept in the refrigerator within a temperature range of 2–8°C (35–46°F). The refrigerator temperature should be set at 40°F (5°C). It is important to have a thermometer for temperature monitoring.
Vaccines should always be stored in trays in the middle of the refrigerator or freezer, never in the door of the compartment. The oldest vaccines should be stored toward the front of the shelf. When new product arrives, it should be placed behind the older product. This allows the older vaccines to be used before their expiration date.
Temperature log sheets should be maintained. The temperature of each compartment is recorded twice each day—once in the morning and once in the afternoon prior to closing. The temperatures should be checked immediately before leaving and upon arrival following a weekend or vacation when the office is closed.
In the event of a refrigeration failure, all vaccines should be placed immediately in a preplanned location that has adequate refrigeration. Any vaccine exposed to temperatures out of range due to power failure or mismanagement of any type should be separated from undamaged vaccines and refrigerator and freezer temperatures noted. The manufacturer and/or the state health department should be contacted with this information for instructions on handling the damaged vaccine. If it is deemed appropriate to use the vaccines in question, a revised expiration date may be assigned to these vaccines.
Always safeguard the electrical supply to the refrigeration unit. The unit should be plugged into a protected outlet that will not be accidentally or intentionally disconnected. Label the refrigeration unit, the electrical cord, the outlet, and plugs with a “DO NOT UNPLUG” notation to further safeguard the electrical supply. If possible, connect the refrigeration unit to a circuit with emergency backup power. There are alarm systems that can be purchased to provide timely warning of electrical failure when the practice is unstaffed.
In the event of an emergency, from a natural disaster or other unforeseen event, It is important to have a backup plan in place, in order to protect our vaccine supply. The CDC gives Emergency Procedures for Protecting Vaccine Inventories to help your office make preparations to keep your vaccines safe.