You will also need to have appropriate practices and procedures in place for vaccine storage and handling. By doing this, you maintain the quality and potency of the vaccine and minimize waste.
The following are some important practices to follow as part of safe storage and handling:
Vaccines must always be refrigerated between +2 C and +8 C to maintain their potency and effectiveness.
Strive to maintain vaccine refrigerator temperatures at +5 degrees Celsius as this provides greater margin against temperature fluctuations.
Before storing the vaccine, the internal temperature of the refrigerator must be stable between +2 and +8 C for the recommended period of seven consecutive days.
Proper vaccine refrigerator placement
Keeping your refrigerator organized can play an important role in maintaining an efficient cold chain supply solution. The following tips are some important and useful tips to ensure safe handling practices in vaccine programs and biomedical/pharmaceutical environments.
Vaccines should be kept away from refrigerator walls, floors, and cold air vents. Placing vaccines on refrigerator walls, floors and cold air vents increases the risk of exposure to temperatures below +2C.
There should always be a little space between vaccine packages to allow for air circulation. Avoid tight packing and stacked packaging.
Display vaccine by-products. Keep vaccines of the same type together.
Check vaccine expiration dates regularly and after each vaccine order. Remember, the first in should always be the first out. Remember the acronym FIFO* (first in, first out).
Always check the vaccine expiration date before use. If expired, return them to the source of vaccine supply immediately.
Vaccine refrigerators must be used at all times and only for vaccine storage. Food, beverages, or other non-medical related products should not be stored in vaccine storage units as this practice can result in frequent door openings and temperature instability.
If your refrigerator is storing few vaccine packets, place several water-filled bottles throughout the refrigerator to help maintain an even, stable temperature.
How should vaccines be stored?
Do not store these vaccines in the refrigerator. Inactivated vaccines are sensitive to both excessive heat and freezing. They should be stored in the refrigerator at 2° to 8°C, with an average temperature of 5°C required
Which vaccines require refrigeration?
Store all other routinely recommended vaccines in the refrigerator at 2°C to 8°C. The required average refrigerator vaccine storage temperature is 5°C. Exposure to temperatures outside these ranges may result in reduced vaccine efficacy and increased risk of vaccine-preventable diseases.
Vaccine Storage Practices
live vaccine
Live vaccines are sensitive to heat. MMRV, varicella, and shingles vaccines must be stored continuously frozen in a freezer at -15°C or colder until administration. MMRV, chickenpox and shingles vaccines will spoil quickly after being removed from the refrigerator. Measles, mumps, and rubella vaccine (MMR) is usually stored in the refrigerator, but it can also be stored in the freezer.
inactivated vaccine
Inactivated vaccines are sensitive to both excessive heat and freezing. They should be stored in the refrigerator at 2° to 8°C, with an average temperature of 5°C required. Exposure to temperatures outside this range can result in reduced vaccine effectiveness and increased risk of vaccine-preventable diseases. Inactivated vaccines can tolerate limited exposure to high temperatures, but they are sensitive to cold and are rapidly damaged by freezing temperatures.
Vaccine storage locations and location
Freezer
In freezers, vaccines should be stored in the middle of the compartment, away from walls, coils, and peripheral areas. Vaccines should not be stored inside the freezer door. The temperature inside the door was unstable and different from the temperature in the main compartment. MMRV, varicella and shingles vaccines can be stored in manual defrost or frost-free freezers at -15° C or lower
NOTE Vaccines should not be stored inside the freezer door. In the refrigerator, vaccines should be stored in the middle of the compartment, away from walls, coils, and peripheral areas.
refrigerator
In the refrigerator, vaccines should be stored in the middle of the compartment, away from coils, walls, floors, and cold air vents. The temperature near the refrigerator floor is unstable and different from the temperature in the middle of the compartments. Therefore, vaccines should never be stored in vegetable bins. Vaccines should not be stored inside refrigerator doors. The temperature inside the door was unstable and different from the temperature in the main compartment. In a combination refrigerator-freezer unit, the top shelf of the refrigerator may be colder than the recommended temperature range as cold air is exhausted from the refrigerator.
Refrigerated vaccines should always be stored away from freezer vents to prevent the vaccine from freezing. Ideally, vaccines should be stored on center shelves, away from cold air vents. However, vaccines can also be stored on upper shelves if they can be kept away from cold drafts and the temperature in the area is within the recommended range. If the upper shelf must be used for vaccine storage, it is best to place the MMR on this shelf because MMR is not as sensitive to freezing temperatures as other refrigerated vaccines.
vaccine spacing
Vaccines should be placed between the vaccine and the compartment wall, with space between each large box, vaccine block, or vaccine tray to allow cold air to circulate around the vaccine. Adequate cold air circulation helps each vaccine reach a consistent temperature throughout its mass and is necessary for storage units to maintain consistent temperatures within compartments. Packing any vaccine storage unit too tightly can affect temperature.
vaccine packaging
Vaccine products with similar packaging should be stored in different locations to avoid confusion and medication errors. For example, if you have pediatric and adult versions of the same vaccine, storing them in different locations can reduce the chance of someone inadvertently choosing the wrong vaccine. Likewise, vaccines with similar names should be stored in different locations. For example, the DTaP and Tdap vaccines can be easily confused, as can the Hib and Hepatitis B vaccines.
NOTE Thinner may be stored inside the refrigerator door. Vaccines should not be stored inside refrigerator doors. In the refrigerator, vaccines should be stored in the middle of the compartment, away from walls and coils, and away from the floor.
Label
The location of each specific vaccine within the storage unit should be clearly marked. This can be accomplished by placing the label directly on the shelf where the vaccine is placed or by labeling the container where boxes of the same vaccine type are placed. Storing each vaccine in a specially labeled section of the refrigerator or freezer helps reduce the chance of someone mistakenly using the wrong type of vaccine. In addition to marking the location of the vaccine, label each opened multi-dose vial with the date it was first opened. Stamp the recombinant vaccine with the date and time of recombination.
Dating these vials is important for two reasons. First, some vaccines expire within a certain period of time after opening or reconstitution. This may not match the expiration date printed on the vial by the manufacturer. For example, multi-dose vials of meningococcal vaccine should be discarded if not used within 35 days of preparation, even if the expiration date stamped by the manufacturer on the vial has not passed. Second, determining the date when vials should be opened or reconstituted helps manage vaccine inventories by identifying which vials should be used first.
storage container
vaccine box
To avoid confusion, vaccine boxes should be stored together by type and in a row. Boxes should be stacked according to expiration date. Vaccines with the shortest shelf life should be located near the front of the storage unit compartment for easy access. Store all opened and unopened vaccine vials in boxes within appropriate storage units so their contents and expiration dates can be easily identified.
Pallets and containers
Trays and containers can be used to hold vaccine boxes. Each tray or container can only hold the same type of vaccine. Other drugs and biologics, if they must be stored in vaccine storage units, should not be stored in trays or containers to avoid the possibility of medication errors. Clearly label the tray or container with the name of the vaccine and place that type of vaccine box on the tray or in a container in the refrigerator or freezer. Trays and containers should not be stacked or placed so close that they impede air circulation within vaccine storage unit compartments.
Storage of non-vaccine products
food and drinks
Never store food or drinks in a vaccine refrigerator or freezer. This practice results in frequent opening of storage unit doors, greater potential for temperature instability and overexposure to light. It can also lead to spills and contamination within the compartment.
Drugs and other biological products
If possible, other drugs and other biological products should not be stored in vaccine storage units. If there is no other option, these products must be stored on separate shelves below the vaccines. This prevents the vaccine from becoming contaminated if other products are spilled and reduces the possibility of medication errors.
