The 6 Rules of Vaccine Management
Rule 1 and 2: Keep Your Refrigerator and
- Use a plug guard to prevent accidental unplugging.
- Place "Do Not
Unplug!" warning signs on plugs and circuit breakers.
- Place thermometers in both refrigerator and
should be kitchen-ware type).
- Check the temperature of refrigerator and freezer
each morning and afternoon and record on a log sheet.
- Don't store food in refrigerator or freezer - they should
be opened only for temperature checks and vaccines.
- Possible problems in refrigerator and freezer temperature
- Thermometer is inaccurate or too close to front or back of unit.
- Refrigerator/freezer needs repair.
- Power is being interrupted.
- Refrigerator and/or freezer are not cold enough.
- Refrigerator is too cold.
- Refrigerator must be kept at 36°
- 46° F (2° - 8° C) not colder, not warmer!
- Freezer must be kept at 5° F (-15°
C) or below if storing Varicella.
- Ice cubes that remain consistently frozen are a good
indicator that the freezer is maintaining a temperature below 32° F (O° C).
- To protect your vaccine in the refrigerator and
- Never store vaccine in the refrigerator or freezer doors
(temperature is too unstable).
- Don't let refrigerator and freezer doors stand open.
- Check refrigerator and freezer doors each night.
- Keep bulk liquid water bottles in the refrigerator and freezer packs
in the freezer -
this maintains the temperature when doors are opened and in
case of power interruption.
Receiving Vaccine Shipments
-VFC Vaccine Shipments: All VFC
(excluding varicella) vaccine is shipped from GIV, and should
have a temperature indicator in the pack. Be sure to check the indicator to make
sure the vaccine is neither too warm nor too cold. The temperature
should be 36° - 46° F (2° - 8° C).
-Other shipments: ice can be melted but package should
be cold. Check temperature and contact VFC if there is any question
about the condition of the vaccine.
-As soon as you receive the shipment,
immediately put the vaccine in the refrigerator
Vaccines that must be frozen: Varicella
Vaccines that must be refrigerated and will be inactivated
by freezing (temperatures below 36° F (2° C).
DTP, DTaP, DTP/Hib, Td, DT
Hib, IPV, Hep B, Hep A
Pneumococcal (PPV23 and PCV7) and Influenza Vaccine
-If vaccines are left out, mark them so they are not used
and then store properly. If the vaccine is VFC vaccine, contact the VFC
Program at (602) 364-3276. If it is privately purchased vaccine, call the Quality
Control Office of the vaccine manufacturer.
MMR is the only refrigerated vaccine that can be frozen.
- Keep a "Handle With Care" sign on your refrigerator door.
Rule 3: Keep MMR Cold and Protected
- This rule applies to any single antigen or combination of
Measles, Mumps, and Rubella.
- MMR is easily inactivated by light, so it is very important
to keep this vaccine in the dark!
- Store in box with ends and lids in
place and closed.
- Keep MMR in the refrigerator until ready to reconstitute
- If you are doing a mass immunization, you can reconstitute
more than 1 dose of MMR if you do the following:
- Use cold diluent.
- Keep syringes cold.
- Protect the syringes from light.
- Discard reconstituted vaccine after 8 hours, even if the vaccine has
been kept cold and protected from light at all times.
Rule 4: Keep Varicella Frozen and
Protected From Light
Varicella vaccine must be kept
frozen at 5° F (-15° C) or less.
Varicella should be blanketed with
Varicella is the most fragile of the
- If this vaccine shipment arrives without dry ice, or if
there is any question about the condition of the vaccine, call VFC for advice.
- This is a powdered vaccine, so it won't look different
- Diluent should be stored at room temperature.
- Use only the diluent supplied with the vaccine.
- Leave in the freezer until needed.
- Protect from light.
- Administer immediately after reconstituting.
- Discard reconstituted vaccine if it isn't used within
30 minutes - do not refreeze!
- Secondary shipping (from one site to be stored at another
site) is NOT permitted.
- Only with prior approval from the VFC Program may VFC
varicella vaccine be transported to be used at another site. Any unused
vaccine must be discarded.
- Before transporting privately purchased varicella vaccine
to another site you must contact the manufacturer for details on how to
protect this vaccine.
Rule 5: Blanket Freezer Vaccines with Ice Packs
- Freeze ice packs to keep the cold
chain and protect the varicella vaccine.
- Make an igloo with the ice packs
and place the varicella vaccine inside.
Rule 6: Rotate Stock
- Expiration dates vary by type of vaccine, lot number.
- Put new vaccine in the back, so you automatically use
old vaccine first.
- Check expiration dates.
- Use short-dated vaccine first.
- Never use expired vaccine.
- Refer to vaccine package inserts.
- Like vaccines should be stored together to avoid possible
mix-up, for example:
- Keep all vaccines containing any combination of DTP on
the same refrigerator shelf, arranged so that DTP is grouped together,
DT grouped together, and so on.
- Order sensibly.
Wasted or spoiled VFC vaccine MUST be
returned to the
Vaccine quality controls ensure
that your agency saves money
your patients get potent vaccines
which protect them against disease.