Technically Speaking: Fires and Floods and Tornadoes, Oh My! Protecting Your Vaccine Supply

Vaccines are formulated with disease-specific active ingredients as well as preservatives and stabilizers. The latter two types of ingredients prolong the shelf life of vaccines and ensure their safety and effectiveness. Temperature control is a crucial part of this equation.

This summer, many parts of the United States have had weather and related problems (e.g., fires, floods, tornadoes, extreme heat) that can lead to power outages of varying length. These events remind us that an office’s vaccine supply must be protected.

From the standpoint of both patient safety and the fiscal bottom line, being prepared when it comes to protecting the vaccine supply in a clinical setting is critical. As such, it’s a good time to evaluate vaccine storage and emergency procedures in your office. Immunize.org makes this super easy with these two resources: “Checklist for Safe Vaccine Storage and Handling” and “Don’t Be Guilty of These Preventable Errors in Vaccine Storage and Handling!” Here are tips adapted from these sheets.

1. While everyone in the office should know the basics of vaccine handling (e.g., getting a shipment put away properly, managing a power outage, etc.), there should be at least one vaccine storage “master” and at least one back-up person who is ready to handle the storage problems that arise when the “master” is on vacation. (You know that’s when the power will go out, right?)
2. Store vaccines in the body of reliable refrigeration equipment, not on the doors. Post Immunize.org’s “Vaccine Handling Tips” as a visual cue to remind everyone which vaccines go in the freezer and which go in the refrigerator.
3. Use CDC-approved equipment. For details, see CDC’s Vaccine Storage and Handling Toolkit (Section 3).
4. Be sure your system’s temperature monitoring device (a digital data logger) is properly set, so that it accurately reflects vaccine temperatures, logs the temperature at least every 30 minutes, and alarms for out-of-range temperatures or in case of low battery. Details on this are also shown in CDC’s Vaccine Storage and Handling Toolkit (Section 3).
5. Be sure that if there is a temperature excursion, someone acts. It’s easy to be lulled into a sense of false security knowing that the temperature is being monitored. Rapidly taking the correct action when something goes awry can save the vaccines. For example, start by completing this form offered by Immunize.org, “Vaccine Storage Troubleshooting Record.” This effort will help you think through next steps. If in doubt, call your state immunization program for guidance. This is especially important for offices that participate in the “Vaccine For Children” (VFC) program.
6. Keep temperature logs for at least three years.
7. Even the fanciest of equipment is subject to the same problems we have in our houses: A) People must close the refrigerator door properly! B) Faulty seals periodically need to be replaced.
8. Is there someone in your home who uses the new milk before they finish the open milk? Or they find expired milk and just leave it there? It’s even worse if “newer” vaccine is used first or if expired vaccines are left in the refrigerator. First, make sure that whoever is putting vaccine away is checking the relative placement, so that vaccine with the closest expiration date is in the front. Second, ensure that everyone is checking for and removing any vaccine that has passed its expiration date. (You may opt to have someone in charge of checking the vaccine supply for these details on a regular basis.)
9. Nothing should be stored in the same refrigerator or freezer with vaccines or other medicines. Not lunch. Not breastmilk. Not birthday cake.
10. Murphy’s Law (see the Engineering Institute of Technology) is tremendously robust, so post a “Do Not Unplug” sign next to electrical outlets for the refrigerator and freezer, and a “Do Not Stop Power” warning label adjacent to the relevant circuit breaker.

For more on vaccine storage and handling, please see the full array of Immunize.org materials in the “Storage and Handling” section of their website. Also, check:

• Centers for Disease Control and Prevention (CDC)
• U.S. Food and Drug Administration (FDA)
• Vaccine manufacturers: Many vaccine manufacturers provide specific guidelines for the storage and handling of their vaccines. Check the official websites or contact the respective manufacturers for detailed information on their products.

Remember that guidelines and recommendations may be updated over time, so it's important to consult the latest information from these sources and stay informed about any updates or changes to vaccine storage and handling practices.