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Storage & Handling - Vaccine Handling
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Emergency Procedure Recommendations

Questions
Answers
  1. What are the appropriate steps if a vaccine compromise is suspected?
    Immediate action must be taken to correct improper vaccine storage conditions and this action should be documented. Label the vaccines "DO NOT USE" and immediately store them under appropriate conditions separate from other vaccine supplies. Notify the primary or back-up vaccine coordinator (if not available, immediate supervisor) immediately of any temperature excursion. Use the Potentially Compromised Vaccine Worksheet, found on the MILVAX-VHCN website, to document the storage unit and ambient room temperatures, the length of time the vaccines may have been exposed to the inappropriate storage temperatures, the situation surrounding the potential loss, and an inventory of the vaccines affected. Note if water bottles were in the refrigerator and/or frozen coolant packs in the freezer at the time of the event. Contact USAMMA/DOC for guidance and their disposition for the affected vaccines. Do not discard vaccines unless directed to by USAMMA/DOC.

  2. What steps should be taken if the vaccine storage unit malfunctions?
    Move the vaccine to a properly functioning storage unit with internal temps within the recommended ranges, then attempt to troubleshoot the problem. Do not allow the vaccine to remain in a nonfunctioning unit for an extended period of time while you attempt to resolve the problem. If you are unsure how long the storage unit will not be functioning properly or you determine that the problem cannot be corrected in time to maintain the internal temperature within the recommended range, activate your clinics Emergency Vaccine Retrieval and Storage Plan.

  3. What steps can be taken to prevent accidental loss of vaccine?
    Post a "DO NOT UNPLUG" sticker near the electrical outlet and on the refrigerator or freezer alerting staff, janitors, and electricians not to unplug the unit. In addition, plug your vaccine storage unit directly into the outlets (never use extension cords or power strips), use a safety-lock plug or an outlet cover to reduce the chance of the unit becoming inadvertently unplugged and avoid using power outlets with built-in circuit switches (they have little red reset buttons) and outlets that can be activated by a wall switch. These can be tripped or switched off, resulting in loss of electricity to the storage unit. All storage devices and alarms should be plugged into back-up power plugs to reduce the chance of accidental loss of power to the units during an outage.

  4. How should vaccines be stored over a weekend or holiday if staff is not available?
    A continuous-monitoring temperature alarm/notification system should be considered, especially for practices with a large inventory, to help alert staff to after-hours emergencies. Alarms should be monitored electronically and physically on a 24 hours, seven days a week basis. Simple systems sound audible alarms when the temperatures inside the storage units exceed the recommended ranges, where as sophisticated systems sound an audible alarm and alert one or more designated person(s) at a specified phone or pager number. Storage areas with restricted access should have a device installed (light indicator/audible alarm) indicating when the storage unit temperature is out of range that can be checked without physically entering the restricted area.

  5. What is an Emergency Vaccine Retrieval and Storage Plan?
    The Emergency Vaccine Retrieval and Storage Plan provides up-to-date information regarding procedures to follow to protect and/or retrieve vaccines as quickly as possible when a potentially compromising situation occurs such as inclement weather conditions, natural disasters, or other emergencies that might disrupt power or flood any office where vaccine is stored. The immunization clinic vaccine coordinator should develop an Emergency Vaccine Retrieval and Storage Plan and keep it in a prominent and easily accessible location near the vaccine storage units.

  6. Why is it important to identify an alternate storage location?
    In case of an emergency situation, having an established working agreement with at least one alternate storage facility with a backup generator where vaccine can be appropriately stored and monitored for the interim, can save thousands of dollars worth of vaccines. Ensure that advanced arrangements are made with the facility(s) to store your vaccine when weather predictions call for inclement conditions (e.g., tornadoes, hurricanes, ice, severe snowstorms), when your vaccine storage equipment cannot be repaired, or when the power cannot be restored before the vaccine storage unit temperature rises above the recommended range.