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Storage & Handling - Vaccine Handling
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Vaccine Diluent and Storage practices

Questions
Answers
  1. What is the required refrigerator vs. freezer temperatures?
    Store all vaccines according to the manufactures' package insert. Certain vaccines are sensitive to freezing temperatures and should be stored in temperatures of 35°F- 46°F (2°C-8°C). Other vaccines lose potency when exposed to increased temperatures because they contain live viruses and should be stored in the freezer at temperatures of 5°F (-15°C) or colder. An exception to the rule is for measles, mumps, and rubella vaccine (MMR) which is routinely stored in the refrigerator, but can also be stored in the freezer (MMR in the lyophilized state is not affected detrimentally by freezing temperatures).

  2. What happens to vaccine contents when vaccines are not properly stored?
    Excessive heat or cold exposure damages vaccine, resulting in loss of potency and once potency is lost it can never be restored. Each time vaccine is exposed to excessive heat or cold, the loss of potency increases and eventually, if the cold chain is not correctly maintained, all potency will be lost, and the vaccine becomes useless.

  3. Do vaccines need to be protected from light?
    Yes. HPV, MMR, MMRV, rotavirus, varicella, and zoster vaccines are sensitive to light, causing loss of potency, so must be protected from light at all times. Store these vaccines at the appropriate temperatures in their boxes with the tops on until they are needed.

  4. How should vaccines be stored in the refrigerator/freezer?
    Vaccines should be placed in the center of the refrigerator/freezer compartment, on the middle shelves, away from the walls, floor and doors of the unit in open containers so air can circulate around the vaccines. If the upper shelf of the refrigerator must be used for vaccine storage, it would be best to place MMR on this shelf because MMR is not sensitive to freezing temperatures.

  5. How should vaccines be labeled in the refrigerator and freezer?
    Staff can easily confuse the vaccines within the storage unit. Labeling the bin where the vaccine is stored can help staff quickly locate and choose the correct product – perhaps preventing a vaccine administration error. Depending on how the vaccines are organized within the storage unit (e.g., top two shelves for pediatric only vaccines, middle shelves for pediatric/ adolescent/adult vaccines and the bottom two shelves for adult only vaccines), labels can be attached to the slotted containers, the bins, or directly to the shelves where the vaccine is stored. Other helpful strategies to prevent administration errors include color coding the labels (e.g., one color for pediatric and one for adult vaccines), separating age-specific vaccines by shelf; and including additional information such as age indications, gender or other information unique to the vaccine on the label.

  6. Can I remove the vaccine from its packaging to store more products in the refrigerator?
    No. Storing loose vaccine vials outside of their boxes is not recommended. This practice makes inventory management more difficult, makes tracking expiration dates more difficult, predisposes to administration errors when vials are confused, and potentially exposes the vaccines to light.

  7. Where is the appropriate place to store diluents?
    Store all diluents according to the manufactures package insert. Diluents packaged separately from their corresponding vaccines can be stored at room temperature or in the refrigerator. Diluents packaged with their vaccines should be stored in the refrigerator next to their vaccines but unlike vaccines, diluents may also be stored on the refrigerator door. ACAM2000 diluent is shipped refrigerated with vaccine but should be stored on shelf at room temperature.

  8. Can vaccines be stored in the same unit where employees' lunches are located?
    No, biologics should never be stored with food or drinks.

  9. Is it safe to store vaccines and other biologics in the same refrigerator with lab specimens or blood products?
    CDC's vaccine storage and handling toolkit states, if possible, other medications and other biologic products should not be stored inside the vaccine storage unit. If there is no other choice, these products must be stored below the vaccines on a different shelf. This prevents contamination of the vaccines should the other products spill, and reduces the likelihood of medication errors.