Storage & Handling
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Vaccine quality is the shared responsibility of all handlers of vaccines from the time a vaccine is manufactured until administration. Emphasis on the importance of good policies and procedures, frequent and on-going training of staff, proper equipment and maintenance will help all staff provide high quality vaccines and reduce waste caused by improper storage.

Even with proper education and training, vaccine losses and recalls continue to occur throughout the DoD due to improper storage and handling. According to the CDC, "improper storage is the most common vaccine delivery problem they encounter." Vaccines, like all temperature sensitive products need to be kept at the appropriate temperature range in order to protect our Service members and beneficiaries. Failure to adhere to recommended specifications for storage and handling of immunizations can reduce their potency, resulting in an inadequate immune response and protection of our patients. Good storage and handling procedures at all vaccine delivery locations ensures we always provide our patients the highest quality of care.

Author: Military Vaccine Agency
The success of military vaccine programs depends heavily on vaccinators understanding, following, and implementing proper vaccine storage and handling practices to ensure vaccine potency and stability. Military and civilian medical staff that administer immunizations in clinics, medical homes, and other facilities play a critical role in improving the health of Service members and beneficiaries. The purpose of this document is to assist immunization clinics and other healthcare facilities to properly store and handle vaccines.

Proper vaccine storage and handling practices play a very important role in protecting individuals and communities from vaccine-preventable diseases.

Vaccine quality is the shared responsibility of everyone, from the time vaccine is manufactured until it is administered.

This is a 4 module online course (note that the second module has been split in two parts), plus quiz, that will provide military healthcare personnel that administer immunizations with the proper vaccine storage and handling procedures that should be followed to ensure vaccine potency and stability.
The purpose of this module is to provide an overview of the proper distribution and cold chain management procedures for ACAM2000® smallpox vaccine. PLEASE NOTE: The content of this module is the same as the content of the Cold Chain Management module in the DoD Smallpox Vaccination Training curriculum.
SB 8-75-11; Section 3-57:  Temperature Sensitive Medical Products (TSMP) Storage and Handling (pg 3-49)
Author: Services
Joint Air Force, Army, Navy, and Coast Guard publication (AR 40–562, BUMEDINST 6230.15B, AFI 48–110_IP, CG COMDTINST M6230.4G)
Author: Lee
Defense Logistics Agency Regulation (DLAR) 4145.21
Department of Army Technical Bulletin (TB) MED 284/TBD*
NAVSUPINST 4610.31B
Air Force Joint Instruction (AFJI) 41-208/TBD*
07 Jan 13

Sample Q&A: Vaccine Handling

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.
Department of Health and Human Service; Office of Inspector General
MMQC-12-1086 10 Feb 12
VAXICOOL AX27L EQUIPMENT INVENTORY ACCOUNTABILITY REPORT
Military Vaccine Agency
New shipping package for VARIVAX from Merck Vaccines (replacing the use of dry ice with 6 refrigerant packs)
New shipping package for ZOSTAVAX from Merck Vaccines (replacing the use of dry ice with 6 refrigerant packs)
Recommendations of the Advisory Committeeon Immunization Practices (ACIP)
Storage and Handling of Immunobiologics (pg 17)
Cold Chain Management Processes and Procedures for all Medical Temperature Sensitive Products
SB 8-75-11; Section 3-57:  Temperature Sensitive Medical Products (TSMP) Storage and Handling (pg 3-49)
MMQC-12-1086 10 Feb 12
VAXICOOL AX27L EQUIPMENT INVENTORY ACCOUNTABILITY REPORT
MMQC-11-1681 28 Oct 11
PROPER TEMPERATURE STORAGE AND HANDLING REQUIREMENTS FOR REFRIGERATED VACCINE.
Military Vaccine Agency
Author: Military Vaccine Agency
The success of military vaccine programs depends heavily on vaccinators understanding, following, and implementing proper vaccine storage and handling practices to ensure vaccine potency and stability. Military and civilian medical staff that administer immunizations in clinics, medical homes, and other facilities play a critical role in improving the health of Service members and beneficiaries. The purpose of this document is to assist immunization clinics and other healthcare facilities to properly store and handle vaccines.
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.

Proper vaccine storage and handling practices play a very important role in protecting individuals and communities from vaccine-preventable diseases.

Vaccine quality is the shared responsibility of everyone, from the time vaccine is manufactured until it is administered.

Author: Military Vaccine Agency
The success of military vaccine programs depends heavily on vaccinators understanding, following, and implementing proper vaccine storage and handling practices to ensure vaccine potency and stability. Military and civilian medical staff that administer immunizations in clinics, medical homes, and other facilities play a critical role in improving the health of Service members and beneficiaries. The purpose of this document is to assist immunization clinics and other healthcare facilities to properly store and handle vaccines.
CDC Pink Book, Epidemiology and Prevention of Vaccine-Preventable Diseases (April 2011), 12th Edition
2012 Epidemiology and Prevention of Vaccine Preventable Disease Series CDC
Video: VaxiCoolVaxiCool (01:38) 21 Jul 11
AcuTemp Model #AX271
Video: VaxiPacVaxiPac (01:14) 21 Jul 11
AcuTemp Model #PX11
Watch this video to learn about: setting up your vaccine storage process, ways to avoid ruining expensive vaccine, resources for improving your vaccine handling, examples of temperature tracking devices

Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
Author(s): Gazmararian JA, Oster NV, Green D, Schuessler L, Howell K,Davis J, Krovisky M, Warburton SW
Publication: AJPM
Subject: Vaccine-Effectiveness
Category: 
Storage & Handling
Author(s): Yuan L, Daniels S, Naus M, Brcic B
Publication: Canadian Family Physician
Subject: Vaccine-Effectiveness
Category: 
Storage & Handling
Author(s): Halpern JS
Publication: Disaster Management & Response
Subject: Vaccine-Effectiveness
Category: 
Storage & Handling
Author(s): Chojnacky M, Miller W, Ripple D, Strouse G
Publication: National Institute of Standards and Technology
Subject: Vaccine-Effectiveness
Category: 
Storage & Handling