STORAGE & HANDLING

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.

Military Vaccine Agency
Published by the MILVAX Agency
MILVAX Agency algorithm and example worksheet
The purpose of this module is to provide an overview of the proper distribution and cold chain management procedures for ACAM2000® smallpox vaccine.
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*
Author: Services
Joint Air Force, Army, Navy, and Coast Guard publication (AR 40–562, BUMEDINST 6230.15A, AFJI 48–110, CG COMDTINST M6230.4F)
18 Nov 10

Sample Q&A: Vaccine Storage

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. Signs warning staff to not unplug the storage unit can be found at the following site http://www.immunize.org/handouts/vaccine-storage-handling.asp. 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.
Cold Chain Management Processes and Procedures for all Medical Temperature Sensitive Products
MILVAX Agency algorithm and example worksheet
Published by the MILVAX Agency
MMQC-12-1086 10 Feb 12
VAXICOOL AX27L EQUIPMENT INVENTORY ACCOUNTABILITY REPORT
MMQC-12-1086 10 Feb 12
VAXICOOL AX27L EQUIPMENT INVENTORY ACCOUNTABILITY REPORT
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.
Centers for Disease Control and Prevention
Military Vaccine Agency
Includes 3 diagrams: Freezer, Refrigerator, and Combination Unit Refrigerator Setup Diagrams. Adapted by MILVAX from examples developed by the California Department of Public Health, Immunization Branch.
CDC Pink Book, Epidemiology and Prevention of Vaccine-Preventable Diseases (April 2011), 12th Edition
CDC Pink Book, Epidemiology and Prevention of Vaccine-Preventable Diseases (April 2011), 12th Edition

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