The Centers for Disease Control and Prevention (CDC) has gone to great lengths to provide recommendations for vaccine handling and storage across the cold chain. Exposing vaccines to out-of-range temperatures can result in permanent loss of potency, putting patients at risk for receiving ineffective vaccinations. Following CDC recommendations will help ensure the effectiveness of vaccinations, reduce cost associated with discarded vaccines, as well as reduce the direct and indirect costs of revaccination.
Because vaccines require storage at specified temperature ranges, refrigerators and freezers play an extremely important role when it comes to vaccine storage and handling. According to a Department of Health and Human Services report, “Vaccines for Children Program - Vulnerabilities in Vaccine Management” released in 2012, 76% of healthcare sites included in a study had vaccines that were exposed to inappropriate temperatures for at least a 5 hour period due to the use of inadequate refrigerators and freezers. These providers had over 9,000 Vaccines for Children doses, worth approximately $370,000 (1).
Are Your Vaccines at Risk?
The CDC provides guidelines on selecting appropriate cold storage solutions to store refrigerated and frozen vaccines. These guidelines were created to ensure that vaccines are stored in the correct type of unit, the correct location within the unit, and at the correct temperature. The CDC makes it very clear that the use of dormitory or bar style refrigerators is unacceptable for vaccine storage. These units typically have a freezer compartment inside of the refrigerator putting vaccines at risk of freezing. Moreover, the use of household combinations units is not preferred. These units do not consistently keep vaccines at the correct temperature because the unit is cooled by circulating air from the freezer compartment into the refrigerator compartment. This poses a significant risk of vaccines being exposed to freezing temperatures and losing potency.
Understanding Medical-grade Cold Storage
The CDC recommends the use of stand-alone refrigerator and freezer units or pharmaceutical/medical-grade units that meet vaccine storage guidelines (2). Pharmaceutical/medical-grade units are specially designed for the safe storage of vaccines. Forced air systems allow for more usable space, and decrease risk of placing vaccines in areas of the refrigerator that do not maintain required temperatures. Pharmaceutical/medical grade cold storage is also designed to quickly recover to set temperature after door openings. Forced air systems typically utilize specially designed drawers and shelves to enable proper air circulation, which also assists in temperature uniformity and recovery. In addition, pharmaceutical/medical grade refrigeration enables precise temperature control and set points, alarms, and may include built-in temperature monitoring that meets CDC recommendations related to calibration.
References:
(1) US Department of Health and Human Services, Office of the Inspector General. VFC Program Vulnerabilities in Vaccine Management. June, 2012. http://oig.hhs.gov/oei/reports/oei-04-10-00430.pdf
(2) US Department of Health and Human Services. Centers for Disease Control and Prevention. Vaccine Storage and Handling Toolkit. May, 2014. http://www.cdc.gov/vaccines/recs/storage/toolkit/storage-handling-toolkit.pdf
