Vaccine Storage Troubleshooting
To maintain the proper temperature ranges, the freezer and refrigerator units must be in good working condition and they must have power at all times. There are several things that can be done to prevent problems.
Plug storage units directly into wall outlets. Do not use power outlets with built-in circuit switches (they have little red reset buttons), outlets that can be activated by a wall switch, or multi-outlet power strips. These can be tripped or switched off, resulting in loss of electricity to the storage unit. Plug only one storage unit into an outlet. This will help to prevent a safety switch from being triggered to turn off power and reduce the risk of overloading the outlet which could be a fire hazard.
Use plug guards or safety-lock plugs to prevent someone from inadvertently unplugging the unit. A temperature alarm system that will alert staff to after-hour temperature excursions, particularly if large vaccine inventories are maintained, may be helpful in assuring a timely response to storage problems. Label circuit breakers to alert custodians and electricians not to unplug vaccine storage units or turn off the power. This can be done by posting a warning sign near the electrical outlet, on storage units, and at the circuit breaker box. Warning signs should include emergency contact information.
Place containers of water, labeled “Do NOT Drink,” in the refrigerator to help stabilize the temperature in the unit. Place water bottles where vaccines are not stored, such as the door, top shelf, and on the floor of the storage unit. The same principle applies to the freezer. Store frozen water bottles in the freezer and the freezer door. Be careful that the water bottles do not weigh down doors so much that the seals are compromised and the doors do not close properly. These measures will help keep the temperature stable with frequent opening and closing of the storage unit.
In addition to temperature monitoring, a physical inspection of storage units should be performed daily. An inspection should include the following:
Are the vaccines placed properly in the unit?
Are the vaccines in their original packaging?
Are vaccines being stored away from the walls, coils, cooling vents, ceiling, and floor and not in the doors?
During a workday it is easy for vaccines to be shifted into an area of the storage unit where the temperature may not be appropriate or stable, such as against a wall, under a cold air vent, or in the door. CDC recommends that vaccines be kept in storage units dedicated only to vaccines. If other biologic specimens, such as blood or urine, must be stored in the same unit as vaccines, specimens should be stored on a lower shelf. This is to ensure that if a specimen leaks, the vaccines will not be contaminated. Food and beverages should not be stored in a vaccine storage unit because frequent opening of the unit can lead to temperature instability.
While it is important to take measures to prevent problems, equally important is taking immediate corrective action when a problem does exist, for example, when the storage unit temperature falls outside the recommended range. Staff should know who to contact in case of a malfunction or disaster.
If you experience a power outage, immediately begin to implement your emergency plan. Depending on room temperature, storage temperatures may be maintained for only a very short period of time. If there is an extended period of time before the situation can be corrected and there are no other storage units available on site, move the vaccines to the back-up storage facility using the guidelines in the emergency plan.
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