Competency #7: Storage and Handling of Immunization Agents
This competency implements Canadian guidelines when storing, handling, or transporting vaccines.
Learning Objectives
The health professional will be able to perform the following:
- State where to access the most recent national guidelines dealing with vaccine storage, handling, and transportation.
- Describe the national guideline requirements for vaccine storage, handling, and transportation and their importance in maximizing the potency and efficacy of each vaccine.
- Outline the key steps for maintaining the cold chain in the practice setting.
- Explain actions taken to report and manage breaks in the cold chain or other insults that compromise vaccine integrity.
Introduction
What is the Cold Chain?
“Cold chain” refers to the process used to maintain optimal conditions during the transport, storage, and handling of vaccines, starting at the manufacturer and ending with the administration of the vaccine to the client. The optimum temperature for refrigerated vaccines is between +2°C and +8°C. For frozen vaccines the optimum temperature is -15°C or lower. In addition, protection from light is a necessary condition for some vaccines.
Cold Chain Diagram
Proper storage temperatures must be maintained at every link in the chain.
Maintaining the potency of vaccines is important for several reasons.
- There is a need to ensure that an effective product is being used. Vaccine failures caused by administration of compromised vaccine may result in the re-emergence or occurrence of vaccine preventable disease.
- Careful management of resources is important. Vaccines are expensive and can be in short supply. Loss of vaccines may result in the cancellation of immunization clinics resulting in lost opportunities to immunize.
- Revaccination of people who have received an ineffective vaccine is professionally uncomfortable and may cause a loss of public confidence in vaccines and/or the health care system.
An estimated 17% to 37% of healthcare providers expose vaccines to improper storage temperatures. Refrigerator temperatures are more commonly kept too cold rather than too warm.
Clinical Practice Guidelines
Storage and Handling of Vaccines – Clinical Practice Guideline
- Appendix A – Maximum-Minimum Thermometer Instructions
- Appendix B-1 – Temperature Log for Vaccines
- Appendix B-2 – Vaccine Temperature Monitoring Log for Offsite Clinics
- Appendix C – WRHA Population and Public Health Cold Chain Failure Response Plan
- Appendix D – WRHA after Hours Vaccine Refrigerator Failure Rescue Procedure (Updated January 9, 2022)
- Appendix D-1 Vaccine rescue locations
- Appendix D-2 After hours packing for vaccine transport
- Appendix D-3 After Hours Adverse Storage Conditions Documentation (FILLABLE, Nov 2024)
- Appendix D-4 Min-Max Thermometer instructions
Operational Guidelines
Resources
Manitoba Health Cold Chain Resources
Manitoba Health Cold Chain Protocol, Procedures for Completing the Manitoba Health Cold Chain Failure Response Form, and other cold chain resources:
- http://www.gov.mb.ca/health/publichealth/cdc/coldchain.html
- National vaccine storage and handling guidelines for immunization providers– Public Health Agency of Canada (2015).