Vaccine Storage and Handling

VACCINE STORAGE AND HANDLING

	Vaccine Storage
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Store in refrigerator Between 2°C and 8°C (36°F and 46°F)		Store in freezer Between −50°C and −15°C (−58°F and +5°F)

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MMR^^† HepA; HepB; HepA-HepB Hib^ 9vHPV^* Influenza (LAIV^, IIV^, RIV^) IPV^ Meningococcal (MenACWY-D, MenACWY-CRM^, MenB-4C, MenB-FHbp^) Pneumococcal (PCV13, PPSV23) Rotavirus^* (RV1, RV5) Diphtheria toxoid, Tetanus toxoid, and Pertussis (DT, DTaP, DTaP-HepB-IPV, DTaP-IPV, DTaP-IPV/Hib, Tdap, Td) RZV*			VAR^* ZVL^* MMRV^* MMR^*^†

DOs	DON’Ts
STORAGE
Do use purpose-built or “pharmaceutical grade” refrigerators or freezers; if not available, can use stand-alone household units.	Don’t use dormitory-style or bar-style combined refrigerator/freezer unit.
Do use a continuous monitoring and recording digital data logger (DDL) with a current and valid Certificate of Calibration Testing for temperature readings.	Don’t use alcohol or mercury thermometers, chart recorders, bi-metal stem temperature, food temperature, and infrared temperature monitoring devices, and other devices without a current and valid Certificate of Calibration Testing.
Do check and record storage unit temperature readings twice daily (in AM and PM).	Don’t leave vaccines in a storage unit that fails to maintain temperatures within the recommended range. Never allow vaccines to remain in a non-functioning unit for an extended period of time.
Do store vaccines in their original packaging until ready for use. Rationale: Reduces exposure to light and provides thermal protection/stability.	Don’t store loose vials or manufacturer-filled syringes outside of their packaging. Rationale: Increases risk of administration errors and vaccine exposure to light.
Do place water bottles on the top shelf, floor, and in the door racks of the storage unit. Label these water bottles “DO NOT DRINK.” Rationale: Water bottles help stabilize temperatures due to frequent opening and closing of the storage unit or a power failure.	Don’t place food or beverages in the same storage unit as the vaccines.
Do store each type of vaccine or diluent in a separate container with the appropriate labels.	Don’t store other medications and biologics in the same container or shelf with vaccines.
Do store vaccines and diluents in the center of the unit (approx. 2–3 inches away from walls, ceilings, floor, and door).	Don’t store vaccines and diluents in areas of the unit that may not provide stable temperatures or adequate air flow (eg, directly under the cooling vents, in drawers, or shelves on the door).
Do place vaccines and diluents with the earliest expiration dates in the front and those with later expiration dates in the back. Check expiration dates at least once a week and immediately remove expired ones.	Don’t store vaccines and diluents with similar packaging or names or with both pediatric and adult formulations together on the same shelf.
Do arrange vaccines and diluents in rows and allow space between each row to promote air flow.	Don’t pack a storage unit too tightly.
Do store diluent with the corresponding refrigerated vaccine, though some diluents can be stored at room temperature (no warmer than 25° C [77° F]).	Don’t store any diluents in the freezer. Diluents should only be stored in either refrigerator or at room temperature.
TRANSPORT
Do deliver vaccines that will be used at an off-site facility directly to that facility. If not possible, use a portable vaccine refrigerator with a temperature monitoring device to transport the vaccines.	Don’t transport vaccines unless absolutely necessary (eg, for mass immunization clinic, during an emergency). Important: Frozen varicella-containing vaccines should NEVER be transported unless in an emergency situation.
Do transport only what is needed for the workday. Important: Total transport time should NOT exceed 8hrs.	Don’t use the trunk of a non-commercial vehicle for the transport of vaccines. Use the passenger compartment instead.
Do transfer the transported vaccines to an appropriate storage unit IMMEDIATELY upon arrival. Check and record the temperature of the storage unit at least 2 times during the workday.	Don’t discard of any vaccines or diluents that you suspect may have been exposed to inappropriate temperatures or conditions. Contact the vaccine manufacturer(s) for guidance. In the meantime, store them in appropriate refrigerated conditions (apart from other vaccines) and label “DO NOT USE”.
PREPARATION
Do prepare vaccines in a designated area away from potentially contaminated items.	Don’t prepare vaccines unless you are ready to administer them to patients.
Do check expiration dates and dosages to ensure medication safety.	Don’t administer vaccines unless you have prepared them yourself.
Do use only the diluent supplied with the vaccine for reconstitution.	Don’t use a stock vial of sterile water or normal saline to reconstitute vaccines.
Do draw up vaccines only at the time of administration.	Don’t transfer predrawn reconstituted vaccines back into their vials for storage.
NOTES
^*Protect from light: Varivax, Zostavax, ProQuad, M-M-R II, Hiberix, Gardasil 9, Afluria, FLUAD, Fluarix, Flublok, Flucelvax, FluLaval, Fluvirin, FluMist, IPOL, Menveo, Bexsero, Rotarix, RotaTeq, Shingrix. ^†Unreconstituted, lyophilized MMR may be frozen or refrigerated.
REFERENCES
U.S. Department of Health and Human Services: Centers for Disease Control and Prevention. Vaccine Storage & Handling Toolkit. January 2018. http://www.cdc.gov/vaccines/hcp/admin/storage/toolkit/storage-handling-toolkit.pdf. Accessed May 15, 2018. (Rev. 8/2018)

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