Vaccines: Ordering, Storage, and Handling
To order publicly-funded vaccines from Southwestern Public Health:
Fax the vaccine order form:
- Woodstock site: 519-539-6206
- St. Thomas site: 519-633-0468
** Only order enough vaccine for one month. Over-stocking can result in high vaccine wastage **
- Vaccine order form (Health care providers)
- Flu vaccine order form (Health care providers)
- Tubersol® order form (Health care providers)
- Vaccine order form (Long-term care facilities)
- Vaccine return form
Learn more about the MOHLTC requirements for Vaccine and Storage Handling.
Public health nurses also respond to all cold chain incidents reported to Southwestern Public Health within 24 hours.
Definition of Cold Chain Incident
A cold chain incident occurs when the vaccine is exposed to temperatures outside the +2°C and +8°C range. This can happen in your refrigerator or during transport from Southwestern Public Health to your facility.
Mandatory Requirements for Cold Chain
In order to be compliant with the mandatory requirements for vaccine storage and handling, facilities must:
- Maintain vaccine fridge temperatures between +2°C and +8°C
- Keep a minimum/maximum thermometer in the fridge to monitor temperatures
- Check fridge temperatures twice daily and record in a log book
- Keep Vaccine Storage and Handling Guidelines and other materials on-site and easily accessible so that staff can consult them.
Responding to Out of Range Temperatures
When you notice refrigerator temperatures are out of range:
- Place all exposed vaccines in a bag marked “DO NOT USE”
- If your fridge has returned to a temperature between +2°C and +8°C, keep the vaccine in your fridge. If your fridge is still out of range and if you have access to another stable, monitored and inspected fridge (i.e. another fridge inspected by Southwestern Public Health in your building), store the vaccine in that fridge until the other is stable. You may also keep the vaccine in a monitored hard-sided cooler for a short period of time until your fridge returns to appropriate temperatures.
- Call Southwestern Public Health immediately at 1-800-922-0096 to report the vaccine exposure.
Based on the temperature logs, the Public Health Nurse will determine the length of exposure and which vaccines are still okay to use.
- Vaccines that have been exposed and may still be used are marked with a red dot and stored in the vaccine refrigerator under cold chain.
- Wasted vaccines which cannot be used are placed in a bag marked with the name of the institution or office that is returning them and “DO NOT USE”. The bag should be sent back to Southwestern Public Health with the vaccine wastage form as soon as possible, as this lessens the change of someone using one by mistake.
- After a cold chain incident, you will be asked to fax copies of the refrigerator temperature logs to Public Health. You may have to submit your temperature logs for a few days to show that the fridge has stable temperatures before you can order vaccine again.
- A Public Health Nurse may choose to visit you after a cold chain incident if it’s serious (i.e. large amounts of wasted vaccines) or if a face-to-face conversation would be helpful. A data logger may be placed in your refrigerator to gather additional information. Data loggers provide continuous temperature recording (at pre-determined intervals) that can be downloaded onto a computer and printed. Data logger readings and reports can be very useful in determining refrigerator functioning.
Using Digital Min/Max Thermometers
A digital min/max thermometer is a thermometer that accurately records the highest and lowest temperatures reached inside the refrigerator since the thermometer was last reset.
- If the thermometer has an IN-OUT switch, make sure it is always in the OUT position
- The temperature probe should be placed in an empty vaccine box that is positioned in the middle of the refrigerator. This location provides the most accurate temperature readings.
- The thermometer’s batteries should be changed twice annually
- Temperatures on the min/max thermometer should be read twice daily and the thermometer reset or cleared after each reading.
There are many effective practices that can be adopted to achieve the best possible vaccine storage and handling:
- Order small amounts of vaccine more often to decrease vaccine wastage in case of a cold chain failure.
- Ensure the vaccine refrigerator is large enough to accommodate the required stock of vaccine.
- Store vaccines on the middle shelves. Never store vaccines in the door shelves, bottom drawer or close to the freezer section, as they could be exposed to significantly warmer or colder temperatures in these locations.
- Storing filled water bottles on the lower shelf and door of the refrigerator may help to maintain an even, stable temperature inside.
- With the exception of these water bottles, do not store anything else in the refrigerator except for vaccines (no food, drinks or lab specimens).
- Ensure that the electrical outlet and refrigerator plug is secured to prevent the refrigerator from accidently being unplugged or turned off.
- Always ensure that the refrigerator door is closed tightly – a Velcro lock will ensure that the door is not accidentally left ajar. Making sure the refrigerator is level will also help keep the door closed.
- Defrost the refrigerator when there is more than 1 cm (¼”) of ice in the freezer compartment.
- Train all members of your office in proper vaccine storage and handling. Staff should be familiar with Vaccine Storage and Handling Guidelines.
- Organize vaccines by type with shorter expiry dates at the front of the refrigerator so that they may be used first.
- Check vaccine expiry dates regularly and return expired vaccines with the vaccine wastage form to Southwestern Public Health