Recording Vaccine Fridge Temperatures – Brief Summary
- All staff should be made aware of the cold chain policy and their responsibilities
- Vaccines should be stored at the manufacturer’s recommended temperature range (+2°C to +8°C)
- The temperature recording should be visible externally without having to open the fridge door
- Only fridges suitable for the specific storage of vaccines should be used. These should be cleaned, serviced and calibrated as per the manufactures guidance
- There should be adequate ventilation space around the refrigerator to allow free circulation of air to cool the compressor motor
- Where possible refrigerators should not be placed against an external wall or near a window as this may be subject to hot and cold temperatures with changes in weather
- To prevent an accidental interruption of the electricity supply fridges should either be directly plumbed into the system or a note placed on the plug socket to ensure it is not removed or switched off
- Only vaccines should be stored in the fridge
- Opening of the fridge door should be kept to a minimum to prevent variations in the internal temperature
- Vaccines should not be exposed to ultraviolet light and not frozen as this can affect vaccine potency
- The vaccines boxes should not touch the sides and back of the fridge walls as this can affect the vaccines
- Where possible vaccines should be stored in their original packaging and placed in the fridge on delivery
- Stock should be rotated on a regular basis checking for expiry dates and any damage to the packaging and this should be documented including:
- Vaccine type and brand
- Quantity
- Batch number and expiry date
- Date and time of receipt
- Signature of person receiving goods
- All vaccines are Prescription Only Medicines (POMs) and must be stored under locked conditions. Either the refrigerator is lockable or the room is locked when not occupied by a member of staff
- Vaccines must never be left unattended once removed from the fridge
- The fridge should be no more than 50% full
- Vaccines should be stored on the shelves but not in the compartments on the door or on the floor of the main unit
- Maximum and minimum fridge temperatures should be recorded at least daily and preferably twice a day, this can be dependent on how often the fridge is accessed.
- The following date should be documented referring to the 4Rs:
- Read
- Record
- Reset
- React
- Any potential breaches in the cold chain should be escalated immediately Vaccine Incidence guidance (publishing.service.gov.uk)
- SPS have produced a useful tool for advice on whether refrigerated medicines can or cannot be used after exposure to out-of-range temperatures which can be found at Refrigerated medicines stability tool – SPS – Specialist Pharmacy Service – The first stop for professional medicines advice
Please access the following links for more detailed information
- CQC GP Myth Buster 17: Vaccine storage and fridges in GP practices | Care Quality Commission (cqc.org.uk) Items stored in a refrigerator should be kept within the range of 2°C to 8°C.
- Green_Book_Chapter_3_v3_0W.pdf (publishing.service.gov.uk) pgs. 28-29 vaccine storage and temperature recordings
You are advised to contact the quality team at your ICS for more support and guidance.
Transporting Vaccines
CQC say “All providers should have a policy which includes how to handle vaccines to maintain the cold chain from the point of delivery to administration. It should include transport of vaccines outside the practice, actions to take in the event of a breach in the cold chain and details of how the practice will ensure learning from cold chain incidents”
The NHS Specialist Pharmacy Service (SPS) has useful guidance on temperature control whilst transporting medicines.
Returned Vaccines That Have Been Transported
Vaccination sessions away from the base clinic should be planned in such a way that the correct amount of vaccine is transported, thereby minimising any need to return vaccine. In general, unused vaccines may be returned to the base clinic vaccine refrigerator, providing there is evidence from the data logger that the cold chain has been maintained. Returned vaccines should be marked, segregated and used at the earliest opportunity. This general information is not applicable to all situations and vaccine specific information should be followed where this is available, for example vaccines that are particularly temperature sensitive or require complex handling.
If the cold chain cannot be guaranteed, then advice must be sought from the manufacturer or local Medicines Information Department/ICS Pharmacy team and if necessary, the vaccines should be destroyed.
Data Loggers
Many practices have been using data loggers for several years as it provides an accurate ongoing temperature recording which can provide additional information should there be a breach in the cold chain. They can also be useful if you are the person overseeing temperature recordings and based in an alternative location. There are a range of data loggers available and the prices can vary, you are advised to refer to the manufactures’ guidance on frequency of calibration.
It is recommended that practices continue to record fridge temperatures manually at least daily even if using a data logger.
Ambient Room Temperature for Storage of Medicines
Safe Ranges for ambient medication, will be dependent on the medicines and can range between 15°C to 25°C for most medicines, although some medicines can be stored at up to 30°C. Some ICBs recommend that if the ambient temperature remains at 25 degrees for a number of consecutive days this should be investigated and recorded as a significant event. You are recommended to speak to the medicines management team at your ICS for clarification and guidance.