| Rachelle Deaker, After the power failure in early December, I was pleased to get word from practices in the area that they had taken precautions in caring for their vaccine. Congratulations on a job well done.
I know of practices that took their vaccines to their local hospital, which had fridges running on emergency power and also a practice nurse who packed the vaccines into an esky with ice packs and took them home to closely monitor the temperature. Other practices had venues on standby with known emergency power, but were not needed as the power was resumed before it was necessary to transfer the vaccines.
Practices that experienced power failure for several hours (most experienced four) with the vaccines exposed to temperatures above the recommended range for a brief period, can keep and use the vaccines within one month. After one month, the vaccines need to be disposed of (place in sharps container when new vaccines arrive). Practices that lost power overnight may need to discard vaccines if precautions were not taken. Please confirm with Marianne Trent at the Public Health Unit on 6620 7514 before disposing of vaccines.
We commend the effort of practices in reducing vaccine wastage. All practices should have a written policy on the necessary steps of vaccine care in the event of a power failure.
In power failures of four hours or less, the fridge door should be kept closed and the temperature monitored. If the failure last more than four hours store vaccines in an insulated container with freezer bricks to keep them cool. Place a thermometer probe in with the vaccines. Some glass door refrigerators may rise in temperature more quickly than solid doors, in this case, transfer vaccines prior to the four hours.
Packing a cooler/esky
- Place insulating material at the bottom and sides of the esky (bubble wrap/ newspaper)
- Place freeze sensitive vaccines in the centre of the container (ones containing hep B). Place freeze tolerant vaccines (MMR) closet to the ice/gel packs.
- Place a min/max thermometer (and freeze indicator if available) in the centre of the vaccine stock.
- Place further insulation material on top.
- Place conditioned ice packs/ gel pack on top, close and seal the lid.
- If you are using a larger cooler, place conditioned ice packs around the sides of the cooler as well as the top.
- Ensure vaccine stock is not in direct contact with the ice pack/gel pack.
- Monitor the temperature (NB. you may need to record the min/max temperature whilst probe is in fridge; then reset once in place and stabilised in cooler (to eliminate any room temperatures recorded whilst cooler is being set-up).
Other options
Most hospitals have emergency back up power supply and may have space in their pharmacy fridge for you to store your vaccines during a power failure. Please check your local area for a venue with back up power (hospitals, pharmacy, club). The entire esky with thermometer can be put in the fridge (room permitting). If this is an option for the practice, include it in your power failure policy.
Over ordering vaccines
Over ordering vaccines can add to difficulty in managing and stabilising temperatures in domestic fridges as overcrowding does not allow for adequate air circulation in a domestic fridge.
Overstocking can lead to excessive vaccine wastage in the event of cold chain failure, when there is a change in the immunisation schedule, and an increased risk of expired vaccine wastage.
When ordering each month follow the simple recommended formula in the new Strive For Five booklet.
Quantity used in the last month is obtained by:
Count the vaccines on encounter forms or by doing a search in the computer database (for MD, search immunisation typing in the last month)
+ 10% of this quantity (buffer or reserve stock)
– minus the amount remaining in fridge
EG. 30 infanrix-hexa used in previous month PLUS 3 (10% of 30) is 33 MINUS 5 left in fridge => order 28.
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