This page outlines how to store, prepare and administer vaccines so that they stay safe and effective.
Vaccines are fragile, biological substances. They can become less effective or even destroyed if they are exposed to temperatures outside the recommended storage range – between +2°C and +8°C. This 'cold chain' begins when the vaccine is made and ends when the vaccine is administered.
The Royal Australian College of General Practitioners’ Standards for general practices (5th edition) recommends following two resources to ensure vaccines keep within the safe temperature range while they are being stored or transported.
These resources are:
- the current edition of the National Vaccine Storage Guidelines: Strive for 5
- the current online edition of the Australian Immunisation Handbook.
The National Vaccine Storage Guidelines: Strive for 5 promote best practice in vaccine storage. Immunisation providers should refer to the guidelines to ensure that equipment and procedures are in place.
Cold chain breaches
Do not use vaccines exposed to temperatures below +2°C or above +8°C without getting further advice. Do not discard these vaccines. For National Immunisation Program vaccines, isolate them and contact state or territory health authorities for advice. For privately purchased vaccines contact the manufacturer or supplier.
Recommendations for the discarding of vaccines may change between health authorities and manufacturers.
Do not discard any vaccines until you get advice.
Essential steps in proper cold chain management
To be confident that the potency of vaccines is maintained, practices must:
- have a reliable refrigerator capable of maintaining a stable temperature. Ensure the fridge is big enough for the practice’s storage needs and frequency of vaccine ordering
- develop processes to maintain the cold chain, which are clearly documented. This may include identification of potential situations of risk to vaccine potency and implementation of appropriate management strategies
- ensure that all practice staff handling vaccines receive ongoing training that is appropriate for the responsibilities of their role
- monitor and record the maximum and minimum temperature of refrigerators used to store vaccines at least once a day and before any vaccines are used
- know what action to take (including reporting and documentation) if the temperature of the refrigerator has been outside the recommended range of 2–8ºC.
Store vaccines in an appropriate refrigerator. If the practice is using a domestic refrigerator, you’ll need to make certain modifications to reduce the risk of adverse vaccine storage events. These modifications are set out in the National Vaccine Storage Guidelines: Strive for 5.
Note that cyclic defrost and bar refrigerators are not recommended because they produce wide changes in internal temperatures.
Data loggers are small electronic devices that continuously measure temperatures and keep a record of the results over a period of time. They can be used to verify cold chain efficacy and to enable a quality control check of the vaccine refrigerator temperatures. They require computer software to download the readings. Some vaccine refrigerators have data loggers inbuilt in them, if not an external data logger can be purchased.
Data loggers are useful in determining and recording:
- the accuracy of the refrigerator thermometer
- temperature fluctuations within the refrigerator and how long the refrigerator stayed at this temperature
- potential cooler or warmer areas within the refrigerator – areas which may not be suitable for vaccine storage.
Nominating a person with primary responsibility
Nominate a member of the practice team to take primary responsibility for cold chain management. This includes taking responsibility for achieving and maintaining compliance with cold chain management guidelines. The role and responsibilities need to be clearly articulated within a position description and appropriate training given as required. It is also important to have another designated and trained staff member as back-up when the responsible person is unavailable.
Routine self-auditing helps to ensure that potent vaccines are being given. An example of a self-audit is contained in the appendix of the National Vaccine Storage Guidelines: Strive for 5.
Always prepare vaccines in line with the manufacturer’s instructions found in product information provided with the vaccine or on the TGA website. Be vigilant about correctly preparing vaccines that need to be reconstituted before administration.
The Australian Immunisation Handbook has comprehensive information about the equipment needed to prepare vaccines.
Handling and administering vaccines
All immunisation providers should be familiar with handling and disposing of sharps according to the National Health and Medical Research Council’s Australian guidelines for the prevention and control of infection in healthcare.
Only people who are suitably trained and qualified can administer vaccines. See your state or territory website for accredited vaccination training courses, for vaccination for nurses.
The Australian Immunisation Handbook has comprehensive information about vaccine procedures, including pre-vaccination, administration and post-vaccination care. It includes details on:
- route of administration
- recommended injection sites