Vaccine Storage & Power Outage Guidelines & Tips

• Read the Vaccine Storage and Handling Guidelines
• Have a contingency plan for equipment malfunction; power outage or other emergencies
• Have assigned staff responsible for vaccine management

Vaccine Refrigeration Factsheet

• Store vaccines in:
  • purpose-built vaccine fridge (is preferred)
  • domestic stand-alone fridge (with modifications)
• Fridge is placed away from direct sunlight and away from external walls
• Have a “Do not unplug” sticker by the electrical outlet so it is not accidentally unplugged or turned off
• Fridge has adequate door seals and a lock

• Use the Vaccine cold chain maintenance and inspection report  when conducting cold chain maintenance inspections in premises that store publicly funded vaccines
• Use short expiring-date vaccines first
• Take vaccines out of the fridge only when ready to use
• Keep vaccines organized by product and in their original boxes
• Store only what your fridge has capacity for, no more than a month’s supply at a time

Temperature Monitoring Device

• Use of a data logger is preferred. it provides a historical and continuous account of refrigerator temperatures.
• Device must record temperatures with at least one or more decimal point(s) (0.1°C)
• Place temperature sensor on the middle shelf, in an empty vaccine box
• Change the batteries on your max/min device at least every six months
• Test your device for accuracy annually

• Ministry documentation requirements for ALL temperature monitoring devices require twice daily checks which include the following information in a Temperature Log Book:
  1. Current temp
  2. Max temp
  3. Min temp
  4. Date
  5. Time
  6. Initials
• Max/min temperature devices are to be reset twice daily
• Data logger/ continuous temperature monitoring devices are to be downloaded weekly
• Ensure temperatures are maintained between +2.0°C to +8.0°C

Contact Toronto Public Health whenever vaccine fridge temperature is out-of-range (<2.0°C or > 8.0°C).

• Review the Cold Chain Inspection Checklist for more detailed instructions

Report a cold chain incident

• Please fax the completed Cold Chain Incident Vaccine Inventory Form to 416-338-2028 or email it to coldchain@toronto.ca
• Bag the exposed vaccines and keep in the fridge, separate from new product(s)
• Do not discard or use the vaccine until you have consulted with Toronto Public Health

• Power Outage and Vaccine Storage Checklist
• Cold Chain Incident Vaccine Inventory Form

To report a vaccine storage failure or for more cold chain incident information, call us at 416-338-2030.

Be Prepared for an Emergency

1. Have a plan. Develop a protocol for alternate vaccine storage in the event of power outage
2. Designate a staff to log max/min temperature twice daily and if necessary, pack vaccine for transport to a monitored fridge at an alternate location.
3. Have packing materials on hand (e.g. cooler, cool gel packs, thermometer)

During Power Outages:

1. Do NOT keep vaccines in a non-functioning unit for an extended period of time.
2. If the power outage is short-term:
   • Do not open vaccine fridge door until the power is restored. Most refrigerated vaccines are relatively stable at room temperature for limited periods of time
   • Monitor and document maximum-minimum and current temperature of your vaccine fridge at least twice daily if possible.  Do not open fridge door to check temperatures
   • Document the length of time the power has been off and the minimum and maximum temperature observed within the fridge
3. For anticipating prolonged power outage, consider vaccine transport procedures to an alternate facility. Follow proper cold chain procedures for storage and handling. Include list of vaccine inventory by name, lot number and amount of doses

When power has been restored:

• Record the temperature of the fridge after power has been restored, when possible
• Continue to monitor fridge temperatures until they are within 2.0°C to 8.0°C range then twice daily
• All facilities who experienced prolonged power outage must report to Toronto Public Health to have their vaccines assessed
• Do not discard or administer the vaccine until you have consulted with Toronto Public Health. We will be working with the vaccine manufacturers to determine which vaccines may be viable.  Bag exposed vaccines and keep separate from new products. Continue to monitor and log temperature range twice daily

Adapted from USA Centers for Disease Control and Prevention