While there has been a high demand for flu and measles vaccines of late, these vaccines and others are only effective if they are stored correctly.
Flu season reminds us that vaccination storage is an important issue in general practice. Vaccines are delicate biological products: if we don’t protect them, they don’t protect our community.
Dr Vicky Sheppeard, Director of Communicable Diseases with NSW Health, provides some timely advice on storing vaccines safely and properly.
In the past few months, the Council has had a number of complaints about suboptimal vaccine storage and administration of out of date vaccines. This is a significant public health risk and resulted in conditions being placed on these doctors’ registrations including that they can no longer receive government-funded vaccines.
“While expired or poorly stored vaccines themselves are not dangerous, the risk is that they’re ineffective,” says Dr Sheppeard. “It is critical patients get the protection they expect.”
Dr Sheppeard highlights a case where due to the current high demands for vaccines, a practice over-ordered on extra stock. “To compensate, the practice nurse removed the vaccines from their packaging to fit all the vaccines in the fridge,” she says. The fridge had a glass front, which meant the vaccines were exposed to light and patients had to be revaccinated. “Even where a practice nurse may do the day to day work storing and checking vaccines, ultimately the GP is the person responsible,” warns Dr Sheppeard.
While all fridges used for storing vaccines require a data logger and detailed observations of temperatures of the fridge, emerging recommendations are that all practices should use purpose-built vaccine fridges.
These fridges provide a constant temperature throughout, as opposed to domestic fridges that have known hot spots or frozen areas. The cost of a vaccine fridge depends on the size of the medical practice. However, Dr Sheppeard recommends them because “they do provide surety, come with built-in data loggers and other IT solutions, and provide reassurances for doctors and patients that vaccines have been cared for properly and will be effective.”
Domestic fridges are no longer considered appropriate for vaccine storage. Therefore, providers that have a domestic or bar fridge should make arrangements to purchase a purpose-built vaccine refrigerator to continue to receive government-funded vaccines.
Top tips for best practice vaccine storage:
- Ensure all vaccines remain between 2 degrees and 8 degrees while aiming to maintain storage at a stable 5 degrees.
- Provide training to all staff involved in vaccine management and offer continual training to keep their knowledge current.
- Rotate stock so that vaccines with the shortest expiry date are used first.
- Protect all vaccines from light, including keeping the refrigerator out of direct sunlight.
- Do not remove vaccines from packaging until they are ready to be administered, particularly if you use a glass-fronted fridge.
- Contact the NSW Health Public Health Unit for advice on cold chain breaches.
- Maintain effective vaccine ordering practises: only order to have the right amount at the right time.
- Maintain all equipment involved in vaccine storage.
From 31 July 2019, additional requirements will be in place.
All GP practices will need to have at least one staff member who has successfully completed the NSW Health Vaccine Storage and Cold Chain Management online learning module.
NSW Health will also conduct random audits of practice compliance. This will include checking that all vaccine doses administered in the practice are notified to the Australian Immunisation Register, as well as verification of the vaccine storage and staff training requirements.
Visit “Strive for 5” National Vaccine Storage Guidelines (3rd edition) to ensure that your practice’s vaccine storage systems comply.
The latest edition of the RACGP’s Standards for General Practice (5th Edition, 2018) also provides excellent guidance on maintaining vaccine potency in general practice (see GP Standard 6).