MEMO: Excursion Reporting and Cold Chain Reminders

TO: Providers Who Order & Store Publicly Funded Vaccine in Niagara

FROM: Vaccine Preventable Disease (VPD) program, Niagara Region Public Health

REFERENCE: Excursion Reporting and Cold Chain Reminders

DATE: May 18, 2022

In an effort to mitigate vaccine wastage and maintain vaccine stability, ensure designated staff:

Are trained in monitoring fridge temperatures
Can implement cold chain troubleshooting measures
Are familiar with vaccine storage and handling guidelines

Fridge Temperature Excursions and Other Emergencies

Promptly report all power failures, excursions or problems with the fridge/thermometers to the VPD program in order to determine next steps related to vaccine stability
- Quarantine the affected vaccine while keeping under cold chain
- Do not assume the vaccine is no longer stable and cannot be used
- Do not administer vaccines until further direction is given by Public Health
- If the thermometer displays LL.L, this is a malfunction and should be reported to Public Health
Carefully document any circumstances of an excursion (including temperatures and time) to ensure the VPD program has the information required to determine ongoing vaccine stability
Record current, minimum and maximum fridge temperatures (not alarm limits “LO” and “HI”) twice daily in the temperature log book
- Print clearly using a blue or black ink pen
- Include the time of the recordings and the initials of the person who recorded the temperatures
- Clear the minimum and maximum temperatures after each recording
- Print clinic name clearly at the top of each temperature log page
Procedures to manage a cold chain excursion may differ depending on whether inventory includes COVID-19 vaccine

Cold Chain Reminders

Continue to fax (905-688-4667) a current 4-week temperature log into the VPD program with every vaccine order and with all out-of-range temperatures
Keep the vaccine fridge temperatures between +2.0°C and +8.0°C
Routinely change thermometer batteries every 4 – 6 months and note this battery change on the temperature log for easy reference
- Changing the battery frequently reverts the thermometer to the “IN” position. Make sure your thermometer is in the “OUT” position for accurate readings.
- If your thermometer needs replacement, contact the VPD program
If a patient is picking up fee-for-service vaccine and transporting from a pharmacy, ensure cold chain was maintained prior to administration

Vaccine Storage

When storing publicly-funded vaccine
- Have a contingency plan in place for equipment malfunction, power outage or other emergencies and follow this plan in the event of a situation
- Notify the VPD program and wait for direction prior to administering any vaccine
- Maintain no more than a one-month supply of vaccine
- Use shorter-dated vaccine products of the same type first
- Keep vaccine products in their original packaging at all times; including when returning any expired/wasted vaccine to Public Health
When storing COVID-19 vaccine
- Immediately contact the VPD program in the event of a power failure or other emergency and do not transport the vaccine
- Quarantine the affected vaccine while keeping under cold chain
- COVID-19 mRNA vaccines are very fragile. Ensure careful handling of vials and syringes before and after dilution.
- It is not recommended that COVID-19 vaccine be moved once in the thawed state

Resources to Help You Store and Handle Vaccines Safely

Bookmark Public Health’s Immunization, Vaccine for Health Professionals webpage for easy access to:

For More Information

Contact the Vaccine Preventable Disease program at 905-688-8248 or 1-888-505-6074 ext. 7396 Monday to Friday 8:30 a.m. - 4:30 p.m. (excluding statutory holidays).