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Vaccine Emergency Procedures

It is important to be prepared and act immediately in case a storage unit’s temperature goes out of range. Vaccines that are subject to out-of-range temperatures may lose potency and no longer be effective.

Download and print the vaccine management plan so you have access to crucial information at all times.

Preparing for a temperature emergency

Backup unit requirements

Every provider is required to identify two (2) backup locations where they can move their vaccine in the event of power outages and equipment malfunctions. Both of these locations must be off-site from your location.

These locations must be large enough for your location’s typical supply of vaccine and meet the temperature monitoring requirements of the Immunization program.

The address and contact information for the back-up locations should be recorded in your vaccine management plan.

If you cannot identify two locations, please reach out to tempcheck@phila.gov.

Approved locations

  • Hospital pharmacies
  • Pharmacies
  • Approved unit at another clinic

Unapproved locations

  • Personal home freezers
  • Personal deep freezers
  • Freezer compartment of a combination unit
  • Storage containers with dry ice

Emergency contact

Identify a non-office hours contact who can access to the vaccine during non-clinic hours.

Record this person’s information in the vaccine management plan.

Gather supplies

Ideally, vaccine should be transported in a portable vaccine refrigerator or a qualified pack out.

Alternatively, gather the supplies below ahead of time so you can respond quickly and keep your vaccine within acceptable temperature ranges during transport.

Hard-sided cooler(s):

  • Large enough for your location’s typical supply of vaccine.
  • At least 2 if you have both refrigerated and frozen vaccines.

Cushioning material:

  • Bubble wrap, packing foam, or Styrofoam™.
  • Enough to layer at least 1” thick above and below vaccine.

Frozen water bottles:

  • Enough for 2 layers in each of the coolers.
  • Extra preparation may be required. See packing guidance below for instructions.

Corrugated cardboard:

  • Two pieces per cooler cut to fit interior dimensions of the cooler(s).

Emergency transport

Before transport

  • Contact your back-up storage location to verify they can accept the vaccines
  • Notify tempcheck@phila.gov (215-685-6777)

Refrigerated vaccine packing guidance

Packing guidance for refrigerated vaccine, ordered from bottom to top. 1. Hard-sided cooler: Large enough for your typical supply of refrigerated vaccine. Can use original shipping boxes from manufacturers if available. 2. Conditioned frozen water bottles: Line bottom of cooler with a single layer of conditioned frozen water bottles. To condition: Submerge in lukewarm water until the ice spins freely inside the bottle, then dry the outside of the bottle. Never use the frozen packaging material that comes with vaccine deliveries. 3. Corrugated cardboard: Cut to fit the interior dimensions of your hard-sided cooler. 4. Cushioning material: At least 1” thick layer of bubble wrap, packing foam, or Styrofoam(TM). 5. Vaccine and temperature probe: Stack boxes of vaccine and dilutents. When cooler is halfway full, place the buffered probe in the center of vaccine. Cover the probe with remaining vaccine. 6. Cushioning material: Cover vaccine with another 1” thick layer of bubble wrap, packing foam, or Styrofoam(TM). 7. Corrugated cardboard: Another layer cut to the dimensions of your cooler to support the water bottles. 8. Conditioned frozen water bottles: Fill the remaining space in the cooler. 9. Lid and DDL: Close the lid. Attach the DDL display and your paper temperature log to the top of the lid.

Frozen vaccine packing guidance

Packing guidance for frozen vaccine, ordered from bottom to top. 1. Hard-sided cooler: Large enough for your typical supply of frozen vaccine. Can use original shipping boxes from manufacturers if available. 2. Frozen water bottles: Line bottom of cooler with a single layer of frozen water bottles. Never use dry ice. 3. Vaccine: Stack vaccine directly on top of frozen water bottles. 4. Temperature probe: Place the buffered temperature probe with the top layer of vaccines. 5. Frozen water bottles: Place another layer to completely cover the vaccines. 6. Bubble wrap: Layer at least two (2) inches thick and cover all the remaining empty space . 7. Lid and DDL: Close the lid. Attach the DDL display and your paper temperature log to the top of the lid.

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For refrigerated vaccine transport:

Frozen water bottles must be conditioned before use to transport refrigerated vaccine.

To condition: Submerge in lukewarm water or hold under running water until the ice spins freely inside the bottle, then dry the outside of the bottle.


For frozen vaccine transport:

Do not condition frozen water bottles to transport frozen vaccine.

Transport the diluent the same way that you store it normally:

  • MMR, Varicella, and MMRV diluent can be stored at room temperature or in the refrigerator.
  • Diluents stored in the refrigerator should be transported with refrigerated vaccines.
  • Diluents stored at room temperature should be transported at room temperature.
  • Diluents packaged with their vaccine should be transported with the vaccine.

After transport

Upon arrival at the back-up location, document the following:

  • Total vaccine transport time
  • Transport cooler temperature(s)
  • Back-up storage unit(s) temperatures

Monitor temperature of the storage unit twice a day on your paper temperature logs.

Contact tempcheck@phila.gov (215-685-6777) to plan to transport the vaccine back to your site once the original issue is resolved.


During an emergency event

General guidance

Notify us at tempcheck@phila.gov (215-685-6777) if there is an out-of-range temperature or you need to transport the vaccines.

Keep your DDL with the vaccine at all times, including transport.

Keep a record of all actions you take during the event and how long they take.

Notify key staff such as the Vaccine Coordinator or backup, and the Medical Director or Chief Medical Officer.

Do not manipulate the digital data logger (DDL) sensor probe.

Cooling or warming the probe does not accurately reflect the temperature of the vaccines. Manipulating the probe can lead to the administration of non-viable vaccine to patients.

Specific emergency responses

Different types of emergencies warrant different responses. Find the section below that aligns with your situation and follow the listed procedures.

These all assume your vaccine have not yet experienced out-of-range temperatures.
Guidance on temperature excursions can be found lower on this page.

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If the DDL alarms, contact tempcheck@phila.gov (215-685-6777).

While you await further instruction:

  • Check if the source of the temperature excursion can be easily resolved (e.g. a door left open, or a unit unplugged).
  • Place a “DO NOT OPEN” sign on storage unit(s) to conserve cold air.
  • Move vaccine and DDL to backup unit if temperature excursion does not resolve within one hour of noticing the out-of-range temperatures.
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If the power is expected to be restored within 2 hours:

Record the following:

  • Time the outage started
  • The unit temperatures using your DDL (CURRENT, MIN/MAX)
  • Room temperature

Place a “DO NOT OPEN” sign on storage unit(s) to conserve cold air.

  • Monitor the interior temperature until power is restored.
  • Do not adjust the thermostat or open the unit to verify the temperature.
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Prepare to move vaccines to one of your back-up storage locations if:

  • You have a power outage that is not over in 2 hours.
  • The office will close before the power is restored.
  • The temperature of your vaccine storage units is rising and may reach out-of-range temperatures.

Before transport:

After an emergency

Continue to use vaccines that have stayed in the proper temperature range.

If any of your vaccine has experienced an out-of-range temperature, follow the guidance listed below on this page about what to do after an excursion.


Temperature excursions

A temperature excursion is any time your vaccine is exposed to an out-of-range temperature. This puts your vaccine at risk of losing potency and becoming ineffective.

Your DDL will alert you when your unit is experiencing a temperature excursion.

Whether you hear the alarm or notice an out-of-range temperature yourself, it is crucial to act immediately and follow the guidance below.

In the event of an excursion

Contact
tempcheck@phila.gov (215-685-6777)

For vaccine that has experienced an out-of-range temperature:

  • Store under proper conditions as soon as possible
  • Label “DO NOT USE”
  • Separate from vaccine that stayed within the proper temperature range

Notify your Vaccine Coordinator or backup coordinator

Record the out-of-range temperatures and the room temperature in the bottom section of your paper temperature logs

Do not discard vaccine unless directed by the Philadelphia Immunization Program

Excursion response form

For some storage unit excursions, the Immunization Program will require that you contact the vaccine manufacturers and complete an Excursion Response Form.

This information must come directly from the manufacturers. Sites are required to provide a case number for each manufacturer.

Immunization Program staff will audit these forms. A new form is required every time you report an excursion event.

Do not assume viability of vaccines. Always contact the manufacturer.

VFC/VFAAR vaccine reimbursement policy

Providers are accountable for any vaccine supplied by the VFC/VFAAR programs and can be held responsible for reimbursement of spoiled vaccine due to negligence.

This reimbursement will consist of dose-for-dose vaccine replacement at the private cost.

Contact DPHProviderHelp@phila.gov for more information.

Non-viable vaccine

Vaccine that has expired, spoiled, or been wasted must be reported through PhilaVax immediately. Orders for additional vaccine may be delayed if this is not completed.

For more guidance on completing a wastage or return, click here.