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Vaccine Storage and Handling in a Power Outage

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Vaccine Storage and Handling in a Power Outage

A pharmacy experiences a power outage that lasts for 4 hours. The pharmacy has two vaccine refrigerators: one for routine vaccines (varicella, MMR, and inactivated influenza) and one for COVID-19 vaccines (mRNA). Both refrigerators are equipped with digital data loggers that record temperature every 15 minutes. During the outage, the temperature in the routine refrigerator rose from 5°C to 10°C, while the COVID-19 refrigerator rose from 5°C to 8°C. The pharmacy has a backup generator, but it failed to start automatically. The staff did not notice the outage until 30 minutes after it began. The pharmacy's emergency plan states that for temperature excursions above 8°C for more than 1 hour, vaccines should be moved to a backup storage unit if available, and the manufacturer should be contacted. No backup storage is available. The power has now been restored.

1. What should be done with the vaccines in each refrigerator?

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Routine refrigerator (varicella, MMR, inactivated influenza):

  • The temperature rose to 10°C for an extended period (likely >1 hour). This exceeds the recommended range (2-8°C).
  • Do not discard. Label 'Do Not Use' and keep refrigerated at 2-8°C.
  • Contact the manufacturer for each vaccine to determine stability. Provide the temperature data and duration.
  • Varicella and MMR are live vaccines and may be more sensitive to heat; inactivated influenza is generally more stable but still requires evaluation.
  • Follow manufacturer guidance: if stable, may be used; if not, discard.

COVID-19 refrigerator (mRNA):

  • The temperature rose to 8°C, which is at the upper limit of the recommended range (2-8°C). The excursion was brief (likely <1 hour).
  • mRNA vaccines are stable at 2-8°C for a limited time (e.g., 30 days for some brands). A short excursion to 8°C may not compromise viability.
  • Contact the manufacturer to confirm. Do not use until cleared.
  • If the manufacturer confirms stability, use the vaccine. Otherwise, discard.

2. What steps should be taken to prevent future occurrences?

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  1. Review and test the backup generator regularly (e.g., monthly) to ensure it starts automatically. Consider a maintenance contract.
  2. Install temperature alarms that alert staff if temperatures go out of range. Ensure alarms are audible and/or send alerts to mobile devices.
  3. Develop a power outage response plan that includes immediate actions: check refrigerators, move vaccines to a backup unit if available, and contact manufacturers.
  4. Train staff on the emergency plan and conduct drills.
  5. Consider a backup storage unit (e.g., a portable vaccine refrigerator or a neighboring pharmacy arrangement).
  6. Document the incident and review the emergency plan after the event.
  7. Check data loggers regularly to ensure they are functioning and recording correctly.