How safe are your vaccine procedures?
Vaccines have played a large role in enabling people and animals to live longer and healthier lives. In our lifetimes, human diseases such as polio have been nearly eradicated. It is hoped that with the same dedication and vigilance, the veterinary community can help eliminate animal diseases such as parvovirus and panleukopenia. Vaccination protocols are the foundation of veterinary wellness. Proper transport, storage, handling, and administration of vaccines are essential, and each person on the veterinary healthcare team plays a role in these important measures (see "Your role in vaccinations").
Why are these measures so critical? Veterinary medicine uses multiple types of vaccines, each with its own sensitivities. Modified-live virus vaccines are particularly heat-sensitive, while killed vaccines are usually much more tolerant of variations in storage and handling, but proper care is still a necessity. Adjuvants, added to many vaccines to improve the immune response, make vaccines more susceptible to freezing. Much of the veterinary vaccine knowledge is borrowed from human research, and the stability of a human vaccine varies greatly based on the pathogen, strain, formulation, manufacturer, and conditions. Cold chain is a term used in human medicine to stress the importance of stable transportation, storage, and handling, and administration of vaccines. Here are some proper cold-chain management practices to follow when working with veterinary vaccines.
TransportationWhen a vaccine shipment arrives at the clinic, open and inspect it immediately for any obvious abnormalities, such as discoloration or particulate formation. An insulated cooler with cold packs is ideal for vaccine transport, whether from the manufacturer to your practice or in a mobile veterinary setting. The vaccine should be insulated to prevent direct contact between the vials or trays and the cold packs. Mobile practices should also include a thermometer to monitor temperature during transportation. To further reduce temperature fluctuations, place the cooler in the vehicle and not outside the passenger compartment (e.g., trunk or truck bed). After unpacking the shipment or upon return to the central clinic for a mobile unit, place all vaccines in the refrigerator for appropriate storage.
Be sure to read the manufacturer recommendations for each vaccine since there may be specific storage requirements, exposure guidelines, or handling information. General recommendations for vaccine storage include protecting the vaccine from ultraviolet light and maintaining it at a stable temperature between 35 F (2 C) and 46 F (8 C). Be sure to rotate stock to avoid the presence of expired vaccine. If there is ever a concern as to the quality of a vaccine for any reason, contact the manufacturer before deciding to discard the product.
Refrigerator temperature is most stable in the center of the refrigerator, so it's the ideal place for vaccine storage. Typically, warmer temperatures are found toward the front door and colder temperatures in the back; avoid these areas for vaccine storage. Keep a quality thermometer in the refrigerator, and log the temperature twice a day. Because of poor temperature control, dorm-size refrigerators are not recommended. Frequent opening and closing of the vaccine refrigerator contributes to unnecessary temperature fluctuations. This is an additional reason to enforce the Occupational Safety and Health Administration (OSHA) policy restricting the presence of food and drink in these refrigerators. Storing water jugs in the refrigerator will help maintain a stable temperature on a daily basis and be beneficial during a power outage. Unstable storage temperatures have been shown to reduce vaccine efficacy and cause an increased rate of vaccine failures and adverse reactions.