Recent headlines remind us of the importance of credible vaccine programmes. With the World Health Organization (WHO) reporting on measles outbreaks in many countries around the world. The recent shocking news from Samoa shows what can happen when public trust in vaccine programmes fail. The outbreak on the pacific island nation was in part triggered following the deaths of two children in 2018, who were administered a wrongly mixed MMR vaccine. This news caused a decline in vaccine uptake. Indeed, the WHO has reported that vaccine hesitancy is one of the ten biggest health threats in 2019.  

Closer to home we are seeing an early arrival of the ‘Flu season’ here in the UK and many are being urged to take the vaccine prior to visiting friends and family for Christmas. So, what needs to be considered when administering a successful immunisation programme? 

Vaccine management and temperature monitoring 

It is important that all staff involved in delivering immunisation programmes understand the correct ordering, storing and administering of vaccines. It is also important that they are aware of maintaining optimum cold chain conditions, so that vaccines remain potent and effective.  

Safe storage of medicines and vaccines is something we all expect. Vaccine and medicine storage have to meet pharmacy temperature monitoring guidelines issued by the MHRA. The GPhC also requires compliance with regulations, to protect standards and ensure best practice. Patient safety is at the core of these regulations. 

How should vaccines be stored? 

Vaccines may lose their effectiveness if they become too hot or too cold at any time. Guidance on storage, distribution and disposal of vaccines can be found in the Green Book. 

Vaccines should be stored in a validated vaccine fridge that is monitored to meet regulatory compliance. This fridge should be set to store vaccines between the recommended +2°C to +8°C temperature range and used solely for the storage of vaccines. It is best practice to aim for a temperature of +5°C, the mid-point in the recommended temperature range. 

It is important the medical fridge is large enough to hold vaccine stock, whilst allowing space around vaccines for air to circulate. This fridge should also be locked, or in a locked room. Having it wired into a switchless socket will avoid it being switched off. Fridges with glass doors and with labelling on the outside, help avoid the door being open for longer than necessary.  

How often should temperatures be monitored? 

With manual monitoring it’s not possible to determine how long the stock was exposed to the out-of-spec temperature. With automated remote monitoring the process is continuous. Alerts are raised automatically if the storage environment falls out of the designated temperature remit. As a result, you can act quickly to ensure the efficacy of vaccine stock. 

Annual calibration of temperature probes to UKAS standards is also recommended.  

Managing your temperature sensitive storage is easier through automated remote monitoring. Data is automatically recorded and reports can be generated simply, meaning you are inspection-ready at any point. 

Vaccine management processes 

As well as safeguarding vaccines through correct storage protocols it is also important to ensure the correct handling and management of the vaccine stock. This involves a series of processes and checks. From receipt of vaccines, through to administering.  

On delivery, a designated member of staff should check the order, looking for possible discrepancies or damage. Once accepted, vaccines should be swiftly stored, in their original packaging, in a validated vaccine fridge. The designated member of staff should also record the receipt of the vaccines in the stock inventory record.  

It is important to maintain accurate records of vaccine stock. Vaccines should be tracked and accounted for and expiry dates monitored so that those close to their expiry are used first. 

Best practice recommendations for vaccine storage include weekly audits of the contents of the vaccine fridge, monthly stock check and rotations and the sharing of audit results and temperature logs quarterly with local screening and immunisation teams. 

 Many of the manual processes could be checked and monitored through our Connected Workflow Management application. A mobile app prompts staff to review and provide evidence, through photos or barcodes, confirming that stock is in date, stored appropriately and with no damage to packaging, for example. Additionally, all checks are automatically date and time stamped. 

Monitoring and workflow data is stored in the cloud and accessed through online dashboards. As a result, the immunisation manager or RP  can have visibility of all storage and medicine management protocols at all times. 

In conclusion, the credibility of immunisation programmes can be undermined by inappropriate ordering, storing and handling of vaccines. Automating through technology can bring greater reliability.  

With automated temperature monitoring, correct vaccine storage can be monitored 24/7. With temperature alerts issued in real-time, any risk to vaccine storage can be acted on immediately. Additionally the management of vaccine stock can be assisted with digital stock inventories, or through digital checks and prompts.

Whichever approach you take it is ultimately important to maintain high quality, safe and effective immunisation programmes. To intern maintain confidence within the community, so that uptake of vaccinations remains high, preventing disease outbreaks.