Being cool about the cold chain

1 September 2011

A cleaner accidentally pulling the plug on your vaccine fridge over the weekend could see thousands of dollars of vaccine lost. FIONA CASSIE finds some cold chain tips from Karen Green of the Immunisation Advisory Centre (IMAC).

Losing a fridge full of vaccines through a major cold chain breach can cost up to $5000. So breaching the cold chain not only puts a vaccine’s effectiveness at risk but also can be costly.

Karen Green, an IMAC regional immunisation advisor, says nurses are well aware cold chain is an important process. “And they are very good at it too.”

But they cannot be complacent. Green’s role for IMAC includes making sure vaccinators have a quality process in place to retain the potency of the vaccines they have on site. All practices have to have cold-chain accreditation that is valid for up to three years and usually with a nurse designated to look after cold-chain main management.

Green says the 2002 cold chain guidelines are due to be updated and all documentation is being reviewed and the guidelines and national standards revamped in conjunction with the Ministry of Health.

Vaccines arrive in New Zealand from Australia and go straight to the national vaccine store in Porirua (run by government science agency ESR), and then out to the eight regional stores run by ProPharma before being delivered to practice refrigerators.

To remain viable, the vaccine has to be kept between two and eight degrees Celsius and if there is a cold-chain failure or breach, a practice fridge can hold up to $5000 worth of stock. So it is a serious responsibility ensuring vaccine is kept a consistent temperature.

Green says breaches are rare and as part of accreditation all practices need an emergency plan in case of power failure. The risk of a power cut breaching the cold chain depends on the length of the power outage. Plans might include shifting vaccine. (These plans were severely tested in the February quake – see page 10).

Fridges have to be well maintained, can’t be used to store food and must be opened as little as possible. “And don’t let the doctors put their Coke in the fridge either,” says Green.

Breaches can be caused by the unpredictable. “You can often find that the cleaning lady has unplugged the fridge to plug in the vacuum cleaner and has forgotten to put the plug back in.” Green says the answer to that dilemma is to put a big “do not unplug” sticker over the plug.

SOME COLD CHAIN TIPS

  • Put vaccine in fridge immediately on arrival
  • Make sure fridge is not overstocked – only hold stock level required for your size of practice
  • Keep vaccine in original packaging
  • Rotate your stock
  • NO food in vaccine fridge
  • Have fridge in a well-ventilated room away from heat source or direct sunlight
  • Have a proper maintenance policy for your fridge.