If there’s one rule to follow when refrigerating vaccines and diluent, here it is: Always refer to the manufacturer’s product information and package inserts for the most up-to-date recommendations.
That said, specific vaccines and diluents generally fall into a few categories with the following guidelines:
When it comes to storing drugs in a refrigerator, it’s all about real estate. Where you store them matters, what you store them in matters, and what you store next to each other matters, too.
Always store vaccines in their original packaging with lids closed until ready for administration.
This best practice protects them from light and provides additional thermal protection.
Never store loose vials or manufacturer-filled syringes outside of their packaging. This poor practice increases the risk of administration errors, makes it difficult to track expiration dates, and properly manage inventory.
Although it might seem like a waste of refrigerator space, reserving the top shelf, floor, and door racks for water bottles is a best practice. Carefully placed water bottles can maintain stable temperatures caused by opening the door frequently or a power failure. Make sure the bottles do not prevent the door from closing securely with a tight seal. Be sure to label each one clearly: DO NOT DRINK.”
Whenever possible, store diluent with the corresponding vaccine in a clearly labeled, separate container. Arrange the containers in rows with space between them to promote air circulation and maintain consistent temperature. Place vaccines and diluent with the earliest expiration dates in front of those with later expiration dates. Finally, keep pediatric and adult formulations on separate shelves to minimize the risk of administration errors.
Avoid storing vaccines and diluent in parts of the unit that don’t provide sufficient air flow, such as in drawers, on door shelves, or directly under cooling vents. Temperature in these areas can differ from the main parts of the unit, making the drug temperatures unstable. And though you might want to make the most of your space, don’t pack a storage unit too tightly, which restricts air circulation and can negatively impact temperature.
Image via CDC
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For more on cold storage for vaccines and medication, read Shipping Vaccines without a Cold Chain? and How to Improve Asset Health of Medical Refrigeration.