Vaccines – power outage strategies or refrigerator failure

A cold chain breach may happen when vaccine is stored outside the recommended temperature range of 2 °C to 8 °C. This may occur during a power outage.

Any service storing vaccines must have a strategy for dealing with power outages.

Power outage equipment

You will need the following equipment during a power outage:

• a sign reading ‘Power out. Keep the fridge door closed and do not use vaccine until further notice’
• ice packs / gel packs and insulating material such as bubble wrap
• a cooler to fit the vaccine stock if the fridge temperature rises to +8°C (see section 9.3 How to pack a cooler)
• a minimum/maximum (min/max) thermometer or data logger for use in a cooler or an alternative fridge.

Power outage – what to do

During a power outage, you should:

• Place a sign on the door of the fridge that says ‘Keep the fridge door closed and do not use vaccine until further notice’.
• Lock the fridge if possible.
• Closely monitor the refrigerator temperature using a battery-operated minimum/maximum thermometer or portable data logger. Ideally, this should be done using a standalone minimum/maximum thermometer with an external display to limit the need to open the door.
• If the temperature rises to +8°C, move vaccines to a prepared cooler, cold box or portable purpose-built vaccine refrigerator. Ensure that all vaccines are packed and monitored with a digital minimum/maximum thermometer or data logger.

Alternative vaccine storage in the event of a power failure may include any of the following:

• a back-up power supply (e.g generator or battery/solar back-up)
• a monitored refrigerator offsite (e.g at a local hospital or pharmacy) – ensure that an agreement has been put in place with the relevant organisation before the event, and also consider that this organisation may be affected by the same power failure
• a cooler – each facility should ensure that they have enough coolers for an emergency

Never transport vaccines to another vaccine refrigerator, cooler or cold box without a minimum/maximum thermometer or data logger to monitor the temperature. Domestic refrigerators (including bar fridges) are not built or designed to store vaccines and must not be used for vaccine storage

Power restored – what to do

When power is returned:

• Record the minimum and maximum temperatures for the fridge.
• Reset the refrigerator temperature when the temperature reaches +8°C or less.
• If the temperature readings are outside 2 °C to 8 °C, complete the cold chain breach report form and send it to the department as soon as possible by email or fax.
• Do not use or discard vaccine until you receive advice from the department.
• Monitor the refrigerator closely (e.g hourly) to ensure that the temperature is consistently stable, then return to twice-daily monitoring.