Menu Search Donate
NICU guideline identifier

Immunisation - cold chain management for newborn services

This document is only valid for the day on which it is accessed. Please read our disclaimer.

The cold chain storage refers to the system of transporting and storing vaccines at +2 to +8°C to avoid cumulative irreversible loss of potency from thermal insult. Vaccines are freeze sensitive. The cold chain starts at the vaccine manufacturers and finishes when the vaccine is administered to the patient.

Vaccines for Newborn Services

Vaccines are on imprest in NICU. The imprest is supplied weekly by Pharmacy.

Transporting of Vaccines from Pharmacy

A chilly bin with ice packs is used.

Vaccines are placed in the shredded paper in the chilly bin. Then a 10mm thick sheet of polystyrene is placed on top of vaccines. Ice packs go on top of polystyrene. (Vaccines are kept separate from the ice packs to avoid freezing of freeze sensitive vaccines). The time taken to transport vaccines should be kept to a minimum. Vaccines are immediately unpacked upon arrival at NICU.

Storage of Vaccines in Newborn Services

Vaccines are stored in the dedicated vaccination fridge in NICU. They are kept in their individual boxes in an open container to allow air to circulate.

Fridge used for storing vaccines

  • A good seal, regular defrosting and minimising the number of times the fridge door is opened will also help temperature stability.
  • Non self-defrosting fridges are the best for the storage of vaccines.
  • NICU has a dedicated Rollex vaccine fridge

Power failure

  • During a power failure the refrigerator door should be left closed
  • If the power fails for more than 4 hours, vaccines should be transferred to an appropriately sized insulated vaccine container with the correct number and size of ice packs to ensure vaccines remain at +2°c to +8°c. A minimum/maximum thermometer will assist with monitoring.
  • If the power is not restored, the vaccines will need to be transferred to an alternative refrigerator that has a power supply , as outlined in the cold chain policy.

Monitoring

  • The NICU vaccine refrigerator is hard wired with an external monitoring system
  • The temperature is checked and recorded daily by the Health Care Assistant
  • If the alarm sounds at any time, push the red alarm button to silence the alarm
  • Document in the Vaccine Refrigerator Recording Book the maximum/minimum temperature alarm
  • Record actions taken on the back of the Vaccine Refrigerator Recording Book

Vaccines exposed to Temperatures outside +2 to +8°C.

Vaccine Temperature below 0°C Temperature between +8°C and +25°C
Hep B Do Not Use Contact immunisation coordinator at www.immune.org.nz
Prevenar 13 Do Not Use Contact immunisation coordinator at www.immune.org.nz
Infanrix-hexa®  Do Not Use Contact immunisation coordinator at www.immune.org.nz
Rota Teq Do Not Use Contact immunisation coordinator at www.immune.org.nz

Immunisation Advisory Centre Co-ordinator facilitators are available to advise on fridge performance and if vaccine damage is suspected. (0800IMMUNE).

Before discarding any vaccine, consult with Pharmacy.

Reviews of Fridges

  • To meet the requirements of the Immunisation Co-ordination Programme and DHB requirements. To maintain recommended fridge and freezer temperatures. 
  • To ensure: 
    Vaccines are maintained in best possible condition. 
    Appropriate storage of medications/IVN 
    Appropriate storage of breast milk/formula. 
  • Responsibility:
    A senior nurse is the co-ordinator of Newborn Services Cold Chain Management and will liaise with the Immunisation Advisory Centre Co-ordinator. 
    Newborn Services Cold Chain Management Team (Nurses/Hospital Aids/Clerks). 
  • Frequency:
    Daily monitoring and recording of fridge/freezer max/min temperature by Hospital Aids in Newborn Services. 
    Spot checks. 
    Daily temperature charts on view on Immunisation and Medication fridges. 
    Previous monthly charts filed in Cold Chain Management Information Folder (yellow) kept in NICU office. 
    Cold Chain Management Team completes monthly and two monthly audit checklist. 
  • Procedure:
    All fridge/freezers within the Newborn Service have: 
    Electronic max/min thermometer and temperature chart attached. 
    Fridge range between +2°C to +8°C. 
    Freezers containing frozen breast milk are maintained at -20°C. 
  • Alarms:  Vaccination and medication refrigerators both have external monitoring systems. 

References

  1. Immunisation Handbook 2014

Did you find this information helpful?

Document Control

  • Date last published: 01 September 2015
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years