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Section 1. Active and Passive Immunization
Active Immunization
Vaccine Handling and Storage
Vaccines should be transported and stored at recommended temperatures. Inattention to vaccine handling and storage conditions can contribute to vaccine failure. Live-virus vaccines, including MMR, MMRV, varicella, yellow fever, live-attenuated influenza, rotavirus, and OPV vaccines, are sensitive to increased temperature (heat sensitive). Exposure of inactivated vaccines to freezing temperature (0.0°C [32.0°F] or colder) is the most common storage error. Inactivated vaccines may tolerate limited exposure to elevated temperatures but are damaged rapidly by freezing (cold sensitive). Examples of cold-sensitive vaccines include diphtheria and tetanus toxoids and acellular pertussis (DTaP) and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines; IPV vaccine; H influenzae type b (Hib) vaccine; pneumococcal polysaccharide and conjugate vaccines; hepatitis A and hepatitis B vaccines; inactivated influenza vaccine; and meningococcal polysaccharide and conjugate vaccines. Some vaccines must be protected from light. This can be done by keeping each vial or syringe in its original carton while in recommended storage and until immediate use. Some products may show physical evidence of altered integrity, and others may retain their normal appearance despite a loss of potency. Physical appearance is not an appropriate basis for determining vaccine acceptability. Therefore, all personnel responsible for handling vaccines in an office or clinic setting should be familiar with standard procedures designed to minimize risk of vaccine failure.
Recommendations for handling and storage of selected biologicals are summarized in several areas, including the package insert for each product; in a publication titled Vaccine Management, available from the Centers for Disease Control and Prevention (CDC)
3 at www.cdc.gov/vaccines/pubs/downloads/bk-vac-mgt.pdf; and in a Web-based toolkit available at www2a.cdc.gov/nip/isd/shtoolkit/splash.html. The most current information about recommended vaccine storage conditions and handling instructions can be obtained directly from manufacturers; their telephone numbers are listed
Related text in Red Book:
- Active Immunization
Red Book 2009: 9-12.[Extract] [Full Version] - Appendix VII. Standards for Child and Adolescent Immunization Practices
Red Book 2009: 854-856.[Extract] [Full Version]
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