Manitoba Health

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Cold Chain Protocol – Vaccines and Biologics

Table of Contents

1.  Introduction and the Importance of Cold Chain
     1.1    What is Cold Chain?

2.  Cold Chain Responsibilities
      2.1    Identification of Responsibility
      2.2    Assigning Duties and Tasks to Personnel
      2.3    Contact Lists

3.   Management and Accountability
       3.1    Accountability of Vaccines and Biologics
       3.2    Inventory Management
       3.3    Expired or Unusable Products

4.   Storage Practices for Vaccines and Biologics
       4.1    Ordering Vaccines and Biologics from Manitoba Health
       4.2    Placement of Vaccines and Biologics in the Refrigerator

5.   Cold Chain Management Equipment
       5.1    Refrigerators for Vaccines and Biologics
       5.2    Types of Refrigerators
       5.3    Modifications to Improve Domestic Fridge Temperature Stability
       5.4    Refrigerator Maintenance
       5.5    Temperature Recording Devices
       5.6    Thermometer Placement

6.   Temperature Monitoring
       6.1    Temperature Monitoring by Assigned Personnel

7.   Packing, Storage and Handling for Off-Site Immunization Clinics
      7.1    Basic Principles
      7.2    Equipment for Transport to Off-Site Clinics
      7.3    Packing for Transport
      7.4    Maintaining Cold Chain at an Off-Site Clinic

8.   Managing Cold Chain Problems
      8.1    What to do when the temperature in the refrigerator goes out of the recommended temperature range for the product
      8.2    What to do when the temperature in the freezer goes out of the recommended temperature range for the product
      8.3    Inventory Management of Cold Chain Failures
      8.4    Refrigerator Malfunctions
      8.5    Freezer Malfunctions

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Appendices

• Appendix 1:  Instructions for the Refrigerator and Temperature Monitoring Maintenance
• Appendix 2:  Defrosting a Refrigerator/Freezer
• Appendix 3:  Malfunctioning Refrigerator Trouble Shooting Checklist
• Appendix 4:  Algorithm to Assess Problems in Temperature Readings
• Appendix 5:  Cold Chain Failure Response Diagram
• Appendix 6:  Contact Information
• Appendix 7:  Malfunctioning Freezer Trouble Shooting Checklist
• Appendix 8:  Contact information and Procedure for Accessing Emergency Dry Ice within Winnipeg

Resource Forms

• Resource 1:  Magnetic Vaccine Storage Diagram
• Resource 2:  Refrigerator/Termperature Monitoring Maintenance Log
• Resource 3:  Temperature Log for Vaccines and Biologics
• Resource 4:  Storage Trouble Shooting Record
• Resource 5:  Cold Chain Failure Response Form and Procedures
• Resource 6:  DO NOT UNPLUG and WARNING Notices
• Resource 7:  Immunization Input Form for Health Care Providers

Worksheets

• Worksheet 1:  Checklist for Storage of Vaccines and Biologics
• Worksheet 2:  Provider or Personnel Agreement Form
• Worksheet 3:  Vaccines and Biologics Storage Tasks – Roles and Responsibilities
• Worksheet 4:  Routine and Emergency Contact List

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Communicable Disease Control (CDC) Public Health Manitoba Health 4th Floor - 300 Carlton St. Winnipeg MB  R3B 3M9  CANADA Health Links – Info Santé 204-788-8200 or 1-888-315-9257