Hesperian Health Guides

Vaccine Management

Keeping vaccines at the right temperature (maintaining the cold chain)

It is very important to keep vaccines at the right temperature. If certain vaccines get warm, they may spoil and not work. And some vaccines must stay cold but cannot be frozen or they will not work. Vaccines need to be kept at the correct temperature from the factory where they are made to the community where a health worker vaccinates the local children. If at any time from manufacturer to transport to storage the vaccine is too warm, or frozen when it shouldn’t be, it becomes useless.

a refrigerator with a sign "vaccines only" on the door, and a sign "warning: don not unplug, vaccine storage" above the electrical outlet.

Vaccines that can be frozen:
OPV (oral poliovirus)
Yellow fever
Japanese encephalitis

Vaccines kept very cold but DO NOT FREEZE:
Hepatitis B (Hep B)
Hib (liquid)
HPV (human papillomavirus)
IPV (inactivated poliovirus)
Rotavirus (liquid and freeze-dried)
Tetanus (DT, Td)

Refrigerator units are used to transport and store vaccines as well as the liquids used to dilute them. Learn which vaccines are stored at what temperatures and what shelf or compartment is used for each. In general, vaccines are stored at a temperature that is under 8° C and slightly above freezing (2° C). See the box with lists of the vaccines that must not be allowed to get too warm and those which are frozen.

Some vaccines can spoil in bright light, including BCG and MMR. To protect them from sunlight and strong indoor lights, keep them in their dark glass vials and their extra packaging.

When a vaccine is made ready for use by mixing it with its diluting liquid, it must also be kept cool. People trained to handle the vaccines will know how many hours vaccines remain useful after mixing and if they need to be discarded at the end of the day.

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Learn how to store, prepare, and give vaccines

Everyone can promote vaccinations and many health workers learn how to give them too. If you are giving vaccinations or handling vaccines, your training will include:

a box labelled "Sharps" with a hand putting a syringe in it.
  • how to prepare the vaccines.
  • how to determine the correct dose for different age groups.
  • where to find expiration dates and how to dispose of expired vaccines.
  • how to choose the correct needle size, angle of injection, and injection place on the body for each vaccine.

For your own health and the health of those you are helping, wash your hands before vaccinating each person. Use a needle one time only and then safely discard it.

Take responsibility for vaccination waste

The last step of a vaccination campaign is often forgotten: properly disposing of the waste. The leftover plastics, needles, and biological materials create health problems for people and the environment, especially if they are burned or buried unsafely or left where children can pick them up. An immunization program can plan to safely dispose of waste by:

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  • using the same vehicles that deliver the supplies to carry away waste for treatment and safe disposal.
  • setting up regional waste treatment centers with burial pits.
  • helping community clinics to set up simple health care waste disposal systems, including separation of wastes and safe burial pits. (See Community Guide to Environmental Health, Chapter 19: Health Care Waste.)

This page was updated:23 Aug 2019