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The Vaccines
For Children (VFC) program maintains
vaccine inventories in the field valued
at over $1 billion. To protect this national
vaccine inventory and minimize the potential
monetary loss from natural disasters
or other emergencies, immunization facilities
should develop a Written Emergency Plan
to safeguard their vaccine inventories.
Emergency
procedures should address the protection
and/or retrieval of vaccines at both
the depot and provider level. Projects
should have the ability to routinely
communicate during normal operations
and quickly communicate action plans
during emergencies or anticipated emergencies
with all providers receiving public purchased
vaccines.
When
states, local officials, or providers
have reasonable cause to believe that
emerging conditions will disrupt vaccine
operations, emergency
procedures should be implemented IN
ADVANCE OF THE EVENT.
In advance of the emergency, all providers
should:
- Identify an alternative storage facility
(hospital, packing plant, state depot,
etc.) with back-up power (generator)
where the vaccine can be properly stored
and monitored for the interim,
- Insure the availability of staff
to pack and move the vaccine,
- Maintain the appropriate packing
materials (insulated containers, ice
packs, dry ice for Varicella/MMR vaccine,
etc.) and,
- Insure a means of transport for the
vaccine to the secure storage facility.
NOTE: Whenever possible, facilities
should suspend vaccination activities
BEFORE the onset of emergency conditions
to allow sufficient time for packing
and transporting vaccine.
The information below is provided as
a guideline for developing facility-specific
Standard Operating Procedures for the
protection of vaccine inventories before
and during emergency conditions.
Emergency Procedures
- List emergency phone numbers,
companies, and points of contact for:
- Electrical power company
- Refrigeration repair company
- Temperature alarm monitoring
company
- Perimeter alarm repair company
- Perimeter alarm monitoring company
- Backup storage facility
- Transportation to backup storage
- Dry ice vendor
- Emergency generator repair company
- National weather service
- Manufacturers
- Merck Sharpe & Dohme: 800-672-6372
- Aventis Pasteur: 800-VACCINE
(800-822-2463)
- GlaxoSmith Kline: 888-825-5249
- Wyeth Lederle Labs: 800-666-7248
- State/project assistance to providers
in possession of vaccine:
- Establish working agreements
with hospitals, health departments
or other facilities to serve as
emergency vaccine storage facilities
and communicate these agreements
with your providers. (This might
also be done at the regional or
county level and/or with the assistance
of Bioterrorism or Emergency Preparedness
Units.)
- Prioritize assistance and communication
to those providers in areas at
highest risk from the emergency.
- Entering vaccine storage facilities:
Describe how to enter the building
and vaccine storage spaces in an emergency
if closed or after hours. Include a
floor diagram and the locations of:
- Doors
- Flash lights
- Spare batteries
- Light switches
- Keys
- Locks
- Alarms
- Circuit breakers
- Packing materials
- Identify who to call for the following
assistance:
- Equipment problems
- Packing containers, cold packs,
(and dry ice, if necessary)
- Backup storage
- Backup transportation
- Security
- Identify what vaccines to pack
first in an emergency and while the
power is still working:
- Pack the refrigerated vaccines
first with an adequate supply of
cold packs.
- Remove and pack the Varicella
vaccine, using dry ice, immediately
before it is to be transported.
- Pack and transport all vaccine
or if that is not possible, determine
the types and amounts to save:
e.g., save only the most expensive
vaccines to minimize dollar loss or
save some portion of all vaccines to
ensure a short term, complete supply
for resuming the vaccination schedule.
We would suggest the first priority
be given to those vaccines which would
be the most expensive to replace.
- Follow vaccine packing procedures
for transport to backup storage facilities:
- Have vaccine packing instructions
readily available for staff unfamiliar
with packing procedures.
- Open refrigerated units only
when absolutely necessary and only
after you have made all preparations
for packing and moving the vaccine
to alternative storage sites.
- Use properly insulated containers.
- Use a properly placed temperature
monitoring device in each container.
- Record vaccine type(s), quantity,
date, time, and originating facility
on the container.
- Document the storage container
temperatures at the time the vaccine
is removed for storage at the alternate
site.
- Move vaccine to backup storage
according to pre-arranged plans.
- How to load transportation vehicle
- Routes to take (alternate routes
if necessary)
- Time enroute
- Ensure vaccine containers are
stored properly in the emergency
storage facility. (Varicella in
freezer; refrigerated vaccines
in refrigerator; adequate circulation;
functioning temperature monitoring
devices, etc.)
NOTE:
The Federal Emergency Management
Agency (FEMA) offers a wide range of
information on disaster preparedness:
http://www.fema.gov/
Related
MMWR article dated Oct. 24, 2003 / 52(42);1023-1025.
Notice
to Readers: Guidelines for Maintaining
and Managing the Vaccine Cold Chain
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