Learning Objectives for this Presentation:
By the end of the presentation participants will be able to identify practises for cold chain maintenance for mass immunization clinics.

Background:
Public Health Nurses in British Columbia provide many immunizations in mass clinic settings.

Objectives:
To identify best practices for cold chain maintenance during mass immunization clinics.

Methods:
BC public health staff completed a survey to assess currrent equipment used, and vaccine transport and handling practices for immunization clinics. Industry partners observed clinic practices during on-site visits. Coolers chosen by public health were tested under laboratory conditions, re-enacting actual environmental patterns and current practice needs. Educational sessions were held to describe testing results, and recommendations for equipment and packaging to maintain the cold chain.

Results:
Survey response rate was 59%. In 20% of jurisdictions, vaccines may be in the field for more than 8 hours. 68% of coolers are not packaged differently in summer and winter, despite temperature differences. Coolers may be opened more than ten times during a clinic, and 7% reported keeping coolers open for more than a minute each time. In observed clinics, vaccine was transferred from larger containers to smaller coolers at vaccination stations. Testing showed that coolers packed with flexible insulating blankets surrounding the vaccine mass, and use of both frozen and refrigerator- temperature gel packs, would maintain a desired temperature for extended periods of time. Packing configurations for summer and winter were provided.

Conclusions:
Based on laboratory testing, BC public health staff have recommendations for equipment and packing procedures for cold chain maintenance. This example of public-private partnership will enhance preparedness for infectious disease events requiring mass immunization.