Safely Transporting Vaccines Between Sites

Background: As H1N1 vaccine was being shipped throughout California in fall 2009, providers were requesting guidance about how to transport vaccine from one site to another. In-house and internet resources were searched in an attempt to find an easy-to-use procedure that providers could use for transporting refrigerated vaccine that would maintain recommended temperatures (35º to 46ºF) and prevent freezing. Although many references were found, the suggested methods and materials varied widely. It became necessary to conduct some validation of materials and methods to develop reasonable and reliable recommendations.

Objectives: To develop a method and procedure for transporting and storing H1N1 vaccine for up to 12 hours that would not freeze (recorded temperature 32ºF or below) the vaccine and would maintain vaccine temperatures between 35ºF and 46ºF.

Methods: A series of 48 tests were conducted with expired flu vaccine using three different insulated coolers/containers and a variety of combinations of refrigerated water bottles, cold packs, and insulating material. Temperatures were monitored with calibrated Min/Max vaccine thermometers with digital displays and gel probes.

Results:

• Temperatures in the coolers with refrigerated water bottles quickly exceeded recommended temperatures.
• Temperatures in coolers with frozen cold packs and little or no bubble wrap quickly reached temperatures below freezing.
• Vaccine packed with the right combination of “sweating” (conditioned) cold packs and bubble wrap stayed within the recommended range, but the thickness of bubble wrap needed depended on the size of the cooler.

Conclusions: It is very easy to freeze vaccine. And it is very difficult to find the right combination of cold packs, insulation, and cooler that will prevent vaccine from freezing and still maintain vaccine temperatures within the narrow recommended temperature range (35ºF to 46 ºF) during vaccine transport and storage for up to 12 hours.