Hello Fellow COVID-19 Vaccine Providers,

Please share with all staff that may have any contact with the COVID-19 vaccine.

The Michigan Department of Health and Human Services (MDHHS), Division of Immunization, has received several questions from you, our COVID-19 providers. These questions are related to different aspects of the COVID-19 vaccination program, so to help answer some of these questions, we are sending weekly tip sheets. Below is our tip for week #7.

Week #7 Educational Tip:

Note: This guidance is for COVID-19 providers. If you are both a VFC and COVID-19 provider, you must always follow the guidelines and requirements for VFC storage and handling.

Correct Storage of Vaccine in a Storage Unit:

Storing COVID-19 vaccines correctly in a vaccine storage unit is critical to protect the vaccine and reduce the chance of vaccine administration errors, especially if COVID-19 vaccine is stored with other vaccines. Best practices include:

• Do not store any vaccine in a dormitory-style or bar-style combined refrigerator/freezer unit under any circumstances.
• Place water bottles on the top shelf, floor, and in the door racks of vaccine storage units, as long as they do not cause issues with closing/keeping the door closed (always defer to the manufacturer guidance). This is to help maintain stable temperatures that might be disrupted by frequently opening and closing unit doors. (Note: Water bottles are not recommended for use in ultra-cold freezers or in all purpose-built or pharmaceutical-grade units—see manufacturer guidance.)
• Avoid placing or storing any items other than vaccines, refrigerated diluents, and water bottles inside storage units.
• Store vaccines and diluents in original packaging.
• Never store loose vials or manufacturer-filled syringes outside of their packaging. This increases the risk of administration errors, exposes vaccine to light, and makes it more difficult to track expiration dates and manage inventory.
• Label shelves and containers to clearly identify where each type of vaccine and diluent is stored. Vaccine Label Examples (cdc.gov)
• Position vaccines and diluents two to three inches from the storage unit walls, ceiling, floor, and door. If using a household-grade unit, avoid storing vaccines and diluents in any part of the unit that may not provide stable temperatures or sufficient air flow (e.g., directly under cooling vents, in deli, fruit, or vegetable drawers, or on refrigerator door shelves). The instability of temperatures and air flow in these areas may expose vaccines to inappropriate storage temperatures.
• Arrange vaccines and diluents in rows and allow space between them to promote air circulation.
• Whenever possible, store diluent with the corresponding refrigerated vaccine. Never store diluent in a freezer.
• Place vaccines and diluents with the earliest expiration dates in front of those with later expiration dates.
• COVID-19 vaccine labels/cartons may not include expiration dates. Know where/how to find the expiration date for each vaccine.
• To help track expiration dates and beyond use dates (BUDs), CDC has a COVID-19 Vaccine Expiration Date Tracking Tool available on its website. COVID-19 Vaccine Expiration Date Tracking Tool (cdc.gov)
• Expiration dates may change as additional stability data become available.
• Place the digital data logger (DDL) in the center of the unit with the vaccines surrounding it. A DDL should be set to measure temperature at least every 30 minutes.

If you store frozen vaccine at your facility, CDC and MDHHS guidance is to use a separate stand-alone freezer for storage, you should not use the freezer in a household-grade combination unit to store vaccine. It is important to review storage equipment with your LHD or email MDHHS to ensure that vaccine is being stored in an appropriate unit.

• Combination refrigerator/freezer units are less capable of simultaneously maintaining proper storage temperatures in both compartments.
• Vaccines that are stored in the refrigerator portion of a combination refrigerator/freezer should be moved away from the vent located in the refrigerator compartment.
• The cold air from the freezer is circulated into the refrigerator compartment to cool it, which can cause your vaccines to freeze.

To protect the storage unit’s power supply:

• Plug in only one storage unit per electrical outlet.
• Use a safety-lock plug or an outlet cover to prevent the unit from being unplugged.
• Post “DO NOT UNPLUG” warning signs at outlets and on storage units to alert staff, custodians, electricians, and other workers not to unplug units.
• Label fuses and circuit breakers to alert people not to turn off power to storage units.
• Use caution when using power outlets that can be tripped or switched off and avoid using built-in circuit switches (that may have reset buttons), outlets activated by a wall switch, and multioutlet power strips.

If you believe the storage unit has failed, implement your emergency vaccine storage and handling standard operating procedures (SOPs). Never allow vaccines to remain in a nonfunctioning unit following a temperature excursion.

Please contact us if you have any questions or concerns at checcimms@michigan.gov.

Thank-you for helping to keep Michiganders safe from the COVID-19 virus,

Oakland County Health Division (OCHD) Immunization Action Plan Program (IAP)