CDC Pink Book Webinars 2020

Beginning July 1, the CDC is offering weekly one-hour videos that provide an overview of vaccination principles, general best practices, immunization strategies, and specific information about vaccine-preventable diseases and the vaccines that prevent them. Each video will also include recent updates from the Advisory on Immunization Practices meetings.

The intended audience is all immunization providers, and continuing education will be available for each video. Due to COVID-19, the videos will be on demand and prerecorded rather than live. No registration is required, and videos will be released on Wednesdays through October 14. Videos can be accessed here.

The 2020 release schedule is below:

July 1Principles of Vaccination
July 8General Best Practice Guidelines, Part 1
July 15General Best Practice Guidelines, Part 2, and Vaccine Safety
July 22Immunization Strategies
July 29Vaccine Storage and Handling and Vaccine Administration
August 5DTaP/Tdap
August 12Rotavirus and Hepatitis A
August 19Meningococcal Vaccine
August 26Mealses, Mumps, Rubella

Webinar: Vaccinating Adults with Chronic Conditions

The CDC’s National Center for Immunization and Respiratory Diseases (NCRID) is hosting a webinar on Vaccinating Adults with Chronic Conditions. The webinar is Thursday, May 28, 2020, at 3:00pm ET. Three physicians will discuss strategies for increasing immunization rates among adults with conditions such as heart disease, lung disease, and diabetes. Adults with these and other chronic health conditions are at increased risk for complications from certain vaccine-preventable diseases and, as such, it is important that they are up-to-date on recommended vaccinations.

Objectives of the webinar are:

  • Explain why vaccines are important for adults with chronic conditions.
  • Describe adult vaccination coverage rates and vaccines recommended for adults with chronic conditions.
  • Effectively communicate with adult patients about the importance of getting recommended vaccines to help manage their chronic condition.
  • Analyze office procedures to reduce missed opportunities to vaccinate.
  • Identify CDC educational resources for healthcare professionals and patients.

Register here.

Managing Vaccine Waste

Each year, vaccine storage and handling errors result in significant financial loss from wasted vaccines and the revaccination of patients. When patients need to be revaccinated, they can lose faith in vaccines and providers. Proper handling and storage of vaccines can help protect patients and prevent vaccine waste. The CDC provides many resources for managing vaccine waste from handbooks and presentations to webinars and on demand courses. Below is an overview of the resources available.

The CDC’s Storage and Handling Resources main page is the hub for all resources. There you can find the Vaccine Storage and Handling Toolkit, an extensive guide to vaccine management. The toolkit can be downloaded from the website, and contains sections on  vaccine cold chain, training staff, inventory management, temperature monitoring, and more.

The main page also contains temperature monitoring best practices fact sheets for both refrigerated and frozen vaccines and a guide for handling a temperature excursion

The CDC also offers a course recommended for all immunization providers. The course is a self-paced document that averages 3 hours to complete, and CME credit is available. The course provides clinicians and other health care providers with ACIP’s best practices guidance on immunization.

The interactive, web-based immunization training course You Call the Shots contains a module on Vaccine Storage and Handling. This course also offers CME credit.

The Immunization Action Coalition provides a collection of handouts and fact sheets. These include signs to post in your clinic reminding staff not to turn off or unplug storage equipment, temperature logs, and various checklists.

For more information, see our blog posts on Handling Vaccine Temperature Anomalies and Refrigerator Repairs and on our LogTag temperature monitoring equipment discount for members. And remember, if you need to upgrade your vaccine storage equipment, CPP offers a grant to offset the cost.

Updated Vaccine Information Statements

The CDC released interim versions of several Vaccine Information Statements (VISs) on April 1. The CDC recommends providers begin using the updated statements immediately.

Below is a list of the updated vaccines and links to their Immunization Action Coalition (IAC) web pages.

A complete list of VISs can be found on the CDC’s website and the IAC’s website.

Emergency Preparedness: Packing Vaccines for Transport during Emergencies

In an emergency situation, you may need to transport vaccinations to a secondary location. The CDC has several guides to help plan for vaccine transport in a number of different scenarios.

Section Six (pages 22-24) of The Vaccine Storage and Handling Toolkit provides guidance for routine transportation, for example traveling to an off-site clinic. In these cases, the CDC recommends transporting with a portable vaccine refrigerator with a temperature monitoring device. However, in an emergency situation, that may not be available. In those cases, the CDC states you can use a conditioned water bottle transport system or, as a last resort, the manufacturer’s original shipping container. Never use a food or beverage cooler.

The CDC’s Guide for Transport during Emergencies contains instructions for using a conditioned water bottle transport system. This system uses frozen and then partially thawed water bottles to keep vaccines cool. Frozen gel packs or coolant packs are not safe to use as they may freeze vaccines. In addition to the water bottles, this transport method also requires insulating material such as bubble wrap or corrugated cardboard, hard-sided or Styrofoam containers, and a temperature monitoring device.

Access the CDC’s guide for detailed instructions on packing the vaccines in a conditioned water bottle transport system along with illustrations.

The AAP also has a guide for safely transporting vaccines in both emergency and non-emergency situations. The guide breaks down transport for frozen and refrigerated vaccines, and contains a list of resources for further information.

Emergency Preparedness: Vaccine Storage and Handling

Emergencies can happen at any time. Whether it’s a severe weather condition, natural disaster, power outage, or unexpected closure due to a pandemic, the end result could compromise vaccine storage conditions. Practices should have standard operative procedures (SOPs) in place for such emergencies.

What if your office needed to close for an extended period of time? In that case, you may need a system for monitoring temperatures remotely. Consider purchasing a phone-enabled or internet-aware alarm to alert you of temperature excursions. Multiple staff members should be on the notification list to ensure appropriate action can be taken, if needed. In addition, your data logger should have enough memory to store at least one month of data, and the data recording should loop when memory is full. This FAQ document from the AAP contains detailed information on data loggers and vaccine monitoring.

Emergencies can happen anytime, including after hours. Work with your facility’s building manager to ensure emergency access. Your storage and handling SOPs should include instructions and a map/diagram for accessing vaccine storage units and the locations of flashlights, keys, circuit breakers, and other useful items.

In a situation where a storage unit is no longer functioning or during a power outage, vaccines may remain inside the unit as long as appropriate temperatures are maintained. It is important to not open the storage unit door unless power is restored or you need to pack the vaccines for transport. Monitor your digital data logger to determine when you need to take additional steps.

If you cannot monitor temperature inside the unit without opening the door, wait until power is restored to record the temperature. At that point, record the room temperature and the temperature inside the unit. Follow your procedure for a temperature excursion and be sure to mark effected vaccines “Do NOT Use” until a decision can be made about whether or not to use them.

If you have external temperature monitoring, record the room temperature and unit temperature as soon as the power goes out. Also record the minimum and maximum temperatures reached. If a temperature excursion should occur, follow your SOPs.

If you have a generator or backup battery power source, this can prevent the need to move vaccines to another location. Both generators and back up battery power sources must be tested quarterly and serviced annually. In addition, ensure you have enough fuel on hand to run your generator for 72 hours.

Even if your practice has a backup power source, you need to establish an alternative storage facility. Establish a working agreement with at least on alternative storage facility such as a hospital, long-term care facility, the Red Cross, or a commercial pharmacy. Ensure that you have 24-hour access to your alternative facility. You can also have a back up storage unit at your facility to use as an alternate.

The CDC’s Vaccine Storage and Handling Toolkit includes a section for establishing SOPs and emergency management. These can be found on pages 25-26 and 30-34.

The Immunization Action Coalition produced a useful Emergency Response Worksheet. It includes instructions, a table for recording vaccines, and helpful numbers. If your practice is in the state of Ohio, the Ohio AAP has a Vaccine Emergency Management Plan with Ohio specific information.

Coming next: what to do in a situation where your vaccines must be transported.

Handling Vaccine Temperature Anomalies and Refrigerator Repairs

Effective refrigeration is an important part of managing your vaccine program. Does your practice know what to do in the case of a temperature anomaly? What about when your vaccine refrigerator needs to be repaired?

Here are 6 tips for when vaccine temperatures go outside of normal limits:

  • Investigate and determine how long the vaccine temperatures have been out of range
  • Check to see if the refrigerator door is ajar or making an unusual noise
  • Inventory the vaccine affected currently in the refrigerator
  • Move vaccines to a temporary refrigerator that is working appropriately 
  • Contact the vaccine manufactures to determine the status of the vaccines
  • Document the entire incident, results and actions taken to prevent another temperature excursion

The Immunization Action Committee created a helpful form to complete after an unacceptable vaccine storage event. This handout and other storage and handling tools can be found here:

If you determine that a refrigerator needs to be repaired after a temperature anomaly, here some sources of good refrigerator repair information:

  • Refrigerator manufacturer
  • Your medical supplies and equipment provider
  • Commercial appliance repair company
  • Other medical practices or hospitals in your area
  • Restaurant equipment repair companies

CPP Buying Group has a robust collection of Vaccine Storage and Handling resources. In addition, we can help with the purchase of a new vaccine refrigerator or freezer. Our Vaccine Storage Equipment Educational Program (VSEEP) provides grants of up to $750 to offset the cost of vaccine storage equipment. Contact our office for more information.