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Flu vaccines time out of the fridge!!!
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crazyred

180 Posts

Posted:  25-Sep-2014 14:13
Hi all, gp's asking how long they are able to keep a box of flu vaccines on their desk and out of the fridge to give to pt's as and when needed? lots of thoughts on this, may need to call manufacturer but wondered if anyone knew the answer, thankyou [:I] crazyred
KatieMoore

271 Posts

Posted:  25-Sep-2014 14:46
I always thought they were good for an hour but sorry, can't give you any evidence for this at the moment.

Katie
kitkat

219 Posts

Posted:  25-Sep-2014 15:16
Need to maintain cold chain, we get them out as required, im sure manufacturer would advise the same. Does dr not have fridge in room?


kk
Mimosa

518 Posts

Posted:  25-Sep-2014 19:42
We don't have a fridge in every nurse room let alone gp rooms, however I would have thought time out depends on vaccine brand to ensure it's ok to use. But as stated would not be able to be returned to the cold chain if they are not used they would need discarding.

Hanging on in there
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sue61bns

67 Posts

Posted:  26-Sep-2014 07:52
If the Drs want some Flu vaccs in room suggest keeping small amount in cool bag and always using those first next session. I was told up to 2 hours out of fridge is ok but couldn't find how long stable in various temps.
Leanne8742

120 Posts

Posted:  26-Sep-2014 20:31
Imuvac leaflet in box actually says allow to reach room temp anyone else noticed this?
abigail89

166 Posts

Posted:  29-Sep-2014 10:59
It's a while since I did flu vacs (now work in Occ Health) but thought all vacs should be at room temp before giving or it stings more.
lualua

613 Posts

Posted:  29-Sep-2014 11:40
At imms update only last week we were told, but off the record, that most imms, and certainly flu, are ok out of the fridge for 'at least a week, likely much longer' but the manufacturers are unwilling to admit. We had an incident before I got here when the fridge got to 10c, and after advice, the poor nurse had to not only throw away, but offer re-vaccination to all the patients as the monitoring thermometer had gone wrong but they didn't know when it went wrong but less than a fortnight.

Freezing much much worse.
Lilywhite

1358 Posts

Posted:  29-Sep-2014 12:00 Log in to like this post
The reality is that yes, 'off the record', a few hours out of the fridge on one occasion is not likely to matter too much at all (if you have access to travax there is a page on thermostability of vaccines).

BUT

this is often outside the manufacturer's guarantee and therefore 'off licence'(and may well also be outside your PGD) once outside the cold chain for longer than the SPC states.

So letting it come up towards room temp just before administration if the SPC states should not usually be a problem, however, most manufacturers have no data on the effects of repeated breaks in the cold chain - so vaccines that go in and out of the fridge repeatedly.

So need to check individual vaccine brands and even if they state they are OK for a set period of time it is usually not good to put unused ones back and do the same again the next day etc.

Please be aware this is my opinion only based on the evidence I have seen, and not meant to be taken as direction
Wilma

191 Posts

Posted:  29-Sep-2014 20:30
I wrote to gsk in 2009 I have just dug out the letter they sent me in reply. I wrote to them after I read that you should allow the vaccine to reach room temp. They said that

"the vaccine has to be stored between 2 and 8 c before injection and it is common practice to wait until the vaccine reaches room temp in order to reduce the pain at injection site which might be induced if there is so much difference between the body temp and the vaccine. This should not have any impact on the action of the vaccine  they are not licenced for use when stored outside 2-8c."

however they then said

"the following information ,based on in house testing can be used to help make a decision in cases of temperature variation above the recommended storage conditions. The maximum time that Flurarix can be stored at controlled room temp (20-25c) is 72 hours. When stored in this manner, the vaccine will maintain its full licensed shelf life if returned to refrigerated storage at 2-8 c.

the customer number was 0800 221441

interesting I thought.
mars

411 Posts

Posted:  30-Sep-2014 09:21
Hi
i ensure that the time is put on the box when taken from the fridge and is used up within the hour (whilst doing flu clinic's).

MP
Tifanm

27 Posts

Posted:  26-Oct-2015 15:55
Hi,
Thanks for the very good information.
Got a bit a mess recently when i picked up a flu vac and the fridge was unfortunately left ajar without myself or anyone noticed. The fridge is kept in a separate room. 20mins later someone heard the fridge alarm and a message was send out to whoever has been in the fridge last. Obviously i had to admit i went 15 mins ago but who else would admit if they have been 5mins ago!!!
I felt at the time as if someone had a cardiac arrest. It was all running around, Dr has to be informed, vaccine cannot be used, incident report has to done. which i admit this is all ok except why cannot we use the vaccine when it was only 15 mins with the vaccine fridge door ajar and the vaccine not left at outside at room temperature. Yes the temperature of the fridge was showing 19 degrees.

But am i wrong to say by not using the vaccine was not right!!
Now all the vaccine has been relocated to another fridge with a high sign DO NOT USE!!!!
Now the worst cae scenario is i was doing a locum. I am ok with them reporting me to the agency but am hoping they do not claim vaccine damage to the agency!!

Anybody had similar scenario and what did you do with the vaccines??
blueberry

8 Posts

Posted:  26-Oct-2015 18:00
Fluenz tetra can be left out for 12 hours . But those not used cannot be returned to fridge. X
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dogfox

15 Posts

Posted:  19-Sep-2016 16:41
I don't understand why the vacs can't be used. Our fridge broke down and the vacs were out of cold chain for a few hours. WE contacted the manufacturers and they said they were fine to use. WE just have to inform the patient give them a leaflet about off licence vacs and do a PSD for it. No vaccines needed to be destroyed or not used.
Della

1578 Posts

Posted:  20-Sep-2016 18:51
It's to do with stability of the vaccines. Each time they are out of the fridge the quality will deteriorate slightly.

All vaccines are different, hence why in the event of fridge failures you have to contact individual manufacturers to get their advice.

I guess knowing a vaccine has been in a fridge that is within a certain temperature range is easier to assess stability than something that has been in and out of the fridge at different temps for differing lengths of time.
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am167krp

3 Posts

Posted:  21-Sep-2016 08:01
I also read that they should be given at room temperature so we keep the box out during the day.
Milly

792 Posts

Posted:  22-Sep-2016 07:38
We have a HCA who deals with contacting the vaccines companies re these issues, he was told stability testing of vaccines changes so every breach in the cold chain they should be contacted to ensure the information we have is current,
Some interesting information above but it differs from what we were advised recently which was fluarix can stay out of the fridge for several hours at room temp (I forget how many off hand but it was a lot) but only if the room temperature stays below something like 21 degrees. We have it all in writing at work and have thermometers in every room for this reason.

Milly

The post above is my own opinion, I'm not always right.
JTownend

9 Posts

Posted:  23-Sep-2016 22:34
Do any of you use a Tinytag data logger? This is placed inside the fridge and you can set it to read the temp as frequently as you want. Ours is set to read it every 7 mins. We then do an audit every month which highlights if the fridge has gone above/below temp and how long for so that when the manufacturer asks you how long the vaccine has been out of range, you can tell them exactly. Also if the fridge has gone out of temp overnight, you can see how long it has been out for. This has saved us a lot of money, especially when we had power cuts in the middle of the night!

JT
Milly

792 Posts

Posted:  24-Sep-2016 20:36
JTownend am I reading that right that you read the data logger once a month?
If so I imagine in that time you could you would have potentially used the vaccines out of range if a breech occurred.
Our data loggers are read first thing in the morning and at lunchtime, that means any breeches in temperature are quickly identified before the vaccines are used.

Milly

The post above is my own opinion, I'm not always right.
JTownend

9 Posts

Posted:  25-Sep-2016 20:46 Log in to like this post
We also have min/max thermometers Milly which have probes in the fridge so if the min or max temp is out of range we would then read the data logger to see how long it was out of range for before using any vaccines out of that fridge.

JT
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