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Vaccine Excursion

Posted
by Eeks Eeks, BSN, RN (New) New Nurse

Specializes in Pediatrics, ambulatory. Has 4 years experience.

Hi guys, just looking for some advice or experiences. I'm fairly new to a facility where I am now acting as a vaccine nurse. I had to transport our vaccines to another facility and, long story short, I did not package them properly. I thought I did until I arrived at the facility and they were 51 degrees F (should be max of 46). The duration of the excursion was less than 30 minutes but I am pretty worried about the vaccines being viable and I don't know if my site will be charged for the losses. I am pretty sure the MMR is toast and I'm especially worried about the Tubersol because my boss told me it's very expensive (they all are!). I haven't called VFC because it happened right at the end of the work day before the weekend. Any experiences with this? I just don't know what to expect.

Edited by Eeks

Jedrnurse, BSN, RN

Specializes in school nurse. Has 29 years experience.

Not sure if all MMR products are Merck, but I'd hope that their hotline is open on the weekends.

From their website (MMR storage and handling):

"For information regarding stability under conditions other than those recommended, call 800.MERCK.90 (800.637.2590)."

Jory, MSN, APRN, CNM

Has 10 years experience.

When you say, "You didn't package them properly", HOW did you transport them.   Rule #1 in transporting medication is seeing if the medication requires refrigeration.  

If you took them out of the refrigerator, what made you think they didn't need to be transported in ice?  How did you know what the temperature was when you got there? 

Eeks, BSN, RN

Specializes in Pediatrics, ambulatory. Has 4 years experience.

I transported the them with cold packs from the fridge and cold water bottles from the fridge. There was a temp logger packed into the lot. I followed an old protocol from the person previously in this role but now that I've carried out transport I can see that that policy needs some adjustments (which I'm planning to make). Now I see that the recommendation is using conditioned frozen water bottles instead of refrigerated cold packs. It was a very short trip and I didn't realize just how fast the temperature would change. I'm planning to call my VFC provider Monday just looking for any experiences with this. Thanks for the input.

peripateticRN, BSN, RN

Specializes in Little of this... little of that.... Has 5 years experience.

While not a fantastic habit to get into, vaccines can normally tolerate a break for a short period of time. The markers we use show the period in which the vaccines were out of range... I believe my organization is OK with a (small) warm deviation of 2-3 hours out of range before it becomes an actual cold chain break. Consult your organization to find out the acceptability limits and make sure to condition your packing materials next time! 

Eeks, BSN, RN

Specializes in Pediatrics, ambulatory. Has 4 years experience.

OK an update: All the vaccines were fine to use according to VFC. Holy moly did I dodge a bullet though. Revised my policies and WILL NOT make that mistake again. I found that peripatetic had a good idea of what was to come. Thanks for the time of day.

I was going to say they should be fine. I had a power outage  once and had to contact every single manufacturer and every single thing I had was fine (I did not have MMR). It's not something you want to happen obviously but most of them can sustain some time out of ideal temp. The excursion are cumulative of course so I had to monitor all the doses and report if any additional excursions occurred to ensure the cumulative time didn't exceed the maximum excursion.