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July 2003 • Volume 37 • Number 7

Infectious Diseases

Use best practices
Handle Vaccines With Care Or You May Rue the Day

Steve Perlstein
Midwest Bureau

CHICAGO — Errors in vaccine handling put patients in danger and can cost hundreds of millions of dollars nationwide each year if physicians don't implement best practices for vaccine storage and handling, Gary Coil said at the National Immunization Conference sponsored by the Centers for Disease Control and Prevention.

A 2002 survey of 737 primary care providers showed that the temperatures of a significant percentage of their refrigerators had been out of acceptable range during a 30-day period, said Mr. Coil, a public health advisor for the CDC's National Immunization Program.

In the survey, 17% (125) of the offices surveyed said their refrigerators had been out of the appropriate temperature range in the past month, and 70% (80) of those offices had refrigerators that were at or below freezing during that period.

“When you have to start recalling kids who you've already vaccinated because the vaccine may have gone bad, it gets very challenging,” he said.

Mr. Coil implored clinicians to follow the CDC's “Ten Commandments” of vaccine storage and handling:

These policies ought to be spelled out in writing in every office, he said. This is important not only to maintain vaccine efficacy and reduce vaccine loss, but also to protect the office against legal liability.

Indeed, Mr. Coil said, many of the vaccine handling guidelines are based on the Hazards Analysis and Critical Control Points (HACCP) system used by food service operations to ensure food safety and to provide liability protection.

HACCP plans identify the critical control points at which the product could be rendered unsafe because of improper handling or storage and provide specific procedures for each of those points.

Failure to handle vaccines properly not only is potentially unsafe, Mr. Coil said, but it can be expensive as well.

He estimated, on the basis of the 2002 survey results, that cold-chain errors from 1995 to 2002 for vaccines other than varicella and MMR (which can be frozen) affected up to 44 million doses, costing between $433 million and $481 million.