- Put the fridge in a well-ventilated area, away from direct sunlight and external walls
- Keep it in a secure area or locked, to prevent unnecessary door openings, the power being switched off or tampering
- If patients can reach the fridge (for example, in a clinic room or waiting area), lock it after each use
- If patients can't reach it (for example, behind reception or in a storage area), lock the fridge or room at the end of each day
- Cover an accessible outlet with a metal cage or a "DO NOT UNPLUG" sticker. Don't plug the fridge into a power bar.
Vaccine storage and handling
Requirements for facilities storing publicly funded vaccine, whether you're setting up for the first time, training new staff or preparing for a cold chain inspection.
Vaccines must be kept between +2.0°C and +8.0°C from the time they're made until they're given. This is called the cold chain.
Fridge out of range or power out right now? Go to cold chain emergencies.
How to return expired vaccine
All closed vials of seasonal influenza need to be returned to Public Health by the end of each flu season. Discard open vials of influenza vaccine and withdrawn COVID-19 vaccine through your biohazard waste. Maintain documentation of all vaccine disposals.
If you have stable vaccines that haven't expired that you no longer want, keep it in your inventory until the expiry date. Public Health cannot take it back for use or redistribute to other facilities.
1
Complete the appropriate boxes on the Vaccine Inventory and Return Form (PDF).
2
Place vaccine in an empty bag.
3
Attach the completed form to the bag (or place inside) and close securely.
4
Write "Vaccine Return" and the facility's name on the outside of the bag.
5
Return the vaccine to Public Health via the delivery service or drop off at a Public Health office.
Use the out of range temperatures - cold chain troubleshooting checklist (PDF) to help find the cause.
- Store vaccine in the middle of the fridge on the internal shelves — not in drawers, the door, or against walls, floors or cold air vents
- Keep vaccine in its original packaging, grouped by product with space between for air to circulate
- Put the shortest expiry dates at the front and use them first
- Never store more than a one-month supply
- Fill empty spaces with full water bottles (not for drinking) to help keep the temperature steady
- No specimens, food or drinks in the vaccine fridge
- Take vaccine out only for immediate use. Mark multi-dose vials with the date opened.
- Don't pre-draw vaccine. Stability in plastic syringes is unknown, and it increases the risk of contamination, errors and wastage.
How to take a reading
- Record the current, maximum and minimum temperatures
- Include the date, time and your initials
- If there's an out-of-range reading, Public Health calculates how long the vaccine was exposed from your last within-range recording
- Then clear (reset) the maximum and minimum temperatures. Never clear before recording; you'll lose the readings.
Temperature recording by setting
| Setting | When to record | Monthly log to Public Health |
| Health care providers and medical offices | Before opening and just before closing | With each vaccine order (current four-week log) |
| Long-term care homes, retirement homes and hospitals | Every 12 hours, typically at shift change | End of every month |
| Pharmacies | Daily, before opening and just before closing | First Wednesday of every month. If you don't submit, your pharmacy may be placed on hold from ordering and receiving vaccines. |
Include your current four-week temperature log (up to the present day) with every vaccine order.
Closing for holidays or vacation? Arrange for a staff member to record temperatures two to three times a week. If you can't, contact Public Health about other storage options.
Thermometers, probes and data loggers
- Digital thermometer: must show current, maximum and minimum temperatures to a tenth of a degree (0.1°C). Change the batteries at least every four to six months. You can buy replacements through Niagara Region Public Health.
- Probe: place it in an empty vaccine box in the centre of the middle shelf. Keep the display outside the fridge so you can read it without opening the door.
- Data logger (recommended back-up): records exactly how long temperatures were out of range, which can reduce vaccine wastage. Set it to record every 10 minutes and download it at least weekly. It doesn't replace your digital thermometer or twice-daily recording.
Transport vaccine in a cooler
- Use a hard-sided cooler with ice packs and fridge temperature gel blankets, kept between +2.0°C and +8.0°C
- Use your designated transport thermometer — never your fridge thermometer. Keep the display outside the cooler and the probe inside.
- Don't let the vaccine or probe touch frozen ice packs
- Record temperatures at least hourly while vaccine is in the cooler
Follow the images in the "How to condition a cooler for vaccine transport" document. Contact Public Health if you don't have a copy.
Avoid
- Clearing readings before recording them or clearing in between log recordings
- Leaving vaccine at room temperature, or storing it in drawers, door shelves, against the walls or on the fridge floor
- Storing vaccine in an unmonitored fridge or cooler
- Recording the alarm limits instead of the fridge temperatures
- Missed recordings or missing temperature logs
- Adjusting fridge settings incorrectly
- Ordering more vaccine than your fridge can safely store
- Dropping vaccine or the fridge thermometer
Do
- Follow the Ministry's Vaccine Storage and Handling Guidelines
- Always record temperatures before clearing the thermometer
- Make small, gradual changes to the thermostat
- Consider a purpose-built vaccine fridge and / or data logger
- Keep temperature logs for 12 months
Have a contingency plan
All facilities storing publicly funded vaccine must have a contigency plan for a cold chain excursion, such as a fridge malfunction or power failure. Base it on the steps in cold chain emergencies.
Recommendations for practices closed due to extended vacation or holidays
If your office will be closed for an extended period of time, ensure vaccine safety and decrease vaccine wastage by assigning a staff member to record fridge temperatures periodically (two to three times per week). If you aren't able to do so, contact Public Health to discuss alternate storage options.
Long-term care homes
Under Ontario Reg. 246 / 22, a generator must be available at all times to store drugs, including vaccines, at safe temperatures.
Prepare for inspections
All new vaccine fridges must be inspected before use, and every fridge is inspected annually. The Ministry's Vaccine Cold Chain Maintenance Inspection Report is faxed to your office after each visit, and the inspection date is reported to the Ministry.
- First inspection: prepare using this page and your "New office set-up for publicly funded vaccine" document
- Annual inspection: review last year's inspection report and address any issues at the time of your inspection
Review each report in full for standards, recommendations and anything you need to put in place.