Vaccine storage practices in primary care physicians' offices in Taiwan

To assess vaccine storage practices in Taiwan's clinics, an evaluation was made to determine whether they follow the relevant guidelines. A cross sectional study was carried out in March 1994, in which sixty-three clinics were selected at random from the 744 clinics in the twenty-one counties of Taiwan. Vaccine storage practices were inspected and the temperature of the central core of refrigerators used by these clinics for vaccine storage was measured. Of the 63 clinics, the majority (93.7%) stored articles other than vaccines in their vaccine refrigerators. Thirty clinics (47.6%) placed simple thermometers in their refrigerators; twenty-nine clinics (46.0%) used recording thermometers to produce temperature charts; and 25 clinics (39.7%) equipped their refrigerators with UPS (uninterruptable power system). Forty (63.5%) of 63 vaccine coordinators who were interviewed indicated at least one power failure per year. All refrigerators used for vaccine storage were of the domestic type without "safe zone" gauges. We discovered inappropriately high temperatures (> 8 degrees C) in 22% (14/63) of all refrigerators. Most refrigerator doors (76.3%, 45/59) or freezing rooms (73.7%, 28/38) were not maintained at a temperature required for storing vaccine. Coordinators should be carefully trained and refrigeration and electrical facilities be reassessed to improve vaccine storage in primary care physicians' offices.