Evaluating the efficacy of vaccine storage in the general practice setting

To describe the implementation of guidelines for vaccine storage in general practice, and their effectiveness in achieving optimum vaccine storage temperatures in fridges.

Repeated cross-sectional surveys over time--phase 1 1996/97, phase 2 1998/99, phase 3 1999/2000.

Central Coast, New South Wales.

Phase 1--all general practices on the Central Coast. Phases 2 and 3--samples of practices.

Each practice was surveyed about how they stored vaccines. A datalogger recorded fridge temperatures over six days. Individual feedback and advice were given.

Proportion of: 1. fridges maintaining a temperature in the 2-8 degrees C range; 2. fridges freezing; 3. practices with one person responsible for vaccine storage; 4. bridge temperature checked daily; 5. fridges storing no items other than vaccines; 6. bridges with thermometers; and 7. associations between storage practices and fridge temperatures.

In phase 1, 102 fridges, and in phase 3, a random sample of 36 practices was surveyed. The findings for phase 1 and phase 3 respectively were: 31% and 50% of fridges were in the 2-8 degrees C range; 36% and 25% were <0 degrees C; one person was responsible in 52% and 53% of cases; 20% and 38% reported daily checks; 74% and 94% of fridges had no extraneous items and 53% and 86% of fridges had thermometers. No statistically significant associations were found between vaccine storage practices and bridge temperatures.

Despite improvements in vaccine storage practices, a quarter of fridges were freezing, thereby compromising the potency of many of the immunisation schedule vaccines.