Storage and handling of vaccines by family doctors

The aim of this study is to see if vaccine storage and handling procedures used by family doctors in a health board region maintain vaccines at maximum potency. All 144 family doctors in the region were invited to be part of the study. Doctors were interviewed in their practice premises about procedures used in dealing with vaccines. Following the interview, practice fridges were examined and temperature recorded. Samples of oral polio were taken from 20 randomly selected fridges for potency testing. Cold chain monitors and freeze watch indicators were used to monitor batches of vaccine stored. Of the 144 doctors, 142 (98.6%) agreed to participate. Of these, 140 used 111 fridges to store vaccine, 2 doctors store vaccine at room temperature. Of the 111 fridges, 6 (5.4%) had the power supply safeguarded, 9 (8.1%) had thermometers, and 36 (32.4%) had vaccine only stored therein. During defrosting, the vaccine in 22 (19.8%) of the fridges was not adequately protected. Of the 138 doctors who use multi-dose vaccine vials, 133 (97.2%) keep them for further use at the end of a day/session, of whom 3 store them at room temperature. The temperature recorded in 42 (37.8%) fridges was outside the recommended range. Thirteen (28.2%) cold-chain monitors indicated vaccine exposed to more than 10 degrees C. Eighteen (90%) of the oral polio samples showed a reduction in total titre of live virus, however, none were below the minimum acceptable. This study indicates that vaccine potency could be seriously compromised due to breaks in the cold-chain and suggests the need for guidelines to be drawn up, implemented and monitored to ensure the integrity of immunisation schemes.