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c. Store only vaccines and medical equipment <br />D. Do not store food and beverages in a vaccine storage unit. <br />Vaccine Storage A. Rotate vaccine stock by placing vaccines with shorter expiration dates in front of those with <br />Practices longer expiration dates; check for short -dated vaccine every week. <br />B. Notify the Local Health Jurisdiction (LHJ) of any vaccine doses that will expire before they can <br />be administered, preferably three months before the expiration date. Only with the approval <br />and direct guidance of the LHJ and only if the cold chain can be ensured, redistribute short - <br />dated vaccines to high-volume providers who are able to administer it before it expires. <br />C. Ensure that the storage and handling of vaccine is in accordance with the manufacturer's <br />specifications and the guidelines as outlined in the CDC Vaccine Storage and Handling <br />Guidelines. <br />Temperature <br />Monitoring <br />A. Have a working thermometer certified in accordance with International Laboratory <br />Accreditation Cooperation ([LAC) standards or by ISO -17025 standards. <br />B. Providers enrolling in the Program for the first time are required to use either a digital data <br />logger or a continuous temperature monitoring system with a detachable probe in a bottle <br />filled with a thermal buffer. <br />C. By 2018, all providers must use either a digital data logger or continuous temperature <br />monitoring system with a detachable probe in a bottle filled with a thermal buffer. Providers <br />should replace thermometers not meeting these specifications when existing thermometers <br />are due for recalibration or replacement. The thermometers should have the following <br />features: <br />a. Alarm for out -of -range temperatures <br />b. Current temperature, as well as minimum and maximum temperatures <br />c. Reset feature <br />d. Low battery indicator <br />e. Accuracy of +/- 1° F (0.5° C) <br />f. Memory storage of at least 4000 readings <br />g. Device will not rewrite over old data and stops recording when memory is full <br />h. User programmable logging interval (or reading rate) <br />D. Have a current certificate of calibration for each thermometer used to monitor vaccine <br />storage temperatures. Depending on manufacturer requirements, thermometers must be re- <br />certified either every year or every other year. <br />E. Post a temperature log on the vaccine storage unit door or nearby in a readily accessible <br />place. Please use the state program's paper temperature log. <br />F. Visually review and manually record refrigerator and freezer temperatures twice each day <br />(beginning and end) ensuring that refrigerator temperatures are between 35° and 46° F (2° <br />and 8° C), and that freezer temperature are between 5°F and -587 or lower (between -15°C <br />and -50°C). <br />G. Take immediate action to correct improper vaccine storage conditions, including <br />inappropriate exposure to light and inappropriate exposure to storage temperatures outside <br />the recommended ranges. Document actions taken on the temperature adjustment tracking <br />log. Inform your Local Health Jurisdiction (LHJ). <br />H. Maintain an ongoing file of temperature logs, and store completed logs for 6 years. Providers <br />must send copies of completed temperature monitoring logs monthly to the local health <br />jurisdiction via fax or email. <br />I. Providers should also send copies of their data logger data to LHJs each month with their <br />paper temperature logs. <br />J. Failure to comply could result in the discontinuation of the provision of vaccine. <br />Vaccine A. Ensure that clinic staff does not pre -draw vaccines into syringes. <br />Preparation B. Draw vaccine only at the time of administration to ensure that the cold chain is maintained <br />and the vaccine is not inappropriately exposed to light. <br />