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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 your LHJ of any vaccine doses that will expire before they can be administered, <br />preferably three months before the expiration date. Only with the approval and direct <br />guidance of the LHJ and only if the cold chain can be ensured, redistribute short-dated <br />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 A. Have a working thermometer certified in accordance with International Laboratory <br />Monitoring Accreditation Cooperation (ILAC) standards or by 150-17025 standards. <br />B. All providers must use either a digital data logger or continuous temperature monitoring <br />system with a detachable probe in a bottle filled with a thermal buffer. <br />C. Thermometers must have the following features: <br />a. A detachable, buffered probe <br />b. An active temperature display that can be easily read from the outside of unit <br />C. Screen shows current temperature, as well as min/max temperatures <br />d. Capacity for continuous monitoring and recording capabilities where the data can be <br />routinely downloaded <br />e. Low battery indicator <br />f. Must use primary thermometer for daily min/max readings, cannot use backup device <br />g, Backup thermometers must also be digital data loggers <br />D. Thermometers should have the following features: <br />a. Alarm for out-of-range temperatures <br />b. Accuracy of +/-1 'F (0.5'C) <br />C. Memory storage of at least 4,000 readings <br />d. User programmable logging interval (or reading rate) at a maximum time interval of <br />every 30 minutes <br />E. 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 />F. 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 />G. Visually review and manually record refrigerator and freezer temperatures twice each day <br />(beginning and end) ensuring that refrigerator temperatures are between 36' and 46' F (2' <br />and 8' C), and that freezer temperature are between S'F and -57'F or lower (between -lS"C <br />and -S0'C). <br />H . 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 LHJ. <br />I. Maintain an ongoing file of temperature logs, and store completed logs for 3 years. Providers <br />must send copies of completed temperature monitoring logs monthly to your LHJ via fax or <br />email. <br />J. Providers should also send copies of their data logger data to LHJs each month with their <br />paper temperature logs. <br />K. 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.