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c. Store only vaccines and medical equipment D. Do not store food and beverages in a vaccine storage unit. Vaccine Storage A. Rotate vaccine stock by placing vaccines with shorter expiration dates in front of those with Practices longer expiration dates; check for short-dated vaccine every week. B. Notify the Local Health Jurisdiction (LHJ) of any vaccine doses that will expire before they can be administered, preferably three months before the expiration date. Only with the approval and direct guidance of the LHJ and only if the cold chain can be ensured, redistribute short- dated vaccines to high-volume providers who are able to administer it before it expires. C. Ensure that the storage and handling of vaccine is in accordance with the manufacturer's specifications and the guidelines as outlined in the CDC Vaccine Storage and Handling Guidelines. Temperature A. Have a working thermometer certified in accordance with International Laboratory Monitoring Accreditation Cooperation (ILAC) standards or by 150-17025 standards. B. Providers enrolling in the Program for the first time are required to use either a digital data logger or a continuous temperature monitoring system with a detachable probe in a bottle filled with a thermal buffer. C. By 2018, all providers must use either a digital data logger or continuous temperature monitoring system with a detachable probe in a bottle filled with a thermal buffer. Providers should replace thermometers not meeting these specifications when existing thermometers are due for recalibration or replacement. The thermometers should have the following features: a. Alarm for out-of-range temperatures b. Current temperature, as well as minimum and maximum temperatures c. Reset feature d. Low battery indicator e. Accuracy of +/-1 ° F (OS C) f. Memory storage of at least 4000 readings g. Device will not rewrite over old data and stops recording when memory is full h. User programmable logging interval (or reading rate) D. Have a current certificate of calibration for each thermometer used to monitor vaccine storage temperatures. Depending on manufacturer requirements, thermometers must be re- certified either every year or every other year. E. Post a temperature log on the vaccine storage unit door or nearby in a readily accessible place. Please use the state program's paper temperature log. F. Visually review and manually record refrigerator and freezer temperatures twice each day (beginning and end) ensuring that refrigerator temperatures are between 35° and 46° F (2° and 8° C), and that freezer temperature are between 5°F and -58°F or lower (between -15°C and -50°C). G. Take immediate action to correct improper vaccine storage conditions, including inappropriate exposure to light and inappropriate exposure to storage temperatures outside the recommended ranges. Document actions taken on the temperature adjustment tracking log. Inform your Local Health Jurisdiction (LHJ). H. Maintain an ongoing file of temperature logs, and store completed logs for 6 years. Providers must send copies of completed temperature monitoring logs monthly to the local health jurisdiction via fax or email. I. Providers should also send copies of their data logger data to LHJs each month with their paper temperature logs. J. Failure to comply could result in the discontinuation of the provision of vaccine. Vaccine A. Ensure that clinic staff does not pre-draw vaccines into syringes. Preparation B. Draw vaccine only at the time of administration to ensure that the cold chain is maintained and the vaccine is not inappropriately exposed to light. I, ,