Vaccine Storage & Handling Online Ordering of Vaccine - - PowerPoint PPT Presentation

Vaccine Storage & Handling Online Ordering of Vaccine

Objectives for Storage & Handling of Vaccine

After viewing this presentation, you will:

• Understand the Vaccine Cold Chain
• Understand the CDC & NSIP requirements for vaccine

storage units

• Temperature control of your vaccine storage units
• Separating specific funding sourced vaccine in your

storage unit

• Understand the difference between “Wasted Vaccine”

and “Spoiled Vaccine”

• What actions to take when you see an alarm on the

data logger

• Emergency Transport of Refrigerated Vaccines

The Vaccine Cold Chain

CDC/NSIP Storage Unit Requirements

VFC Vaccine Storage Units

• The CDC/NSIP highly recommends stand-alone refrigerators and

freezers for VFC providers to store VFC vaccine.

• NSIP requires any provider replacing a combination refrigerator or

freezer to purchase stand-alone units. This ensures they will not have any other temperature excursions and waste vaccine.

• NSIP must be notified that a new storage unit has been purchased .
• After purchasing and installing the new unit, providers must get 5

days of temps to ensure the unit is stable to put vaccine in it.

• In Southern Nevada, notify Dhon Urg that you are getting a new

unit in. Dhon will approve the new unit after 5 days of temps. In Northern Nevada, contact Glenn Witt (Vaccine Manager) or Dr. Pam Forest (Quality Assurance Manager.)

CDC/NSIP Storage Unit Requirements

VFC Vaccine Storage Units

• A new storage unit must be large enough to store vaccine

at the busiest time of the year without limiting air flow to the vaccine.

• A solid door on the refrigerator is better than a glass door

when power outages happen.

• Should not have digital temperature controls (unless the

unit is pharmaceutical grade). Dial type temperature controls give more accurate changes.

• The new unit should have sufficient room to store water

bottles to stabilize temperatures.

• Dorm Style refrigerators are NEVER acceptable!

Storing Separate Funded Vaccine Types

• Always separate private vaccine from VFC/CHIP

vaccine in your fridge and freezer.

• Store private vaccine on separate shelves from the VFC
• Mark the shelves with “Private” or “VFC”
• If you must store private vaccine on the same shelf as VFC Vaccine,

ensure the box the vaccine is in is marked appropriately

Expired or Spoiled Vaccine vs Wasted Vaccine

• Expired or Spoiled Vaccines: Nonviable vaccine in it’s original container (vial
• r syringe) that is able to be returned to McKesson for excise tax credit. This

includes expired vaccine or vaccine that has been “Spoiled” due to:

• Natural disaster/power outage
• Refrigerator too cold or too warm
• Failure to store properly upon receipt
• Spoiled in transit
• Mechanical failure
• Recall
• Remove expired or spoiled vaccine from the storage unit and label “Do Not

Use”

• Fill out Incident Report on what happened and what vaccines were effected
• Complete the UPS Label Request for Spoiled/Expired vaccines and fax to NSIP

with the Incident Report.

• **Open multi-dose vials such as Polio, Zoster that have been spoiled cannot

be returned to McKesson. Throw in Sharps Container** Unopened vials can be returned.

Expired or Spoiled Vaccine vs Wasted Vaccine

• Wasted vaccines are: Nonviable vaccine that is

NOT able to be returned to McKesson due to:

• Vaccine drawn into a syringe but not administered
• Vaccine in open vial but doses not administered
• Compromised vial a broken vial, lost vial, or vial integrity/sterility

compromised

• **Expired “open” multi-dose vials of Polio or Zoster must cannot be

returned to McKesson**

Temperature Monitoring with Data Loggers

• NSIP has been providing free of charge the Tred30-

7R Log Tag temperature recorder since 2013.

• Pros
• Downloads data over email system to

multiple people

• Much more accurate than regular

min/max thermometers

• Provides clinics staff, NSIP, and the

manufacturers detailed information about temperatures the vaccine has been exposed to and for how long

• Easy to use
• Comes with a 2 year Certificate of Calibration
• Battery Operated

Temperature Monitoring with Data Loggers

• Cons:
• Program on the computer for down loads must be under a specific user

profile

• No audible alarm, only visual
• For some users, the digital readings are too small
• If provider IT departments complete security

updates, the program setting can be erased

Actions To Take For Temperature Alarms

When you see an alarm, you must take IMMEDIATE action! . STOP VACCINATING!!!

• 1. Immediately download (and send) data to the State
• 2. Analyze the data, and adjust the storage unit’s temperature

accordingly

• 3. Contact the manufacturers
• 4. Complete a Vaccine Incident Report

Temperature Monitoring with Data Loggers

• What is wrong with this picture?

Temperature Monitoring with Data Loggers

• This graph shows min/max temperature checks

Backup Thermometers are a CDC/NSIP Requirement

• Backup Thermometers
• As of January 2015, the CDC requires that all providers

have a backup thermometer on hand.

• NSIP cannot supply these to the providers.
• It is not required to be a Data Logger, but it must meet the

following standards:

• Digital display on the outside of the storage unit.
• Detachable probe in a bottle filled with thermal buffer

such as glycol.

• Has an alarm alert for out of range temperatures
• Has a low battery indicator
• Provides min/max temperatures

Backup Thermometers are a CDC/NSIP Requirement

• Backup Thermometer Requirements (continued)
• Comes with a Certificate of Calibration that calibration was performed by an

ILAC/MRA accredited laboratory or testing conforms to ISO 17025 requirements

• This backup thermometer can be stored in a convenient location but NSIP

recommends keeping the probe in glycol solution in the refrigerator so it is conditioned.

• In 2018, the CDC will be making a requirement that all backup

thermometers have to be a data logger.

Emergency Transport of Refrigerated Vaccine

• When power will be out longer than 2 hours at your

clinic, you need to move the vaccines to another location.

• Always use a hard sided coolers or the Styrofoam

vaccine shipping containers that came from McKesson.

• You will need the following supplies to pack the

vaccines in the coolers

• 16 oz bottles of water that have been frozen
• Bubble wrap for insulation
• Corrugated cardboard cut to fit the dimensions of the cooler
• Data logger for temperature monitoring before, during and after transport
• f the vaccine

Emergency Transport of Refrigerated Vaccine

Condition frozen water bottles

• Use 16 oz water bottles for medium/large

coolers or 8 oz water bottles for small coolers

• Condition the frozen bottles by placing them

in water or running under water. You want to see water starting to form near the surface

• f the bottle and it spins freely.
• CDC recommends NOT using the coolant

packs from the original shipping container.

• After the bottles are conditioned, line the

bottom of the cooler with the water bottles. Place bubble wrap over the water bottles so you have about an inch of of layer. Then place a piece of cardboard on top of the bubble wrap

Emergency Transport of Refrigerated Vaccine

Place another open layer of bubble wrap in cooler on top of the cardboard and pack the vaccines on that.

• Place the glycol bottle for the data logger

in the center of the vaccines so you get an accurate measure for temperatures. Place another layer of bubble wrap

• ver the vaccines then a layer of

cardboard over that.

Emergency Transport of Refrigerated Vaccine

Lastly, place another layer of conditioned water bottles on the top layer of cardboard. Close the lid to the cooler ensuring the probe wire comes out to plug into the data logger. Start the data logger so it is recording the temps.

• This packing system has been tested by the CDC Storage and Handling Team
• It will keep your refrigerated vaccines at the proper temperatures up to 8

hours.

• If you had a temperature excursion during the transport, Mark the vaccines

“Do Not Use” and store at the appropriate temperatures.

• Contact the manufacturers and NSIP until you know the vaccines are still

good for use.

VFC Vaccine Online Ordering Through NV WebIZ

Objectives for Online Ordering through NV WebIZ

After viewing this portion of the presentation you will:

• Understand the level requirements for both your clinic and

staff to be at in NV WebIZ to place orders

• Understand how to reconcile in NV WebIZ if your clinic is

using the HL7 connection

• Understand where to go in NV WebIZ to place an order
• Understand how to receive a shipment into inventory
• Understand how to search for an order that you placed
• Understand how to place a return through NV WebIZ

Place a New Order

• Before placing an order, you MUST reconcile the prior

months inventory and close that inventory

• If you use an HL7 connection, you must complete your

aggregate reporting of doses administered and close the reconciliation

Place a New Order

• Go to the Vaccine Orders Screen
• Then click on “Add New Vaccine Order”

1 2 3 4

Place a New Order

• Click on the arrow button to pull down the clinic

name you are ordering for.

• Then click next

1 2

Place a New Order

• You will go through another screen confirming
• Shipping addresses and hours for delivery. If anything is incorrect, fill out a “Provider

Change Form” and fax or email it to NSIP immediately. Do not proceed with the

• rder until the items are fixed.
• If everything is correct, then click on the box at the bottom certifying the information

is correct

• Then click “Next” at the top

1 2

Place a New Order

• This is the new screen for ordering vaccines since the last WebIZ update.
• When you see the order status as “IN WORK”, this means that the order is still in your WebIZ profile and

has not been sent to the VFC program. You can save your work and come back to it at a later time.

• Type in which vaccine you want to order. A pick list will show and you can pick the vaccine and

presentation you want.

Place a New Order

• After selecting the vaccine you must ensure the proper intent shows (Pediatric vs. Adult).
• Then put in how many packages of the vaccine you want. This automatically populates

the doses per package, total doses ordered and costs.

• Click on “Add to Order”

Place a New Order

• After you added the vaccine to the order, your screen looks like this.
• Click on “Update” and it saves your work.

Place a New Order

• When you are finished selecting the vaccines you want, you must submit the order to the

VFC Program.

• Click on the green arrow and select “Submit to VFC Program. The order will NOT come to

NSIP if you do not complete this step.

1 2

Place a New Order

• After you have sent the order to NSIP for consideration, your order status changes to

“Submitted for Approval”

• Once I have approved your order, the order status will change to “Approved” and you

will receive the fax confirmation from Tammy Brown that your order has been filled.

Receiving a Shipment into Inventory

• When your vaccine shipment arrives:
• Receive them into inventory in WebIZ – this adds them to your on-hand

inventory

• Do not manually add publicly purchased vaccine shipments to your

WebIZ inventory – use the Receive Shipment function

Receiving a Shipment into Inventory

• Go to the On-Hand Inventory Screen
• Click the Pending VTrckS Shipments Link.

Receiving a Shipment into Inventory

• Find the vaccine you have in the shipping container
• n this report and click Receive.

Receiving a Shipment into Inventory

• NV WebIZ will check for a potential duplicate lot

number vaccine in your inventory

• Follow the prompts to continue to add the vaccine to your inventory
• If the new vaccine NDC and lot numbers is not a

match to any others in your inventory, click Proceed with Create. It will add this new lot number to your inventory.

• Repeat this process for each vaccine in the

shipping report in WebIZ.

Receiving a Shipment into Inventory

• You can confirm the newly added vaccine(s) are in

you on-hand inventory, click On-Hand.

Receiving a Shipment into Inventory

• Look for the vaccines you just received.

Conclusion

• There is a module for Returning Vaccines under the

inventory module as well.

• Training videos and user guides an be found on the

State VFC Website under VFC Program and then Training & Education. The guides and video are not updated to reflect the new NV WebIZ screens. The state VFC website is: http://dpbh.nv.gov/Programs/VFC/VFC_-_Home/

• If you have questions or issues you can contact the
• nline ordering help desk at (775) 684-5939 (Tammy

Brown) or (775)684-3462 (Glenn Witt)

• We also have a online ordering help desk email:

nvizonlineorders@health.nv.gov