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Missouri Department of Health and Senior Services
Bureau of Immunizations
4/15/2024
Single dose shipments
Damaged boxes
Storage in a Pyxis © like refrigerator
2. Store vaccines in the central or middle part of the unit, with space between both the vaccine
and the sides/back of the unit.
3. Do not store vaccines in the doors, vegetable or crisper bins, or on the floor of the unit, or
under or near cooling vents.
4. Do not store food or drink in vaccine storage units.
5. Place water bottles or coolant packs throughout the refrigerator and freezer storage units
to:
a. Stabilize or extend temperatures during a power outage,
b. Dampen the effects of frequent opening/closing of door, and
c. Serve as physical barriers preventing the placement of vaccines in areas of the unit
that are at high risk for temperature excursions.
The only exception is if a unit manufacturer indicates water bottles or coolant packs could
negatively impact unit functionality.
6. Rotate stock regularly or when a new shipment arrives so that newer vaccines are stored
behind the soonest-to-expire.
7. Immediately remove any expired vaccine from the storage unit. Bag and label all expired
vaccine as “Do Not Use” until the vaccines are able to be returned.
8. Open only one vial or box of a particular vaccine at a time to control vaccine use and allow
for easier inventory control. For multi-dose vials, indicate on the label the date and time the
vial was reconstituted or first used. Make a tick mark on the label when administered in
order to keep inventory control of the multi-dose vial. Do not discard multi-dose vials of
IPOL (Inactivated Poliovirus Vaccine) before the expiration date on the vial until the vaccine
has expired. Open vials of IPOL cannot be returned or transferred.
9. Store vaccine products with similar packaging in different locations in the storage unit to
avoid confusion and vaccination errors.
10. Limit access to the vaccine supply to authorized personnel only.
11. Install locks on refrigerators and, if possible, the electrical plugs. Label the plugs “Do Not
Disconnect.”
12. Vaccines must be prepared immediately prior to administration.
13. Write the expiration date on the outside of the box so it is easily visible yet not obscuring
vital vaccine information on the box.
14. Check to make sure that refrigerator and freezer doors are shut regularly.
15. Organize your vaccine by age group.
16. VFC, 317 and private stock must be easily distinguished. You may use separate shelves,
separate units, or bin storage.
17. Use open baskets for vaccine organization and air circulation.
18. Arrange vaccines/diluent in rows, allowing for air circulation.
19. Arrange vaccines/diluents centrally at least two to three (2 – 3) inches from walls, ceiling,
floor and door.
Can we store other biologics or medicine in the vaccine refrigerator or freezer? Storing
biologics or medicine is not a recommended practice. This can lead to administration mistakes.
However, if done, the biologics or medicine must be on the lowest shelf in the unit.