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NC Department of Health and Human Services
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North Carolina Immunization Branch

Emergency Preparedness

Preparation is key to successfully handling an emergency, whether it is a hurricane, unexpected power failure, or a refrigerator or freezer malfunction.

Take the following steps and precautions to protect your vaccines.

Stay prepared for unexpected emergencies:

  • Review and update your routine and emergency vaccine storage and handling plans as needed.
    • Once you’re under pressure, having a written and documented plan will take guesswork out of protecting your vaccine supply. Remember that in flood-prone areas, disaster threats to your facility may continue for days after the initial storm has passed.
  • Ensure staff are familiar with emergency management plans including after-hours roles and

When an emergency strikes:

  • Suspend vaccination activities if possible BEFORE the onset of emergency conditions to allow time to prepare.
  • Shelter vaccines in place, when possible.
  • Move vaccines only when it is apparent you will be without power for an extended amount of time, and it is safe to do so.
  • Know where you will get supplies now as it may be difficult during an emergency.
  • Ensure vaccine supplies are stored off the floor to prevent damage from potential flooding.
  • Create and implement a monitoring/notification system during times of inclement weather or other conditions that might cause a power outage.
  • Test emergency generator(s) and review test log(s) to ensure successful operation.
  • Verify enough fuel is available for generators for at least 72 hours of continuous use.
  • Review vaccine transport guide(s) to verify you have appropriate packing materials to safely store vaccine temporarily.
  • Use a CDC recommended Digital Data Logger (DDL) with a current and valid Certificate of Calibration Testing to monitor temperatures.
  • Place new batteries in your primary and backup digital data loggers.
  • Confirm staff is up to date on Tdap vaccine.

If a power failure occurs:

  • Determine the cause and estimate the time it will take to Vaccines may remain inside a nonfunctioning unit as long as appropriate temperatures are maintained. Monitor your DDL to determine when additional action should be taken.
  • Maintain thermal conditions, do not open the storage unit door until power is restored or it is determined that vaccines must be packed in separate storage containers and/or transported. Storage unit temperature may be maintained with the proper amount of water bottles in a refrigerator and frozen water bottles in a freezer. Have at least a case (24) of 8 or 16.9 fluid ounce frozen water bottles on-site that can be conditioned for transport.
  • Prepare for your emergency procedure to shelter in place or transport after 30 minutes without power, including pre-chilling on-site coolers or notifying the emergency back-up location.
  • Consider the type of vaccine being transported and the storage capacity at the back-up location.
  • Monitor the data logger thermometer to ensure vaccines remain within the appropriate temperature range(s) during transport.
  • Avoid freezing vaccine during transport so not to damage it.
  • Exposure to temperatures outside of the recommended range may damage the immunogenicity and not be visually apparent.
  • Do not wait for refrigerator temperatures to reach 8°C (46°F) or freezer temperatures to reach -15°C (5°F) to begin emergency vaccine procedures, remembering that immediate action is required when temperatures fall outside the recommended range(s).
  • Document date and time vaccines were moved to the back-up location and monitor temperatures in the back-up refrigerator/freezer where vaccines are stored. Back-up storage units must adhere to the same requirements as the primary storage units.

When power is restored:

  • Record the temperature in the unit as soon as possible.
  • Continue to monitor temperatures until they reach the normal 2–8°C range in the refrigerator, or -15°C or colder in the freezer.
  • Record duration of increased temperature exposure and maximum temperature observed.
  • Separate exposed vaccine from new product and continue to store at the proper temperature(s), if possible, remembering that vaccine shipments could be suspended due to road conditions.
  • Mark vaccine exposed to out-of-range temperatures with the date and time and label “DO NOT USE,” move exposed vaccine to approved, working storage unit and contact the Immunization Branch at 1-877-873-6247.

Contact us:

  • Call the Immunization Branch at 1-877-873-6247 with questions.
  • Note we may be closed during times of inclement weather. All voicemail messages left during closure will be returned the following business day or as soon as possible.

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