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Availability And Storage Of Vaccines In Community Pharmacies
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Factors Affecting Temperature Variation
There
are many factors that can alter the temperature of vaccines inside a
refrigerator or a freezer. The only way to be sure of temperature
stability is to do twice daily testing and to record the data.
Temperatures can vary in the storage unit based on the contents or load,
the seasonal temperature, how often the door is opened or left ajar,
and power interruptions. It is recommended not to open the door more
than four times a day, as this exposes the vaccines to temperature
Equipment and Maintenance
a. Thermometers
Thermometers
have different calibrations and accuracies thus ask the manufacturer
for the accuracy of your specific thermometer, ensuring it has a
calibration accurate within +/- 1°C. The only thermometer recommended
for domestic vaccine storage units are min/max thermometers that are
properly monitored. These thermometers monitor the temperature
constantly and can provide the duration of time the unit has operated
outside of the recommended temperature range. Min/max thermometers still
must be checked twice a day. Record the current temperature as well as
the min and max temperature since the last time it was reset. The
thermometer must be reset each time a reading is taken in order to clear
the min/ max temperatures. You may want to consider an alarmed min/max
thermometer regardless of if you store a large or small supply of
vaccinesin your unit in order to ensure there are no after-hours
breaches in the cold chain that would go unnoticed until the next day.
Always properly record and store the daily thermometer readings and have
them available for audit if a cold chain incident occurs. In the event
of a look-back, retain the temperature logs for 2 years.
Thermometer
placement is also essential! They should be placed in the center of the
unit away from the walls, door or fan and adjacent to the vaccines in
the vaccine box on the middle shelf.
Back Up Equipment
Always
anticipate that vaccine storage equipment may fail. Arrange to have a
backup generator available or another facility with proper equipment
where the vaccines may be temporarily stored.
Daily, Weekly, Quarterly, and Annual Equipment Maintenance Tasks
Regular
maintenance of all equipment is recommended to maintain optimal
functioning thus preventing equipment malfunctions. Recording that
maintenance tasks were completed is as important as performing the
tasks. Always record the date equipment was installed, when repairs and
routine cleaning tasks were done, the manufacturer’s instructions for
routine maintenance, and the contact information for the service
provider.
1.5 Role of Pharmacists in Vaccine Utilization
The
effective utilization and successful routine immunization is influenced
by varying factors which could aid or hamper the process. One of such
factors is the role that could be played by community pharmacists. These
roles are multifaceted and are discussed below.
Pharmacists as vaccine educators
Community
pharmacists are valuable sources of information for patients. As
vaccine educators, pharmacists act to educate and recommend to the
patients the importance of and need for receiving vaccinations.
Physician views toward the community pharmacist’s role in patient
advocacy include assisting physicians in monitoring pharmacotherapy, and
providing patient counseling and medical information (Bradshaw and
Doucette, 1998; Owens et al., 2009) The coordination and education
regarding the importance of receiving routine and recommended
vaccinations, and the vaccine product itself, would fall into this view
of community pharmacists as sources of information. As discussed
earlier, pharmacists have been trained in providing clinical services
and patient communication; it is only appropriate that they employ this
training in advocating vaccinations. Pharmacist-provided patient vaccine
education, screening, and recommendations have been shown to increase
vaccination rates (Fuchs, 2006).
Pharmacists have been successful in
their role as vaccine educators by screening patients and providing
recommendations to patients and providers. As providers of medication
therapy management and a source of patient medication records, community
pharmacists are able to identify patients at risk for
vaccine-preventable diseases through use of pharmacy data and patient
interviews (Kassam, et al., 2001). Community pharmacists also educate
the community through awareness campaigns and distributing literature on
the need for vaccination and where to obtain the needed vaccinations.
Using a combination of screening pharmacy records, distributing vaccine
literature, and urging vaccination, community pharmacists in the Isle of
Wight, England, vaccinated 9.7% of all patients who received influenza
vaccine on the island during the 2010–2011 influenza seasons. They also
noted that it was a pharmacy staff reminder that led to the initiation
of two-thirds of these vaccinations (Warner, et al., 2013). Similar
results exist for pharmacist-driven interventions for the zoster
vaccine. Pharmacists and pharmacy staff who promoted the zoster vaccine
and provided personal selling and patient education were able to
increase the number of zoster vaccinations compared with when there was
no pharmacist intervention (Teetre, et al., 2014; Wang, et al.,2013).
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