Non-Emergency Vaccine Transport

General Principles of Transport

Vaccine transport to off-site or satellite facilities is different from both shipping and emergency transport. Shipping usually involves a professional carrier and a longer distance and timeframe for moving vaccines between locations. Emergency transport usually involves relocating vaccines to protect them when a facility's ability to store vaccines is compromised because of a power outage, for example.

Vaccine Transport

Vaccines should not be routinely transported. In instances where non-emergency transportation of vaccines is necessary, take precautions to protect the vaccines by using appropriate packing materials and procedures that provide the maximum protection.

☑ 🖍 Use a transport temperature monitoring log to document temperatures and how long the vaccine is in the portable storage container. Regardless of how the vaccine is transported (car, professional carrier, snowmobile, boat, small plane, etc.), if vaccines are packed by a provider, the BUD should be applied using the manufacturer's guidance. For example, if a frozen vaccine may be stored at refrigerated temperatures for 24 hours, transport is included in this time frame.

☑ 🖍 Ensure your facility has enough supplies to transport your largest annual inventory (e.g., during respiratory virus season). Appropriate materials include:

• Vaccine transport containers, such as
  • Portable vaccine refrigerator/freezer/ultra-cold freezer units (preferred option).
  • Qualified containers and packouts1 if appropriate portable refrigeration units are not available.
  • Soft-sided containers specifically engineered for vaccine transport are acceptable. Do not use commercially available soft-sided food or beverage coolers, as most are poorly insulated and are likely to be affected by room or outdoor temperatures.
• Coolant materials, such as
  • Phase change materials (PCMs) that can be conditioned between 4°C and 5°C (39°F and 41°F).
  • Conditioned2 frozen 16.9- or 8-ounce water bottles.
• Insulating materials such as bubble wrap and corrugated cardboard—enough to form two layers per container.
• TMDs for each vaccine transport container.

Equipment and Materials for Vaccine Transport

It is always safest to have vaccines delivered directly to a facility with a vaccine storage unit ready to receive the shipment, but this is not always possible. If necessary, vaccines may be transported using a portable vaccine refrigerator with a temperature monitoring device placed with the vaccines. If a portable vaccine refrigerator is not available, qualified containers and packouts with a TMD in each container can be used. For transport to an off-site clinic, bring only what is needed for the workday.

Non-Emergency Transport Systems

Coolants for Transport

PCMs between 4°C and 5°C (39°F and 41°F) can also be purchased to maintain proper temperatures. Follow the manufacturer's instructions for use to reduce the risk of freezing vaccines during transport.

Do not use frozen gel packs or coolant packs from original vaccine shipments to pack refrigerated vaccines. They can still freeze vaccines even if they are conditioned or appear to be "sweating."

Transport Planning and Preparation

Improper packing for transport is as risky for vaccines as a failed storage unit.

☑ 🖍 Include vaccine packing and transport guidance in routine and emergency storage and handling sections of the facility's SOP.

At a minimum, include the following in all staff-facilitated transport procedures and protocols:

• In advance, identify trained staff to pack vaccines, as well as primary and backup drivers and vehicles for transport.
• Consider renting a refrigerated truck for transporting a large quantity of vaccines or transporting vaccines for an extended distance.
• Take an inventory of vaccines and record actions taken to protect the vaccines during transport.
• Open storage unit doors only when necessary and only after completing all preparations for packing and moving vaccines.
• If using a company or personal vehicle, transport vaccines only inside the passenger cabin, not in the trunk or truck bed, where it may be too hot or too cold.
• Move transport containers directly to a vehicle that is already at a comfortable temperature, neither too hot nor too cold.
• Avoid leaving containers in areas exposed to direct sunlight.
• Check vaccine temperature upon arrival at the alternative vaccine storage facility, and immediately store vaccines at recommended temperatures.
• Check with the immunization program for additional guidance and resources on emergency transport of vaccines, particularly in major emergencies.

Transporting Opened Multidose Vials

In rare circumstances, a partially used vial may need to be transported to or from an off-site/satellite facility operated by the same provider. In these instances, the cold chain must be properly maintained, and use after transport must align with expiry date or BUD. However, a partially used vial cannot be transferred from one provider to another, or across state lines. Contact your immunization program for specific state or local regulations impacting this activity.

Transporting Predrawn Syringes

It is best practice to transport vaccine in unopened vials or manufacturer-filled syringes. However, there may be rare instances, such as large off-site vaccine clinics, when the only option is to transport vaccines in predrawn syringes. Predrawn syringes should be properly labeled and stored according to the manufacturer's guidance. Additional information on predrawn vaccine is found in Section 5.

Transporting Vaccine Diluents

☑ Transport diluents with their corresponding vaccines to ensure there are always equal amounts of vaccines and diluents for reconstitution. Follow the manufacturer's guidance for specific temperature requirements.

If diluents stored at room temperature (20°C to 25°C [68°F to 77°F]) are going to be transported with refrigerated vaccines, they should be refrigerated in advance for as long as possible so they do not raise the container temperature when placed with refrigerated vaccines.

Transporting Frozen Vaccines

☑ If frozen vaccines must be transported, use a portable vaccine freezer unit or qualified container and packout that maintains temperatures between-50°C and-15°C (-58°F and +5°F) or -90°C and -60°C (-130°Fand-76°F) for ultra-cold transport.

Follow these steps for transporting frozen vaccines:

• Place a TMD (preferably with a buffered probe) in the container as close as possible to the vaccines.
• Immediately upon arrival at the destination, unpack the vaccines and place them in a freezer at a temperature range between -50°C and -15°C (-58°F and +5°F) or -90°C and -60°C (-130°F and -76°F) for ultra-cold freezer storage. Any stand-alone freezer that maintains these temperatures is acceptable.
• Record the
  • Time that vaccines are removed from the storage unit and placed in the transport container.
  • Temperature during transport.
  • Time at the end of transport when vaccines are placed in a stable storage unit.

☑ Do not use dry ice, even for temporary transport or storage.

Dry ice might expose frozen vaccines to temperatures colder than -50°C (-58°F).

Temperature Monitoring During Transport

☑ Use a continuous TMD, preferably a DDL with the capability to measure minimum/maximum temperatures, for monitoring and recording temperatures while transporting vaccines.

• Use a TMD or DDL that has an accuracy of ±0.5° C (±1° F).
• Place the buffered temperature probe directly with the vaccines.
• Keep the TMD display on top of vaccines so the temperature can be easily seen.
• Record the time and minimum/maximum temperature at the beginning of transport.

Temperature Monitoring After Transport

☑ 🖍 Immediately upon arrival at the destination, store vaccines in an appropriate storage unit with a TMD.

Be sure to follow these guidelines for monitoring and recording storage unit temperature:

• If the device displays minimum/maximum temperatures, this information should be checked and recorded as soon as the vaccines are stored.
  • 🖍 VFC providers must review and document temperature data every hour using a DDL with a digital display and a probe in buffered material.
• If the device does not display minimum/maximum temperatures, then the current temperature should be checked and recorded at least twice (at the start and end of the workday).

If vaccines cannot be stored in an on-site storage unit, they should be kept in the portable vaccine storage unit using the following guidance:

• If using a DDL that records minimum/maximum temperatures, only check and record temperatures each time the portable vaccine storage unit is opened.
• If the TMD measures current temperatures only, place the probe as close as possible to the vaccines, and check and record temperatures hourly.
• Keep the container closed as much as possible.
• In off-site clinic settings, each person preparing and administering vaccines should remove no more than one multidose vial or 10 doses at a time.

VFC Reminder

VFC providers and others who administer vaccines purchased with public funds should contact their immunization program for state-specific requirements related to vaccine transport.

Icon Guide

☑ CDC Guidance

🖍 VFC provider requirement

★ Best Practices

⚠︎ Important Reminders