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Management of Immunizing & Other Biologic Agents
This section presents information on the purchasing, storage, administration, and disposal of immunizing agents.
Purchase & Receipt of Immunizing Agents
Immunizing agents generally should be procured from governmental sources. Some State and/or local health departments provide immunizing agents at no charge. This source should be investigated first. Commercial sources may be used when their prices are more economical than governmental sources or when urgently needed items are not immediately available from the Government. Government sources of supply are:
- U.S. Public Health Service
Supply Service Center
Perry Point, MD 21902 - Veterans Administration Supply Depot (134E)
P.O. Box 27
Hines, IL 60141 - Defense Personnel Support System
2800 South 20th Street
Philadelphia, PA 19101 - General Services Administration (GSA)14
- State and local health departments
- The Centers for Disease Control and Prevention
Catalogues are available from the above sources and contain all necessary ordering and shipping information.
In 1994, the Department of Health and Human Services implemented the Vaccines for Children (VFC) program that provides free vaccines to children who are on Medicaid, are without insurance or underinsured, or are Indian/Alaskan Natives. Many Job Corps youth may be eligible for this program. Centers are encouraged to contact their State/local health departments to determine vaccine availability under this program.
Storage
The efficacy of vaccines and other immunization agents depends upon the integrity of the antigens, which they contain. Storage at improper temperatures may result in a rapid loss of potency and/or antigenicity. Thus, vaccines that have not been properly stored may not protect the recipients. For example, children vaccinated with live, attenuated measles vaccine that has been stored on refrigerator door shelves (where temperatures fluctuate) may not be protected and may develop clinical measles in later years. Therefore, it is essential that all vaccines be refrigerated (or frozen when this form of storage is recommended) immediately upon receipt, according to the manufacturer's instructions.
The following aspects of vaccine management are basic to a complete program. To ensure purity, potency, and unnecessary loss of vaccine, it is vitally important to follow prescribed rules.
- Follow the storage and handling instructions contained in the manufacturer's package inserts.
- Assign responsibility for vaccine storage management to one individual in each facility where vaccine stocks are kept.
- Monitor and maintain records of temperature readings of freezers and refrigerators at all times, including nights, holidays, and weekends. A telephone call list should be available in case of emergency.
- Never store vaccine on refrigerator door shelves.
- Maintain inventory control records that permit monitoring of individual lot numbers.
- Rotate vaccine stocks so as to use lots with the closest expiration dates first. Never use outdated vaccine.
- Establish an alert/notification system to make sure that vaccine shipments are expected and, if not received on schedule, the distributor is notified.
- Never store more vaccine than necessary, especially in areas with questionable monitoring capabilities.
Administration
The Needlestick Safety and Prevention Act (PL 106-430), signed into law on November 6, 2000, requires employers to identify, evaluate, and implement safer medical devices. The Act also requires maintenance of a sharps injury log and mandates involvement of non-managerial healthcare workers in evaluating and choosing devices.
Requirements of this Act apply to all blood drawing, injections and immunizations administered on center [see PRH-5, Section 5.13 (R8)].
Disposal
Vaccines nearing the expiration date may be returned for credit or exchange if the manufacturer agrees to accept them. Otherwise, live vaccines must be autoclaved for 20 minutes, incinerated, or buried (e.g., sanitary landfill). Inactivated vaccines and toxoids should be disposed of as suggested by the manufacturer.
14 Orders should be placed with GSA Regional Office for the GSA region in which a center is located.