Vaccine Temperature Log For Refrigerator - Fahrenheit
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4Temperature Log for Refrigerator — Fahrenheit
F
Month/Year:___________________ Days 1–15
º
Take Action!
Completing this temperature log: Check the temperature in the refrigera-
If temperature is too warm (above 46
F) or too cold (below 35
F):
o
o
tor compartment of your vaccine storage unit at least twice each working day.
1. Store the vaccine under proper conditions as quickly as possible.
Place an “X” in the box that corresponds with the temperature, the time of the
2. Temporarily mark exposed vaccine “do not use” until you have verified
temperature reading, and your initials. Once the month has ended, save each
whether or not the vaccine may be used.
month’s completed form for 3 years, unless state or local jurisdictions require a
3. Call the immunization program at your state or local health department
longer time period.
and/or the vaccine manufacturer to determine whether the potency of the
If the recorded temperature is warmer than 46ºF or colder than 35ºF: this
vaccine(s) has been affected: (_______) ______________________.
represents an unacceptable temperature range. You must
take action!
4. Document the action taken on the reverse side of this log.
Staff Initials
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15
Day of Month
Room Temp.
Exact Time
am pm am pm am pm
am pm am pm
am pm am pm am pm am pm am pm am pm am pm am pm am pm
am pm
*Write any unacceptable
temps (above 46
F or below
o
35
F) on these lines.
o
Then take action!
Danger! Temperatures above 46ºF are too warm!
Write any unacceptable temperature on the lines above* and call your state or local health department immediately!
46ºF
Danger! Temperatures above 5
o
F are too warm!
Write any unacceptable temperature on the lines above* and call your VFC Rep immediately!
45ºF
44ºF
43ºF
42ºF
41ºF
40ºF
39ºF
38ºF
37ºF
36ºF
35ºF
Danger! Temperatures below 35ºF are too cold!
Write any unacceptable temperature on the lines above* and call your state or local health department immediately!
See back for “Vaccine Storage Troubleshooting Record”
Adapted with appreciation from California Department of Public Health
• Item #P3037F (8/11)
Technical content reviewed by the Centers for Disease Control and Prevention, August 2011.
Distributed by the Immunization Action Coalition • (651) 647-9009 • • •
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