Vaccine Emperature Log For Refrigerator - Fahrenheit printable pdf download

Temperature Log for Refrigerator – Fahrenheit

Month

Year

VFC PIN or other ID #

Page 1 of 3

DAYS 1 – 15

Facility Name

Monitor temperatures closely!

Take action if temp is out of range – too warm (above 46ºF) or too cold (below 36ºF).

1. W rite your initials below in “Staff Initials,” and note the time in “Exact Time.”

1. L abel exposed vaccine “do not use,” and store it under proper conditions as quickly as possible.

2. R ecord temps twice each workday.

Do not discard vaccines unless directed to by your state/local health department and/or the

3. R ecord the min/max temps once each workday – preferably in the morning.

manufacturer(s).

4. P ut an “X” in the row that corresponds to the refrigerator’s temperature.

2. R ecord the out-of-range temps and the room temp in the “Action” area on the bottom of the log.

5. If any out-of-range temp, see instructions to the right.

3. N otify your vaccine coordinator, or call the immunization program at your state or local health

6. A fter each month has ended, save each month’s log for 3 years, unless state/local

department for guidance.

jurisdictions require a longer period.

4. D ocument the action taken on the “Vaccine Storage Troubleshooting Record” on page 3.

Day of Month

Staﬀ Initials

Exact Time

Min/Max Temp

(since previous reading)

Danger! Temperatures above 46ºF are too warm! Write any out-of-range temps and room temp on the lines below and call your state or local health department immediately!

Aim for 40

Danger! Temperatures below 36ºF are too cold! Write any out-of-range temps and room temp on the lines below and call your state or local health department immediately!

Write any out-of-range

temps (above 46ºF

or below 36ºF) here:

Room Temperature

If you have a vaccine storage issue, also complete “Vaccine Storage Troubleshooting Record” found on page 3.

Adapted with appreciation from California Department of Public Health

Technical content reviewed by the Centers for Disease Control and Prevention

Immunization Action Coalition

651 - 647 - 9009

Saint Paul, Minnesota

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