1. Preventing Vaccine Wastage through Site Visits
Colorado Vaccines for Children Program

2. Why an initial site visit?
Basically the Colorado Vaccines for Children (VFC) program wanted to properly instruct our VFC providers in cold chain management, storage and handling, and vaccine inventory management procedures.

3. OR
We at the Colorado VFC program wanted to instruct our new VFC providers on proper procedures before they developed the infamous “bad” procedures. We have all come to know and love.

4. Advantages of a doing an initial site visit
It allows a representative of the Vaccines for Children (VFC) Program to inspect the refrigerator and freezer at the providers facility.
It can also allow a representative of the VFC program to properly instruct the personnel at the facility in proper cold chain management, and its importance in maintaining viable vaccine.
And finally, a representative of the VFC program can instruct VFC provider personnel in proper ordering procedure, vaccine inventory management, and vaccine return policy.

5. Inspection refrigerator and freezer
Things to look for during inspection
Determine if refrigerator and freezer are in good shape and capable of storing vaccine.
Check temperatures in both refrigerator and freezer to verify they are both with the excepted temperature ranges.
What to do if temperatures are out of range.

6. Cold Chain Management
Explanation of what Cold Chain Management consists of.
Beginning with receipt of vaccine order.
Staff who will be handling vaccine.
Storage of vaccine in proper area
What to do with vaccine if viability of vaccine is questioned.

7. Tools to assist in cold chain management
Temperature logs
Handouts
Thermometers
Temperature tracers (recorders)
Orange warning tags

8. Emergency Plan KEEP IT SIMPLE KEEP IT UPDATED One page front & back
Include contact information
Location of supplies to transport or store vaccine.
Instructions on how-to properly store the vaccine
Where to take vaccine if necessary
KEEP IT UPDATED
Keep contact information current
Verify supplies are where they are suppose to be
Update the vaccine packaging instructions if necessary

9. Proper ordering, inventory management, and vaccine return
Monthly ordering
Inventory management
Vaccine return

10. Who received site visits
New VFC enrollees for
2002
2003
2004

11. Data compared by year Number of site visits received by providers.
Look at the number of doses wasted.
Determine wastage in dollar amount.

12. Number of Total Site Visits

13. Number of New Providers & Site Visits Combined

14. Doses Wasted

15. Wastage by Year ($)

16. Where do we go from here
Continue storage and handling visits for new providers
Identify providers that hire new staff and are in charge of the VFC vaccines within their offices
Regional presentations

17. Conclusion
So by addressing the issues of cold chain management, storage and handling, and inventory management procedures.
You can make a difference in vaccine wastage.

18. Contact Information
Rudy Balquin
Colorado Immunization Program