It is just as important to maintain the correct temperature in cold boxes and vaccine carriers as it is in your refrigerator. To do this, you should follow the steps below:

• Place an adequate number of conditioned (melting) ice-packs or chilled water bottles in the cold box or vaccine carrier.
• Always place the cold box or vaccine carrier in the shade – never in a sunny place.
• Avoid opening the lid of your cold box or vaccine carrier except when you are removing a vaccine, and close it again immediately afterwards.
• Use the foam pad above the conditioned ice-packs to hold vials during immunization sessions.

If the ice-packs have completely melted

If you find that the ice-packs inside the cold box or vaccine carrier have completely melted during an immunization session, you should follow the steps below:

• Discard all vials of reconstituted vaccines (BCG and measles).
• Check the VVM status of the vaccines, and return those that can still be used to a refrigerator at the correct temperature as soon as possible.
• Place them in the ‘use first’ box, and use them before other vials at your next immunization session.