Box 6.3  Guidelines for loading a vaccine refrigerator

• Freeze and store ice-packs in the freezer compartment.
• Store all the vaccines and diluents in the refrigerator compartment.
• If there is not enough space, diluents can be stored at room temperature.
• It is important to chill diluents by putting them in the refrigerator for several hours before you use them to reconstitute BCG or measles vaccines.
• Arrange the boxes of vaccine so air can move between them.
• Keep boxes of freeze-sensitive vaccines (pentavalent, PCV10, TT and HepB) away from the freezing compartment, the refrigeration plates, and the side or bottom linings of the refrigerator, where they might become frozen by accident.
• Keep melted ice-packs or ordinary plastic water bottles filled with chilled water on the bottom shelf of a front-loading refrigerator. These help to keep the temperature cool in case of a power cut.
• Store vaccines in locations appropriate to the style of refrigerator you use. For a front-loading refrigerator with the freezing compartment on the top (Figure 6.12), vaccines should be stored as follows:
  • OPV and freeze-dried vaccines (BCG and measles) on the top shelf
  • all other vaccines on the middle shelves
  • diluents on the bottom.
• Some refrigerators have ice-packs lining the freezing compartment. This type is called an ice-lined refrigerator (Figure 6.13). In this type, all the vaccines should be stored in the basket provided with the refrigerator as follows:
  • measles vaccine, BCG and OPV are stored in the bottom only
  • freeze-sensitive vaccines (pentavalent, PCV10, TT and HepB) in the top only.