Box 6.4 Guidelines for loading cold boxes and vaccine carriers

• At the beginning of the day of the immunization session, take all the frozen ice-packs you need from the freezer compartment of the refrigerator and close the door.
• Allow the frozen ice-packs to sit at room temperature until the ice begins to melt and water starts to form. This is important because if the ice packs are too cold, freeze-sensitive vaccines may be damaged by freezing.
• Check to see if each ice-pack has been prepared properly by shaking it and listening for the sound of water moving around the ice inside. Ice-packs in which the ice has begun to melt are called conditioned ice-packs.
• Put conditioned ice-packs against each of the four sides of the cold box or vaccine carrier, and also on the bottom of the cold box. Ordinary plastic bottles of chilled water can also be used.
• Put the vaccines and diluents in the middle of the cold box or carrier.
• In vaccine carriers, place a foam pad on top of the conditioned ice-packs. In cold boxes, place conditioned ice-packs on top of the vaccines.
• Close the lid of the cold box or vaccine carrier tightly. It is then ready to be taken to the immunization session.